^ANDERSON  A  DAHL, 4 

|  MEDICAL  BOOKSELLERS,  $ 
, i  N  W  CORNER  ^ 

OONGRCSS  A  HONORS  STS  t 

ill _ 


8 


THE  UNIVERSITY 
OF  ILLINOIS 


LIBRARY 

<ol5 

P85K3 


Return  this  book  on  or  before  the 
Latest  Date  stamped  below.  A 
charge  is  made  on  all  overdue 
books.  TT  .  T  _ 

U.  of  I.  Library 


I 


I 


Digitized  by  the  Internet  Archive 
in  2018  with  funding  from 

University  of  Illinois  Urbana-Champaign  Alternates 


https://archive.org/details/handbookofmateri00pott_0 


HANDBOOK 


OF 

MATERIA  MEDICA,  PHARMACY,  AND 

THERAPEUTICS. 


POTTER. 


NOTICES  OF  THE  PRESS 

OF  PREVIOUS  EDITIONS  OF 

DR.  POTTER’S  HANDBOOK. 


From  the  New  York  Medical  Journal. 

“  Dr.  Potter’s  Handbook  will  find  a  place,  and  a  very  important  one,  in  our  colleges 
and  tbe  libraries  of  our  practitioners.  It  contains  almost  everything  that  can  be  found  in 
the  larger  works  in  a  more  concise  form  and  brought  up  to  a  rather  more  recent  date.  .  .  . 
The  section  on  pharmacy  and  prescription  writing  is  very  carefully  prepared,  all  the  phar¬ 
maceutical  processes  are  described,  and  the  composition  of  the  official  preparations  is 
given.  Under  the  head  of  prescription  writing  considerable  attention  is  paid  to  the  subject 
of  incompatibilities,  and  the  student  will  here  find  many  valuable  hints  for  his  guidance  in 
this  difficult  subject.  Besides  this  there  are,  under  the  head  of  special  therapeutics,  very 
many  formulas  for  the  treatment  of  particular  diseases  and  abnormal  conditions,  arranged 
alphabetically  for  easy  reference.  This  will  be  especially  valuable  to  young  practitioners, 
and  will  frequently  save  the  trouble  of  looking  through  large  works  and  monographs  for 
suitable  formulae  in  the  treatment  of  special  cases.  This  department  is  fuller  in  this  book 
than  in  any  with  which  we  are  acquainted.” 

From  the  Therapeutic  Gazette. 

“  The  author  has  aimed  to  embrace  in  a  single  volume  the  essentials  of  practical 
materia  medica  and  therapeutics,  and  has  produced  a  book  small  enough  for  easy  carriage 
and  easy  reference,  large  enough  to  contain  a  carefully-digested,  but  full,  clear  and  well- 
arranged  mass  of  information.  He  has  not  adhered  to  any  pharmacopoeia,  as  is  the  case 
of  certain  recent  manuals,  thereby  limiting  his  work,  and  in  this  day  of  new  remedies 
causing  constant  disappointment,  but  has  brought  it  up  to  date  in  the  most  satisfactory 
way.  No  new  remedy  of  any  acknowledged  value  is  omitted  from  this  list.  Under  each 
the  section  on  physiological  action  and  therapeutics  has  been  written  with  care.  ...  In 
the  enumeration  of  drugs  suited  to  different  disorders  a  very  successful  effort  at  discrimi¬ 
nation  has  been  made,  both  in  the  stage  of  disease  and  in  the  cases  peculiarly  suited  to 
the  remedy.  It  is  no  mere  list  of  diseases  followed  by  a  catalogue  of  drugs,  but  is  a  digest 
of  modern  therapeutics,  and  as  such  will  prove  of  immense  use  to  its  possessor.” 

From  the  Pacific  Medical  and  Surgical  Journal. 

“  In  looking  over  the  work,  we  are  not  surprised  that  it  has  taken  the  author  the  best 
part  of  two  years  in  its  preparation,  for  it  shows  on  every  page  great  labor  and  careful 
research  ;  and  as  no  good  work  goes  unrewarded,  we  feel  that  he  will  be  compensated  by 
the  favor  with  which  his  book  will  be  received  by  the  profession.  We  have  been  indeed 
pleased  with  the  examination  made,  and  have  already  used  it  for  reference.  As  the  title 
informs  us,  it  is  not  materia  medica  alone — in  fact,  this  is  the  least  important  part  of  the 
book — but  it  contains  the  essentials  of  therapeutics,  pharmacy  and  the  physiological  action 
of  drugs,  besides  many  points  of  information  which  are  useful  to  the  student  and  a  con¬ 
venience  to  find  in  one  and  the  same  book.” 

From  the  American  Practitioner  and  Nows. 

“  Dr.  Potter’s  work  contains  what  is  worthy  to  be  preserved  of  the  materia  medica 
and  therapeutics  of  times  old  and  new,  and  sets  it  to  the  physician’s  hand  in  admirable 
shape.” 

Fro?n  the  Buffalo  Medical  and  Surgical  Journal. 

“  This  work,  as  seen  by  its  title,  embraces  much  that  is  new  to  the  profession,  includ¬ 
ing,  as  it  does,  well-written  and  concise  articles  on  extemporaneous  pharmacy,  as  well  as 
official.  The  part  on  physiological  action  of  medicines  is  well  written  and  comprehensive. 
The  portion  of  the  book  relating  to  special  therapeutics  of  disease  is  especially  valuable,  as 
it  is  so  concise  and  to  the  point.  Taking  it  all  in  all,  this  is  a  book  well  worth  having.” 

*£*  The  price  of  this  book  is  $4.00  in  cloth  binding,  or  $5.00  in  full  leather.  It  may 
be  had  through  any  bookseller,  or  upon  receipt  of  price  will  be  sent,  postpaid,  to  any 
address  by  the  publishers. 


HANDBOOK 


OF 


Materia  Medica,  Pharmacy,  and 


ERAPEUTICS, 


INCLUDING  THE 


PHYSIOLOGICAL  ACTION  OF  DRUGS,  THE  SPECIAL  THERA¬ 
PEUTICS  OF  DISEASE,  OFFICIAL  AND  PRACTICAL 
PHARMACY,  AND  MINUTE  DIRECTIONS  FOR 
PRESCRIPTION  WRITING. 


PROFESSOR  OF  THE  THEORY  AND  PRACTICE  OF  MEDICINE  IN  THE  COOPER  MEDICAL  COLLEGE  OF  SAN 

francisco:  author  of  “  quiz-compends”  of  anatomy  and  materia  medica,  “an 

INDEX  OF  COMPARATIVE  THERAPEUTICS,”  AND  “A  STUDY  OF  SPEECH  AND 
ITS  DEFECTS.”  LATE  A.  A.  SURGEON,  U.  S.  ARMY,  AND 
BRIGADE-SURGEON,  N.  G.  OF  CALIFORNIA. 


THIRD  EDITION.  REVISED. 


PHILADELPHIA: 


P.  BLAKISTON,  SON  &  CO 


1012  Walnut  Street. 


1891 . 


Copyright,  1891, 

By  P.  BLAKISTON,  SON  &  CO. 


Press  of  Wm.  F.  Fell  &  Co., 

1220-24  SANSOM  ST., 

PHILADELPHIA. 


TO  MY  WIFE 

WHOSE  UNFAILING  AND 
DEVOTED  CARE 

AND  PATIENT  ENCOURAGEMENT, 
DURING  THE  PAST  THIRTEEN  YEARS, 
HAS  SUPPORTED  THE  AUTHOR 
IN  EVERY  EXIGENCY 
OF  HIS 

PROFESSIONAL  LIFE. 


684739 


■ 


PREFACE  TO  THE  FIRST  EDITION. 


The  book,  which  this  preface  completes,  has  occupied  the  writer’s 
leisure  hours  during  the  past  two  years,  and  in  a  measure  has  grown  out 
of  some  less  pretentious  volumes  previously  written  by  him.  The  con¬ 
tinued  favor  shown  by  teachers  and  students,  both  in  this  country  and 
in  England,  to  his  three  manuals  in  the  “  Quiz-Compend  ”  series  for 
students,  and  particularly  to  the  volume  on  Materia  Medicaand  Therapeu¬ 
tics,  has  encouraged  their  author  to  hope  that  a  handbook  from  him  on 
the  same  subject,  but  embracing  a  wider  scope,  might  meet  with  a  corres¬ 
ponding  degree  of  appreciation.  The  fact  that  quite  a  number  of  new 
manuals  on  Materia  Medica  have  lately  appeared,  has  not  deterred  him 
from  entering  the  field,  nor  diminished  his  confidence  in  the  approbation 
of  his  readers ;  but  has  rather  seemed  a  proof  that  most  of  the  older  text¬ 
books  on  this  branch  of  medical  knowledge  are  no  longer  satisfactory, 
even  with  the  regular  revisions  which  they  undergo  at  stated  periods. 
Hence  he  expects  for  this  handbook  a  position,  among  the  recent  manuals 
of  its  class,  as  high  as  its  merits  and  demerits  may  entitle  it  to  receive  in 
the  estimation  of  those  for  whose  use  it  has  been  prepared. 

The  author’s  intention  has  been  to  produce  a  book  which  would 
embrace  in  a  single  volume  the  Essentials  of  practical  Materia  Medica 
and  Therapeutics,  treating  of  each  subject  in  as  concise  phraseology  as 
possible  consistent  with  the  delineation  of  every  important  feature.  He 
has  also  endeavored  to  formulate  such  minute  and  definite  directions  for 
the  framing  of  Prescriptions  as  might  elucidate  what  to  many  is  a  very 
difficult  problem.  Furthermore,  he  has  tried  to  present  as  much  infor¬ 
mation  upon  the  subject  of  Pharmacy  as  every  physician  should  possess, 
in  order  to  handle  the  implements  of  his  profession  with  confidence,  and 
to  direct  their  use  by  others  with  pharmaceutical  accuracy. 

The  complete  fulfilment  of  these  aims  would  be  realized  if  the  book 
should  take  rank  as  a  working  companion  to  the  advanced  student  and 
the  junior  practitioner  ;  and  be  deemed  by  them  a  reliable  guide  through 
the  forest  of  observations  and  experiments  on  drug  actions  and  uses,  which 
makes  progress  slow  for  the  already  over-burdened  mind,  when  ploughing 
through  the  more  exhaustive  and  exhausting  text-books. 

Although  this  book  is  essentially  a  compilation,  as  all  books  of  its  class 
must  be,  there  will  be  found  in  its  pages  much  original  matter  derived 

vii 


Vlll 


PREFACE. 


from  the  writer’s  own  experience  in  professional  life.  The  arrangement 
of  the  matter  will  be  found  to  be  in  some  respects  unique.  After  full 
consideration  of  the  many  arrangements  of  the  Materia  Medica  in  vogue, 
a  modified  alphabetical  plan  was  adopted,  by  which  the  advantages  of  the 
alphabetical  order  might  be  retained,  while  permitting  the  grouping 
together  of  agents  which  are  closely  related,  physiologically  and  thera¬ 
peutically,  under  the  title  of  the  principal  member  of  the  class — the 
chief,  as  it  were,  of  that  particular  clan.  Thus,  under  the  title  Amyl 
Nitris  (Nitrite  of  Amyl),  will  be  found  mention  also  of  the  Nitrites  of 
Ethyl,  Sodium  and  Potassium,  and  their  congener  Nitro-Glycerin,  all  of 
which  are  closely  allied  to  the  first-named  and  to  each  other,  in  respect 
of  their  actions  and  uses.  A  very  elaborate  section  on  Drug  Classifica¬ 
tion  is  placed  before  the  Materia  Medica,  in  order  to  supplement  such 
deficiencies  in  grouping  as  are  inevitable  in  an  alphabetical  arrangement. 

In  detailing  the  characteristics  of  an  important  drug,  its  physical  pro¬ 
perties  and  chemical  constituents  are  first  briefly  enumerated,  then  its 
preparations  are  described  in  the  official  language  of  the  pharmacopoeia, 
usually  somewhat  abbreviated  ;  any  important  unofficial  preparations  being 
also  noted,  and  all  the  compounds  into  which  it  enters  enumerated. 
Next  the  physiological  action  is  taken  up,  its  characteristic  features  being 
first  described  ;  then  the  actions  resulting  from  an  ordinary  medicinal 
dose,  next  those  produced  by  small  doses  continued,  and  finally  those 
from  a  toxic  dose.  These  are  followed  by  a  brief  account  of  its  antago¬ 
nists,  antidotes  and  incompatibles,  if  any  ;  and  a  concise  summary  of  its 
therapeutical  applications  closes  the  article  ; — the  whole  presenting,  it  is 
hoped,  a  clearly  defined  word-picture  of  the  drug  under  consideration. 
Every  article  and  preparation  comprised  in  the  last  edition  of  the  U.  S. 
Pharmacopoeia  is  fully  noticed,  while  all  the  prominent  unofficial  agents 
receive  such  mention  as  their  respective  importance  seems  to  demand. 

The  second  part  of  the  book  is  devoted  to  Pharmacy,  and  has  been 
written  from  the  standpoint  of  a  conviction  that  many  young  practitioners 
would  gladly  dispense  their  own  medicines,  if  provided  with  a  few  practi¬ 
cal  directions  on  the  subject ;  thereby  saving  many  a  dollar  from  the  drug 
store,  preventing  in  their  own  practices  at  least  the  “renewals”  which 
constitute  so  bad  a  feature  of  modern  pharmaceutics,  and  gaining  for 
themselves  a  practical  acquaintance  with  their  professional  weapons  which 
cannot  but  make  them  better  physicians  and  more  accurate  prescribers. 
In  this  section  of  the  book  Prescription  Writing  receives  full  consideration, 
and  many  standard  formulae  are  given  as  samples  of  prescriptions  of  each 
kind  in  extemporaneous  use. 

In  the  third  part  the  subject  of  Special  Therapeutics  is  treated  of  elabo¬ 
rately,  and  in  the  form  of  an  alphabetically  arranged  Index  to  the  treat¬ 
ment  of  diseases,  as  laid  down  by  the  most  recent  authorities.  Every 


PREFACE. 


IX 


indication  for  the  use  of  a  drug  is  referred  to  its  author  by  his  initial,  and 
to  the  most  prominent  articles  are  appended  a  few  selected  formulae,  to 
serve  as  guides  to  the  neophyte  in  prescribing. 

The  Appendix  contains  numerous  tables,  comprising  diagnostic  hints, 
Latin  terms  and  phrases,  formulae  for  hypodermic  use,  metric  equivalents, 
specific  gravities  and  volumes,  and  obstetric  memoranda  ;  as  also  Notes 
on  temperature  in  disease,  the  use  of  the  clinical  thermometer,  the  treat¬ 
ment  of  poisoning,  and  the  examination  of  urine  ;  also  formulae  repre¬ 
senting  the  most  noted  patent  medicines. 

The  Index  has  received  special  attention,  from  a  conviction  that,  if 
well  made,  it  is  the  best  part  of  a  good  book.  Every  title,  synonym 
and  other  reference  of  importance  is  included  therein,  double  and 
treble  entries  being  made  in  every  instance  which  seemed  to  require  such 
repetition. 

Nearly  all  the  regular  text-books  have  been  laid  under  contribution  in 
the  preparation  of  the  book,  but  especial  use  has  been  made  of  the  works 
of  Bartholow,  Ringer,  Wood,  Phillips,  Piffard,  Waring  and  Brunton,  in 
their  latest  editions;  as  well  as  of  the  writer’s  verbatim  notes  of  two 
courses  of  didactic  and  clinical  lectures  delivered  by  Professors  Bartholow 
and  Da  Costa  in  the  Jefferson  Medical  College  and  Hospital  and  in  the 
auditorium  of  the  Pennsylvania  Hospital.  On  pages  479  and  480  will  be 
found  a  full  list  of  the  authorities  referred  to  by  initials  in  the  section  on 
Special  Therapeutics. 

The  term  “officinal,”  as  applied  to  drugs  recognized  by  the  pharma¬ 
copoeia  has  been  discarded,  the  word  “  official  ”  being  used  instead  ;  for 
the  simple  reason  that  the  idea  to  be  conveyed  is  expressed  more  correctly 
by  the  latter  term  than  by  the  former  one.  When  none  but  official  drugs 
and  preparations  were  kept  in  the  officina  or  drug  store,  it  was  eminently 
proper  to  call  them  “officinal,”  but  inasmuch  as  this  class  does  not 
nowadays  constitute  much  over  one-fourth  part  of  the  officinal  stock,  it 
is  a  wilful  debasement  of  our  professional  weapons,  as  well  as  an  inexcu¬ 
sable  misnomer,  to  apply  the  shop-title  to  them  any  longer. 

Cooper  Medical  College,  San  Francisco, 

December,  1886. 


For  this,  the  third  edition,  the  text  has  been  thoroughly  revised,  many 
articles  have  been  entirely  re-written,  much  new  matter  has  been  incor¬ 
porated  throughout,  including  such  of  the  new  remedies  as  seem  to  have 
established  themselves  in  professional  regard.  Several  changes  have  been 
made  in  the  arrangement  of  the  material,  to  facilitate  the  use  of  the  book 
for  daily  reference.  Greek  words  are  expressed  phonetically  and  in  the 


X 


PREFACE. 


familiar  English  alphabet,  for  the  benefit  of  those  who  are  not  familiar 
with  the  Greek  letters.  In  every  division  of  the  book  the  author  has 
endeavored  to  improve  without  destroying  the  characteristic  features 
which  have  proven  so  acceptable  to  students  and  practitioners  of  medi¬ 
cine. 

SAM’L  O.  L.  POTTER. 

London,  September,  1891. 


TABLE  OF  CONTENTS 


PAGE 

INTRODUCTION, .  17 

Materia  Medica, .  17 

Pharmacy, . 17 

Empirical  Therapeutics, .  18 

Rational  Therapeutics, .  18 

Administration  of  Medicines, .  20 

Classification  of  Medicines, .  23 

Stimulants  and  Sedatives, .  23 

Agents  acting  chiefly  on  the  Nervous  System, .  24 

Agents  acting  on  the  Organs  of  Special  Sense, .  28 

Agents  acting  on  Respiration, .  30 

Agents  acting  on  the  Circulation, .  33 

Agents  acting  on  the  Digestive  System, .  34 

Agents  acting  on  Metabolism, .  41 

Agents  acting  on  Excretion, . 43 

Agents  acting  on  the  Generative  System, . 47 

Agents  acting  on  the  Cutaneous  Surface, . 49 

Agents  acting  on  Microbes,  Ferments,  etc., .  51 

Agents  acting  upon  each  other, .  52 

Dosage  of  Medicines, .  54 

PART  I.— MATERIA  MEDICA  AND  THERAPEUTICS, .  55 

Abrus  to  Zingiber, . 55-406 

PART  II.— PHARMACY  AND  PRESCRIPTION  WRITING,  ....  407 

Constituents  of  Vegetable  Drugs, . 408 

Official  Operations, . 410 

Official  Preparations, . 419 

Extemporaneous  Pharmacy, . 434 

Weights  and  Measures, . 435 

Metric  System, . 436 

Approximate  or  Domestic  Measures, . 438 

Specific  Gravity  and  Specific  Volume, . 439 

Prescriptions, . 439 

Analysis  of  a  Prescription, . 439 

Principles  of  Combination, . 441 

Prescription  Writing, . 442 

Abbreviations, . 443 

Prescription  Blanks, . 443 

Renewals, . 444 

Filling  a  Prescription, . 445 

Stock  Solutions, . 447 

Rules  for  the  Pharmaceutical  Student, . 447 


xi 


Xll  TABLE  OF  CONTENTS. 

PAGE 

Incompatibility, . 448 

Chemical  Incompatibility,  . . 448 

Pharmaceutical  Incompatibility, . 450 

Therapeutical  Incompatibility, . 451 

Rules  for  Avoidance  of  Dangers, . 452 

Extemporaneous  Preparations  and  Formulae, . 453 

Excipients  for  Mixtures, . 433 

Excipients  for  Emulsions,  . 438 

Excipients  for  Pills, . 463 

PART  III.— SPECIAL  THERAPEUTICS, . 479 

References  and  Bibliography, . 479 

Abdominal  Plethora  to  Yellow  Fever, . 480-690 

APPENDIX, . 691 

Latin  Terms,  Phrases,  etc.,  used  in  Prescriptions, . 691 

Verbs,  Participles,  Prepositions,  etc., . 699,  700 

Genitive  Case-endings, . 700 

Hypodermic  Formulae, . 701 

Chlorodyne,  Comparisons  of  Ten  Formulae  therefor, . 703 

Patent  Medicines, . 704 

The  Treatment  of  Poisoning, . 707 

Tables  of  Differential  Diagnosis, . 712 

Notes  on  Temperature  in  Disease, . 717 

Clinical  Thermometry, . 717 

Obstetrical  Memoranda, . 719 

Signs  of  Pregnancy, . 719 

Signs  of  Labor, . 719 

Average  Pelvic  Diameters, . 720 

Development  of  the  Foetus,  . 720 

Diameters  of  the  Foetal  Skull  at  Term, . 720 

Asphyxia  and  Apncea, . 721 

Clinical  Examination  of  the  Urine, . 722 

Ethics,  the  Hippocratic  Oath,  etc., . 724 

Table  of  Specific  Gravities  and  Specific  Volumes, . 725 

Table  of  Drops  in,  and  Weights  of,  a  Fluid-drachm  of  Various 

Liquids, . 726 

Table  of  Weights  and  Measures, . 726 

Table  for  Converting  Apothecaries’  Weights  and  Measures  into 
Grams, . 727 

INDEX, . 729 


INTRODUCTION. 


Pharmacology,  ( pharmakon ,  a  drug,  logos ,  a  discourse,) — is  a  gen¬ 
eral  term  which  properly  includes  all  matters  pertaining  to  the  study  of 
medicinal  agents  in  the  widest  possible  sense,  embracing  all  of  Materia 
Medica  and  Pharmacy,  with  so  much  of  Therapeutics  as  relates  to  drugs. 
The  term  is  however  frequently  employed  in  a  more  restricted  sense, 
including  only  the  physiological  action  of  drugs;  a  subject  to  which  the 
title  Pharmacodynamics  is  much  more  appropriately  applied. 

Materia  Medica  is  that  branch  of  medical  science  which  treats  of 
the  substances  used  as  medicines,  their  origin,  composition,  physical 
characteristics,  chemical  properties,  modes  of  preparation  and  adminis¬ 
tration,  physiological  and  toxicological  actions. 

Pharmacodynamics,  ( pharmakon ,  a  drug,  dunamis,  power,) — is  the  proper  title  for 
that  portion  of  the  Materia  Medica  which  relates  to  the  physiological  action  of  drugs, 
that  is,  the  influence  of  drugs  upon  the  healthy  human  body  to  modify  its  physiological 
activity. 

Toxicology  is  another  subdivision,  and  includes  the  effects  of  drugs  when  adminis¬ 
tered  in  poisonous  doses,  together  with  the  study  of  the  drug- antagonists  for  the  most 
dangerous  symptoms  produced,  and  the  appropriate  chemical  antidotes. 

Pharmacy  is  the  art  of  preparing  medicines  for  use  and  dispensing 
them  on  the  order  of  the  therapeutist.  It  includes  a  knowledge  of  the 
Materia  Medica,  an  acquaintance  with  the  theories  and  manipulations  of 
chemistry,  and  an  intimate  practical  knowledge  of  many  special  opera¬ 
tions  peculiar  to  itself. 

Therapeutics,  ( therapeuein ,  to  attend  upon,) — includes  all  that  re¬ 
lates  to  the  science  and  art  of  healing ;  and  embraces  the  application, 
not  only  of  medicines  to  the  alleviation  or  cure  of  disease,  but  of  all 
other  agents  which  may  aid  in  the  accomplishment  of  the  same  result. 

The  operations  of  Nature  herself,  as  well  as  of  the  substances  described  in  the  Materia 
Medica,  and  those  of  all  other  remedial  measures,  as  food,  climate,  clothing,  heat,  cold, 
electricity,  etc.,  are  all  embraced  in  the  general  term  Therapeutics,  which  may  be  divided 
into  two  grand  divisions,  viz.  : — 

Natural  Therapeutics,  including  the  operations  of  the  Vis  Medicatrix  Naturae, — 
the  modes  and  processes  of  healing  which  occur  independently  of  Art,  for  the  spon¬ 
taneous  decline  and  cure  of  disease.  There  is  no  more  completely  established  dogma  in 
science,  than  that — The  Living  Organism  is  in  itself  adequate  to  the  cure  of  all  its  curable 
disorders.  This  Natural  Law  enables  the  homoeopath  to  relate  his  sugar  cures,  aids  the 
medical  skeptic  to  hold' to  his  infidelity,  and  helps  all  physicians  out  of  more  close  places 
than  most  of  them  are  willing  to  acknowledge  before  their  clientele.  This  part  of  the 
subject  is  not  taught  in  the  schools  except  in  connection  with  pathologv,  and  by  the  chair 
of  Theory  and  Practice  of  Medicine.  It  is  deserving  of  a  special  chair  and  of  more 
systematic  treatment  than  it  receives. 


T  7 


1 8 


INTRODUCTION. 


Applied  Therapeutics  embraces  the  application  by  Art  of  agents  foreign  to  the 
living  organism,  for  the  purpose  of  aiding  Nature  to  restore  the  body  to  a  healthy  condi¬ 
tion.  This  division  is  the  portion  of  the  subject  which  is  taught  separately  and  systemati¬ 
cally  in  the  schools,  and  therefore  is  alone  considered  in  the  following  pages. 

Other  divisions  of  the  general  subject  of  Therapeutics  employed  in 
professional  literature  and  conversation  are  those  entitled  “  Empirical” 
and  “  Rational  Therapeutics.” 

Empirical  Therapeutics  is  a  term  applied  to  the  use  of  medicinal  or 
other  therapeutical  agents  for  the  sole  reason  that  they  have  been  tried 
previously  with  successful  results  in  cases  apparently  identical  with  the  one 
under  treatment.  By  those  who  advocate  this  method  it  is  styled  the 
Therapeutics  of  Experience,  and  claimed  to  be  an  accumulation  of  means 
of  combating  disease  simply  by  observation  and  experiment,  independ¬ 
ently  of  physio-pathological  reasoning  (Hartshorne).  It  was  necessarily 
the  original  method  in  Therapeutics,  has  conferred  many  rich  gifts  upon 
medical  science,  and  has  been  advocated  by  many  great  physicians,  its 
latest  and  ablest  expounder  being  the  eminent  and  lamented  Niemeyer. 

The  use  of  Opium  to  relieve  pain, — that  of  Cinchona  for  malarial  fevers, — of  Colchi- 
cum  in  gout, — of  Potassium  Iodide  in  syphilis, — of  the  Bromides  in  epilepsy, — of  Cod- 
liver  Oil  in  phthisis, — are  examples  of  the  empirical  use  of  remedies.  But,  after  all  has 
been  said  for  it  that  can  be  said,  the  fact  remains  that  it  is  essentially  an  unscientific 
method,  a  mere  elaboration  of  the  prevailing  popular  habit  of  recommending  Mrs.  A.  to 
use  pepper  tea,  because  it  cured  Mrs.  B.  of  “  the  very  same  trouble.”  Permitted  to  reign 
supreme  it  would  be  destructive  to  all  exactness  in  therapeutical  progress.  The  so-called 
“experience”  of  one  observer  is  too  often  overbalanced  by  the  experience  of  another 
equally  competent  and  trustworthy ;  and  as  few  are  encouraged  to  record  their  failures 
with  remedies,  there  can  be  no  scientific  comparison  of  the  failures  with  the  reported  suc¬ 
cesses.  For  this  reason  empirical  methods  would  tend  to  a  minimum  degree  of  accuracy 
in  a  science  which,  in  the  very  nature  of  things,  can  never  be  an  exact  one; — though 
undoubtedly  such  methods  will  always  prevail  to  some  extent. 

Rational  Therapeutics  embraces  the  use  of  remedies  for  reasons 
based  on  a  knowledge  (i)  of  the  pathological  conditions  present  in  the 
subject,  and  (2)  of  the  physiological  action  of  the  agent  employed. 
This  method  is  the  very  antithesis  of  empiricism,  and  has  been  the  lead¬ 
ing  idea  in  every  revolt  against  empirical  therapeutics  in  the  past.  Humor- 
alism,  Chemicism,  Solidism,  Stimulism,  Galenism  in  the  2d  century, 
Paracelcism  in  the  1 6th,  and  Hahnemannism  in  the  19th,  all  originated 
in  efforts  to  find  a  more  rational  system  of  administering  medicines  than 
the  prevailing  empiricism  of  the  day. 

The  illustrious  Albrecht  von  Haller,  the  father  of  Physiology  and  the 
author  of  the  doctrine  of  Irritability,  was  the  real  originator  of  modern 
physiological  therapeutics.  In  the  preface  to  his  Swiss  Pharmacopoeia 
{circa  A.D.  1755),  occur  the  following  remarkable  directions, — the  first 
recorded  of  their  kind  : — 

“Nempe  primum  in  corpore  sano  medela  tentanda  est,  sine  peregrina  ulla  miscela : 
odoreque  et  sapore  ejus  exploratis,  exigua  illius  dosis  ingerenda  et  ad  omnes  quae  inde 
contingunt  afifectiones,  quis  pulsus,  quis  calor,  quae  respiratio,  quaenam  excretiones,  attend- 
endum.  Inde  adductum  phenominorum  in  sano  obviorum,  transeas  ad  experimenta  in 
corpore  aegroto.” 


INTRODUCTION. 


19 


“  In  the  first  place  the  remedy  is  to  be  tried  on  the  healthy  body ,  without  any  foreign 
substance  mixed  with  it ;  having  been  examined  as  to  its  odor  and  taste ,  a  small  dose  is 
to  be  taken ,  and  the  attention  directed  to  all  effecis  which  thereupon  occur  ;  such  as  upon 
the  pulse,  the  temperature ,  the  respiration ,  the  excretions.  Having  thereby  adduced  their 
obvious  phenomena  in  health,  you  may  pass  on  to  experiment  upon  the  sick  body 

Forty  or  more  years  after  these  rules  were  laid  down  ex  cathedra  by 
Haller,  the  central  idea  contained  in  them  was  incorporated  as  one  of 
the  main  pillars,  into  a  medical  edifice  then  being  erected  in  Germany. 
In  the  course  of  construction  this  pillar  became  so  hidden  beneath  a  super¬ 
structure  of  palpable  absurdities,  that  the  medical  profession,  in  its  anxiety 
to  steer  clear  of  the  whole  mass,  almost  forgot  the  corner-stone  of  truth, 
appropriated  from  the  teachings  of  one  of  its  own  greatest,  teachers. 
While,  however,  the  masses  of  the  profession,  blinded  by  prejudice,  turned 
away  from  everything  which  savored  of  drug-experiment,  a  few  in  every 
country  were  quietly  working  on  the  lines  of  Haller’s  dogma  that  Drug¬ 
proving  is  the  only  true  basis  of  Drug-using.  As  a  result  of  their  labor, 
the  present  generation  sees  the  development  of  an  idea,  announced 
130  years  ago,  but  now  inspiring  the  minds  of  teachers  and  students  all 
over  the  civilized  world.  Medical  Colleges  are  recognizing  physiological 
drug-experimentation  as  a  part  of  their  regular  curricula  ; — laboratories 
are  fitted  up  in  many  of  the  schools  with  costly  instruments  of  precision, 
for  the  more  exact  prosecution  of  this  study ;  and  under  the  direction  of 
such  men  as  Wood,  Ringer,  Murrell,  Brunton,  Hildebrandt,  Lieber- 
meister,  Husemann,  Schmiedeberg,  etc.,  systematic  researches  are  being 
conducted  upon  animals  to  ascertain  the  physiological  action  of  every 
agent  hitherto  used  in  medicine.  The  alkaloids,  and  other  component 
principles  of  vegetable  drugs,  are  being  subjected  to  the  same  rigid  obser¬ 
vation, — as  also  every  new  compound  which  chemistry  gives  to  medicine. 
Journals,  in  every  civilized  country,  teem  with  the  results  of  these  labors  ; 
and  no  medical  student  is  permitted  to  pass  the  graduating  ordeal  until  he 
has  mastered  the  essential  characteristics  of  the  physiological  action  of 
the  important  medicaments  so  far  as  established.  What  has  hitherto 
been  the  conviction  of  but  a  few,  is  daily  growing  into  a  fixed  canon  of 
professional  belief, — that  physiological  experimentation  with  drugs  must 
be  the  basis  of  their  therapeutical  employment,  and  that  all  real  advance 
towards  the  establishment  of  Therapeutics  as  a  science,  must  be  made 
upon  the  lines  laid  down  by  Haller,  i.  e.,  drug-proving  upon  the  healthy 
human  organism.  Still,  in  the  words  of  Brown-Sequard,  “  Therapeutics 
will  cease  to  be  empirical,  only  when  this  last  kind  of  knowledge  shall 
be  fully  obtained;  ” — but  its  fulness  will  never  be  fully  realized,  unless 
the  results  have  been  thoroughly  considered  with  full  regard  to  the  differ¬ 
ences  due  to  the  action  of  drugs  in  different  doses  on  the  human  organism 
in  health  and  disease.  [  Compare  pages  yj,  54,  infra. ] 


ADMINISTRATION  OF  MEDICINES. 


Medicines  may  be  introduced  into  the  circulation  by  various  routes,  as 
the  gastro-intestinal  tract,  the  rectum,  the  respiratory  tract,  the  veins  and 
arteries,  the  subcutaneous  cellular  tissue,  and  the  integument  itself. 

The  Gastro-intestinal  Route  is  the  one  most  frequently  employed, 
being  the  most  convenient.  The  remedies,  after  being  swallowed,  find 
their  way  into  the  current  of  the  circulation,  through  the  walls  of  the 
gastro-intestinal  bloodvessels  and  the  lacteals.  When  the  stomach  is 
empty  and  its  mucous  membrane  healthy,  crystalloidal  substances  in 
solution  pass  through  the  walls  of  its  vessels  with  great  rapidity.  Col¬ 
loidal  substances  (fats,  albumen,  gum,  gelatin,  etc.)  require  to  be  digested 
and  emulsified  before  they  can  be  absorbed. 

The  Rectum  will  absorb  many  substances  applied  in  the  form  of 
Enemata  or  Suppositories.  Those  most  suited  to  this  route  are  the  salts 
of  the  alkaloids  in  solution,  especially  those  of  Morphine,  Atropine  and 
Strychnine,  the  latter  being  absorbed  more  rapidly  per  rectum  than  by  the 
stomach.  Acid  solutions,  if  not  too  frequently  repeated,  are  also  well 
administered  by  this  channel. 

The  Respiratory  Tract  admits  of  the  rapid  absorption  of  medicinal 
substances  through  its  extensive  blood-supply.  The  inhalation  of  vapors 
or  atomized  fluids,  the  insufflation  of  powders  into  the  nares,  fauces, 
larynx,  etc.,  and  the  use  of  a  medicated  nasal  douche,  are  methods  whereby 
this  channel  may  be  utilized. 

The  Veins  are  only  used  as  a  route  of  medication  in  emergencies, 
where  the  other  channels  are  not  available,  and  where  immediate  action 
is  necessary  to  the  preservation  of  life,  the  operation  being  a  highly 
dangerous  one.  The  injection  intravenously  of  Saline  Solutions  in  the 
collapse  of  cholera,  diabetic  coma,  etc., — Blood  or  Milk  as  a  last  resort  in 
excessive  hemorrhage,  epilepsy,  uraemia,  the  collapse  of  cholera,  etc., — 
and  a  solution  of  Ammonia  for  the  bites  of  venomous  reptiles,  Hydro¬ 
cyanic-acid  poisoning,  Opium  narcosis,  Chloroform  asphyxia,  etc.,  are  the 
instances  admitted  in  practice. 


20 


INTRODUCTION. 


21 


Arterial  Transfusion  has  also  been  performed  successfully  in  a 
number  of  cases,  and  is  considered  safer  than  venous  transfusion  when 
a  large  quantity  of  fluid  has  to  be  introduced  into  the  circulation.  A 
special  apparatus  is  employed  for  these  purposes,  known  as  Aveling’s 
Transfusion  Syringe,  but  the  ordinary  Dieulafoy’s  aspirator  slightly 
modified,  may  be  used  with  safety  and  convenience.  The  danger  of  the 
operation  lies  in  the  liability  of  the  introduction  of  air  into  the  circu¬ 
lation,  an  occurrence  which  causes  instant  death  in  the  human  subject. 

The  Hypodermic  Method  is  the  introduction  of  medicines  into 
the  organism  by  injecting  them  into  the  subcutaneous  areolar  tissue, 
from  which  they  are  quickly  absorbed  by  the  lymphatic  and  capillary 
vessels.  The  great  advantage  of  this  method  is  the  absolute  certainty  as 
to  the  quantity  of  drug  actively  affecting  the  organism,  a  very  essential 
question  when  using  small  quantities,  as  with  powerful  alkaloids.  Another 
is  the  avoidance  of  reactions  between  the  drug  and  the  secretions  of  the 
stomach,  which  may  destroy  the  activity  of  the  former,  or  seriously 
change  its  character.  The  Medicines  must  be  in  solution,  of  neutral 
reaction  and  freshly  prepared,  the  usual  menstruum  being  distilled  water; 
though  spring  water  filtered  will  answer  just  as  well,  and  much  better 
than  distilled  water  which  has  been  standing  several  days,  and  exposed 
from  time  to  time  to  the  air.  The  solution  is  to  be  injected  beneath  the 
skin,  by  a  hypodermic  syringe,  care  being  taken  to  avoid  puncturing  a 
vein.  The  most  suitable  localities  for  the  injection  are  the  external 
aspect  of  the  arms  and  thighs,  the  abdomen,  the  back,  and  the  calves  of 
the  legs.  On  the  external  aspect  of  the  thigh,  just  in  front  of  the  great 
trochanter,  there  is  an  area  of  some  two  inches  square,  over  which  the 
insertion  of  a  fine  hypodermic  needle  is  not  felt,  so  barren  is  the  skin 
in  that  region  of  the  sensitive  nerve  filaments. 


After  nearly  filling  the  syringe  with  the  solution  to  be  used,  the  needle  should  be  screwed 
on  tightly;  and  with  the  instrument  held  in  a  vertical  position,  point  uppermost,  the 
excess  of  solution  over  the  amount  required  should  be  ejected,  thus  expelling  air-bubbles 
and  filling  the  needle  itself.  A  portion  of  skin  should  be  grasped  by  the  thumb  and  fore¬ 
finger  at  the  site  selected  for  the  injection,  into  which  the  needle  should  then  be  quickly 
inserted  until  its  point  has  passed  beneath  the  skin,  when  the  piston  may  be  pressed  down 
slowly,  delivering  the  solution  so  gradually  as  to  avoid  rupturing  the  tissue.  If  the  solu¬ 
tions  are  freshly  prepared  with  clean  water,  the  needles  kept  clean  and  sharp,  and  the 
injection  be  made  beneath  the  skin  not  into  it ,  there  will  be  no  risk  of  producing  abscesses 
with  the  agents  ordinarily  employed.  Tablets  for  hypodermic  use  are  prepared  by  the 
prominent  manufacturers,  each  containing  one  dose.  They  may  be  readily  dissolved  in  a 
teaspoon  at  the  bedside,  and  are  very  convenient  for  the  pocket,  if  put  up  in  a  case  with 
a  good  hypodermic  syringe,  as  may  be  obtained  from  Parke,  Davis  and  Co.,  of  Detroit. 
Their  regular  line  of  Hypodermic  Tablets  includes  the  agents  named  in  the  following  list, 
put  up  in  tubes  of  25  each. 


22 


INTRODUCTION. 


List  of  Hypodermic  Tablets. 


Aconitine  (crystals), 
Apomorphine  Muriate, 
Atropine  Sulphate,  . 
Atropine  Sulphate,  . 
Cocaine  Hydrochlorate, 
Conine  Hydrobromate, 
Colchicine, 

Corrosive  Sub.  and  Urea 
Digitalin  (soluble),  . 
Gelsemine  Muriate, 
Hyoscine  Hydrobromate 
Hyoscyamine,  . 
Morphine  Sulphate, 


[For  Formulae  for  Hypodermic  Solutions,  see  Appendix.] 


Parenchymatous  Injection  is  the  delivery  of  a  medicine  deeply 
into  the  tissues,  either  to  affect  a  muscle  itself  or  to  locally  influence  some 
important  nerve-trunk.  The  principal  agents  used  in  this  manner  are 
Strychnine  for  palsied  muscles,  Chloroform  for  sciatic  and  other  neuralgias, 
and  Salts  of  Cocaine  for  local  anaesthesia. 

The  Skin  is  an  active  absorbent  of  crystalloidal  substances  when  its 
epidermis  or  cuticle  is  removed.  By  this  route  there  are  four  methods  of 
introducing  medicaments  into  the  circulation,  viz. — the  Enepidermic, 
Epidermic  and  Endermic  Methods,  and  Inoculation. 

The  Enepidermic  Method  consists  in  placing  the  medicine  in 
simple  contact  with  the  epidermis,  no  friction  being  used  to  hasten  its 
penetration.  Chloroform  and  Oleic  Acid  solutions  of  the  alkaloids  pass 
by  osmosis  in  this  manner  with  comparative  ease,  but  aqueous  solutions 
act  very  slowly  and  alcoholic  ones  with  great  difficulty  if  at  all. 

The  Epidermic  Method  consists  in  the  use  of  friction  to  promote 
the  passage  of  the  medicament  between  the  cells  of  the  epidermis.  Mer¬ 
curial  Ointment,  Cod-liver  Oil,  and  other  fats,  Oleates,  etc.,  are  used  in 
this  way  for  their  local  and  systemic  effects. 

The  Endermic  Method  obviates  the  difficulty  of  absorption  through 
the  cuticle  by  removing  the  latter  through  the  agency  of  a  blister,  and 
then  powdering  the  medicament  over  the  surface  of  the  denuded  derma. 

An  ordinary  Cantharides-plaster,  followed  by  a  poultice  to  raise  the  blister,  may  be 
employed ;  but  a  quicker  method  is  to  place  upon  the  skin  a  piece  of  lint  soaked  in  Stronger 
Water  of  Ammonia,  covering  it  with  a  watch-glass  or  a  piece  of  oiled  silk  to  prevent  evapo¬ 
ration.  The  blister  raises  rapidly  and  should  then  be  removed  with  scissors.  Morphine, 
Atropine,  Quinine  and  Strychnine,  are  the  agents  generally  used  in  this  manner,  but  the 
method  is  painful  and  unpopular. 

Inoculation  is  the  introduction  of  medicinal  agents  through  the 
scraped  or  punctured  skin  by  an  operation  similar  to  that  employed  for 
vaccination. 


CLASSIFICATION  OF  MEDICINES. 


In  the  present  state  of  knowledge  respecting  the  actions  and  uses  of 
medicinal  agents,  no  really  scientific  classification  of  these  substances  is 
possible.  Some  writers  have  adopted  a  system  based  on  the  natural  rela¬ 
tions  of  the  various  articles  to  each  other,  while  many  classify  them 
according  to  their  effects  on  the  human  system,  and  others  make  no 
attempt  at  arrangement  but  treat  of  them  in  alphabetical  order.  The 
latter  method  has  been  followed  in  this  work,  from  a  conviction  that  every 
medicine  should' first  be  studied  as  an  individual,  both  with  respect  to  its 
physiological  actions  and  its  therapeutical  applications.  When  the  student 
has  thus  made  himself  familiar  with  the  characteristic  features  of  each 
article  of  the  Materia  Medica,  he  may  begin,  by  comparing  one  with 
another,  to  seek  acquaintance  with  their  more  delicate  lights  and  shades. 
Some  system  of  classification  then  becomes  imperative  as  an  aid  to  the 
memory,  and  as  the  titles  of  the  groups  to  which  the  various  agents  belong 
in  any  physiological  classification  are  also  used  to  express  their  actions 
and  uses,  the  following  synopsis  is  inserted  as  an  appropriate  introduction 
to  the  section  on  Materia  Medica  and  Therapeutics. 


Stimulants  and  Sedatives. 

These  are  general  terms  employed  in  various  classifications  with  very 
little  discrimination. 

Stimulant  ( Stimulus ,  a  goad), — is  a  term  which  is  used  in  various 
senses  when  applied  to  medicinal  agents.  Alcoholic  preparations,  which 
are  true  narcotics,  are  commonly  termed  “  stimulants,”  and  the  same 
expression  is  employed  to  designate  any  agent  which  excites  the  organic 
action  of  a  part  of  the  economy. 

Diffusible  Stimulants  are  those  which  have  a  prompt  but  transient  effect,  such  as 
Alcohol,  Ammonia,  Camphor,  etc.  Spinal  Stimulants  exalt  the  functions  of  the  cord,  as 
Strychnine,  Picrotoxin,  Ergot,  Atropine,  Phosphorus.  Cardiac  Stimulants  increase  the 
action  of  the  heart,  as  Alcohol,  Atropine  and  Morphine  in  small  doses,  Strychnine,  etc., 
also  Squill,  Convallaria,  Cimicifuga  and  Digitalis,  which  slow  but  strengthen  the  cardiac 
action.  Vaso- motor  Stimulants ,  as  Alcohol,  Chloroform,  Ether,  Ammonia,  Strychnine, 
Digitalis  and  Squill,  acting  on  the  vaso-motor  centre;  and  the  Nitrites,  Belladonna,  Elec¬ 
tricity,  Volatile  Oils,  etc.,  acting  as  local  dilators  of  the  vascular  system.  Cerebral  Stimu¬ 
lants ,  as  Alcohol,  Opium,  Belladonna,  Caffeine,  Cocaine,  Theine,  Cannabis,  Chloroform, 
Ether,  Tobacco,  etc.  Renal  Stimulants ,  as  the  diuretic  group.  Stomachic  Stimulants , 

23 


24 


AGENTS  ACTING  CHIEFLY  ON  THE  NERVOUS  SYSTEM. 


as  the  Aromatics,  Volatile  Oils,  Vegetable  Bitters,  Mineral  Acids,  Nux  Vomica,  Mustard, 
Capsicum,  etc.  Hepatic  Stimulants ,  as  Nitro-muriatic  and  Nitric  Acids,  and  the  chola- 
gogue  purgatives  Podophyllum,  Jalap,  Leptandra,  Euonymin,  Iridin,  etc.  Intestinal 
Stimulants ,  as  Mercurials,  Elaterium,  Colocynth,  Jalap,  Scammony,  Podophyllum,  etc., 
which  affect  the  glandular  apparatus, —  and  Belladonna,  Physostigma,  Nux  Vomica,  Rhu¬ 
barb,  Senna,  Aloes,  Frangula,  Cascara,  etc.,  which  chiefly  affect  the  muscular  fibres  and 
the  intestinal  nerves.  Ctitaneous  Stimulants ,  as  the  diaphoretic  group,  and  the  rubefa¬ 
cients  Mustard,  Capsicum,  Turpentine,  Ammonia,  etc.  All  stimulation  reacts  into 
depression,  and  most  of  the  agents  which  stimulate  the  nerve  centres  at  first  soon  depress 
and  finally  paralyze  them. 


Sedatives  (, Sedo ,  I  allay), — are  agents  which  exert  a  soothing  influ¬ 
ence  on  the  system  by  lessening  functional  activity,  depressing  motility 
and  diminishing  pain. 

General  Sedatives  include  the  narcotics  and  anaesthetics.  Local  Sedatives  include  Aco¬ 
nite,  Opium,  Ice,  etc.  Pulmonary  Sedatives,  as  Hydrocyanic  Acid,  Veratrine,  and  the 
nauseants  and  emetics.  Spinal  Sedatives,  as  Physostigma,  Gelsemium,  Potassium  Bro¬ 
mide.  Stomachic  Sedatives  include  Arsenic,  Bismuth,  Nitrate  of  Silver,  Bicarbonate  of 
Sodium.  Vascular  Sedatives,  as  Digitalis,  Tobacco,  Aconite,  Veratrum,  and  the  emetics. 
Nervous  Sedatives,  among  which  are  Potassium  Bromide,  Tobacco,  Lobelia,  and  the 
group  of  spinal  depressants. 


Agents  Acting  Chiefly  on  the  Nervous  System. 

Motor- Excitants  are  agents  which  increase  the  functional  activity 
of  the  spinal  cord  and  the  motor  apparatus,  producing  disturbances  of 
motility,  heightened  reflex  excitability,  and  tetanic  convulsions  when 
given  in  large  doses,  their  ultimate  effect  being  motor  paralysis  from  over- 
stimulation. 


The  most  important  members  of  this  class  are  Nux  Vomica  and  Ignatia,  with  their 
alkaloids  Strychnine  and  Brucine ,  also  Thebaine ,  the  tetanizing  alkaloid  of  Opium.  It 
also  includes  Morphine  and  Atropine,  which,  though  at  first  sedative,  when  given  in  large 
doses  produce  convulsions.  The  respiratory  centre  in  the  medulla  is  stimulated  by  Strych¬ 
nine,  Atropine,  Ammonia,  and  small  doses  of  Alcohol,  Ether  and  Chloroform.  The 
motor  convolutions  in  the  brain  are  stimulated  by  Alcohol  in  moderate  doses,  as  also  for 
a  brief  period  by  Ether  and  Chloroform. 

The  end-organs  of  the  motor  nerves  are  stimulated  by  the  local  use  of  Electricity,  Strych¬ 
nine  and  friction  ;  and  are  irritated  by  the  internal  administration  of  Aconitine,  Nicotine, 
Camphor,  Pilocarpine  and  Pyridine.  Other  members  of  this  class  are  embraced  in  the 
following  list : — 


Nux  Vomica. 

Ignatia. 

Strychnine. 

Brucine. 

Thebaine. 

Morphine.* 

Atropine.* 


Alcohol. f 

Ether.f 

Chloroform.f 

Ammonia. 

Absinthe. 

Buxine. 

Calabarine. 


Ergot. 

Ustilago. 

Gossypium 

Picrotoxin. 

Aconitine. 

Nicotine. 

Camphor. 


Digitalis. 

Convallaria. 

Cimicifuga. 

Pilocarpine. 

Pyridine. 

Rhus  Toxicoden. 
Electricity. 


Motor- Depressants  lower  the  functional  activity  of  the  spinal  cord 
and  motor  apparatus,  and  in  large  doses  paralyze  them.  Some  act  indi¬ 
rectly  by  reducing  the  spinal  circulation,  as  Digitalis,  Aconite  and  large 


*  In  large  doses. 


f  In  small  doses. 


AGENTS  ACTING  ON  THE  NERVOUS  SYSTEM. 


25 


doses  of  Quinine ;  others  by  a  directly  paralyzant  action  on  the  centres. 
The  principal  members  of  this  class  may  be  enumerated  as  follows,  viz. :  — 


Opium,  Morphine. 

Curare. 

Amyl  Nitrite. 

Gelsemium. 

Conium. 

Sodium  Nitrite. 

Muscarine. 

Chloral. 

Methyl  Strychnine. 

Pulsatilla. 

Ergot  (at  last). 

Ethyl  Strychnine. 

Grindelia. 

Arnica. 

Methyl  Thebaine. 

Phytolacca. 

Ailanthus. 

Methyl  Veratrine. 

Physostigma. 

Veratrum. 

Methyl  Conine. 

Belladonna. 

Alcohol.* 

Other  Methyl  Compounds. 

Stramonium. 

Ether.* 

Ammonium  Cyanide. 

Hyoscyamus. 

Chloroform.* 

Ammonium  Iodide. 

Pilocarpus. 

Bromides. 

Ethyl  Ammonium  Chloride. 

Quebracho. 

Potassium. 

Amyl  Ammonium  Chloride. 

Camphor. 

Lithium. 

Amyl  Ammonium  Iodide. 

Aconite. 

Zinc. 

Amyl  Ammonium  Sulphate. 

Tobacco. 

Prussic  Acid. 

Other  Compound  Ammonias. 

Lobelia. 

Potass.  Cyanide. 

Galvanism. 

The  motor  centres  in  the  medulla  are  powerfully  depressed  by  Opium,  Morphine,  Aco¬ 
nite,  Conium,  Chloral,  Physostigma,  and  large  doses  of  Alcohol,  Ether  and  Chloroform. 
The  three  last  named  are  also  paralyzers  of  the  motor  convolutions  in  the  brain,  arresting 
all  voluntary  movements  when  administered  in  sufficient  quantity.  The  anterior  cornua 
of  the  cord  are  greatly  depressed  by  Physostigma  and  other  agents,  and  the  motor  nerves 
by  Conium,  Methyl-Strychnine,  etc.,  both  actions  resulting  in  paralysis  of  the  limbs.  Cu¬ 
rare ,  even  in  small  doses,  paralyzes  the  end-organs  of  the  motor  nerves,  and  Belladonna, 
the  compound  Ammonias,  Methyl  compounds,  etc.,  exercise  a  similar  but  less  powerful 
influence.  Galvanism  is  also  an  effective  local  depressant  of  motor  activity. 


Local  Stimulants  increase  common  sensibility  to  the  extent  of  pro¬ 
ducing  pain,  chiefly  by  direct  action  upon  the  end-organs  of  the  sensory 
nerves  in  the  skin,  though  some  act  probably  by  stimulating  the  local 
circulation,  as  in  inflammation.  The  principal  members  of  this  group 


are — 

Faradism. 

Heat. 

Cold. 

Alcohol. 

Ether. 


Chloroform. 
Carbolic  Acid. 
Creasote. 
Mineral  Acids. 
Ammonia. 


Volatile  Oils. 

Acrid  Essential  Oils 
Metallic  Salts. 
Veratrine  (at  first). 
Cantharis  (at  first). 


Local  Anaesthetics  and  Anodynes  {an,  without,  aistheysis,  percep¬ 
tion,  odunay ,  pain), — reduce  the  functions  of  the  sensory  nerves  until 
they  lose  the  power  of  receiving  or  conducting  sensations.  Some  act  by 
direct  depression  of  the  end-organs  in  the  skin,  etc.,  others  by  impairing 
the  conductivity  of  the  sensory  nerves,  while  some  act  indirectly  by 
reducing  the  local  circulation.  The  Anodynes  diminish,  and  the  Anaes¬ 
thetics  destroy,  for  a  time,  the  sensibility  of  the  skin  or  mucous  membrane. 
The  chief  agents  of  this  class  are — 


Local  Anodynes. 

Aconite,  Aconitine. 
Belladonna,  Atropine. 
Opium,  Morphine. 


Local  Ancesthetics. 

Extreme  Cold,  Ice. 
Ether  Spray. 
Carbolic  Acid. 


*  In  large  doses. 


j-  In  small  doses. 


26 


AGENTS  ACTING  ON  THE  NERVOUS  SYSTEM. 


Local  Anodynes. 

Carbolic  Acid. 
Chloroform. 

Chloral. 

Veratrum,  Veratrine. 
Volatile  Oils. 
Galvanism. 


Local  Anaesthetics. 

Erythroxylon. 

Cocaine. 

Hydrocyanic  Acid. 
Creasote. 

Oil  of  Turpentine. 
Iodoform. 


Cerebral  Excitants, — are  remedies  which  increase  the  functional 
activity  of  the  cerebrum,  without  producing  any  subsequent  depression,  or 
any  suspension  of  the  cerebral  functions.  They  act  partly  by  increasing 
the  action  of  the  heart  and  consequently  the  rapidity  of  the  circulation, 
partly  by  a  direct  action  upon  the  gray  matter  of  the  brain.  The  chief 
members  of  this  group  are — 


Alcohol  (at  first). 

Ammoniac. 

Asafetida. 

Camphor. 

Cannabis. 

Valerian. 

Ammonia  (inhaled). 


Coffee,  Caffeine. 

Tea,  Theine. 

Guarana,  Guaranine. 
Erythroxylon,  Cocaine. 
Tobacco. 

Strychnine. 

Acetic  Acid  (inhaled). 


Deliriants  excite  the  functions  of  the  higher  brain  to  such  a  degree  as 
to  disorder  the  mental  faculties,  producing  intellectual  confusion,  loss 
of  will-power,  delirium  and  even  convulsions.  They  are  all  narcotics 
(though  all  narcotics  are  not  deliriants),  and  may  be  listed  as  follows, 
viz. — 


Alcohol. 

Belladonna. 

Stramonium. 

Hyoscyamus. 


Cannabis  Indica. 
Chloral. 

Lupulus  (at  first). 
Opium  (at  first). 


Cerebral  Depressants  lower  or  suspend  the  functions  of  the  higher 
cerebrum  after  a  preliminary  stage  of  excitement.  Under  this  head  may 
be  included  the  Narcotics,  General  Anaesthetics,  and  several  of  the  Anti- 
spasmodics,  all  acting  on  the  cells  of  the  convolutions,  at  first  stimu¬ 
lating  the  brain-functions,  they  produce  after  a  time  stupor,  coma  and 
insensibility. 

The  most  useful  of  this  class  are  the  Bromides,  Zinc  and  Caffeine,  as  they  also  diminish 
reflex  excitability  and  thus  secure  rest  of  the  nervous  system.  Some  of  them  are  decidedly 
dangerous,  as  they  may  paralyze  the  heart  or  the  medulla  and  its  centres  of  organic  life 
before  the  consciousness  is  much  disturbed ;  such  being  Chloroform,  Aconite,  Opium,  and 
the  irritant  poisons. 


Narcotics  ( narkay ,  stupor), — are  agents  which,  at  first  excitant  to  the 
higher  brain,  produce  profound  sleep,  characterized  by  stupor,  and  if  the 
dose  be  sufficient,  coma,  insensibility  and  death  by  paralysis  of  the  medul¬ 
lary  centres  governing  respiration  and  other  functions  of  organic  life. 
They  are  closely  related  to  stimulants,  Opium  and  Alcohol  being  good 


AGENTS  ACTING  ON  THE  NERVOUS  SYSTEM. 


2  7 


illustrations,  in  the  different  stages  of  their  action,  of  both  stimulant  and 
narcotic  effects.  They  give  us  the  power  of  lowering  perception,  inducing 
sleep  and  soothing  the  vital  functions  by  rest,  all  of  which  are  means  of 
great  therapeutical  value.  The  chief  narcotics  are — 


Alcohol. 

Opium,  Morphine. 
Belladonna,  Atropine. 
Hyoscyamus. 
Stramonium. 


Cannabis  Indica. 
Humulus. 

Chloroform,  Ether,  etc. 

Chloral-hydrate. 

Croton-chloral. 


Hypnotics  (heupnos, sleep), — are  remedies  which  produce  sleep,  and  in 
this  wide  sense  of  the  term  the  class  would  include  the  Narcotics  and  the 
Anaesthetics,  as  well  as  those  agents  which  may  be  termed  Pure  Hypnot¬ 
ics,  which  induce  sleep  by  bringing  the  brain  into  a  favorable  condition 
therefor,  rather  than  by  direct  soporific  action.  In  this  sense  the  purest 
hypnotics  are  the  Bromides,  but  artificial  sleep  may  be  produced  by 
many  other  agents.  The  principal  members  of  this  class  are  the  follow¬ 
ing  : — 


Opium,  Morphine,  Narceine. 

Chloral-hydrate. 

Croton-chloral. 

Cannabis. 

Cannabin  Tannate. 

Hyoscyamus. 

Paraldehyde. 

Hops. 

Sulphonal. 

Chloralamid. 

Methylal. 

General  Anaesthetics. 


Urethane. 

Sodium  Bromide. 

Calcium  Bromide. 
Lithium  Bromide. 

Zinc  Bromide. 

Potassium  Bromide. 
Monobromated  Camphor. 
Lettuce 
Lactic  Acid. 

Amylene  Hydrate. 
Piscidia  Erythrina. 


Analgesics  (an,  without,  algos ,  pain),  or  Anodynes  (an,  without, 
odunay ,  pain), — are  remedies  which  relieve  pain  either  by  direct  depression 
of  the  centres  of  perception  and  sensation  in  the  cerebrum,  or  by  impair¬ 
ing  the  conductivity  of  the  sensory  nerve  fibres.  Opium  is  the  most 
efficient  of  all  analgesics,  because  it  arrests  the  afferent  impressions  at 
every  step  of  their  track — at  their  formation,  along  the  course  of  their 
conduction,  and  at  the  point  where  they  impinge  on  the  sensorium.  The 
Local  Anodynes  have  been  described,  and  the  list  of  General  Anodynes 
includes  the  following-named  agents,  viz. — 


Opium,  Morphine. 
Belladonna,  Atropine. 
Cannabis  Indica. 
Stramonium. 
Hyoscyamus. 
Gelsemium. 


Aconite. 

Chloroform,  Ether,  etc. 

Comum. 

Chloral-hydrate. 

Croton-chloral. 

Lupulus. 


Anaesthetics  (an,  without,  aisthaysis,  perception), — are  agents  which 
destroy  sensation.  Local  Aticesthetics  have  been  described.  General 
A nceslhetics  are  certain  volatile  substances,  mostly  belonging  to  the  class 


28 


AGENTS  ACTING  ON  ORGANS  OF  SPECIAL  SENSE. 


of  alcohols  and  ethers,  which  when  inhaled  produce  complete  uncon¬ 
sciousness  and  loss  of  sensation  (anaesthesia),  with  lessened  motor  power. 

Narcotics  also  produce  anaesthesia,  but  the  term  is  usually  restricted  to  the  effects  of  the 
volatile  agents  referred  to.  The  principal  members  of  this  group  are — 

Ether  (Oxide  of  Ethyl).  Nitrous  Oxide. 

Chloroform.  Bromide  of  Ethyl. 

Bichloride  of  Methylene.  Bichloride  of  Ethylene. 

Antispasmodics  ( anti ,  against  spasmos,  a  spasm), — are  agents  which 
prevent  or  allay  spasm  of  voluntary  or  involuntary  muscles  in  any  portion 
of  the  organism.  Some  of  the  agents  belonging  to  this  class  act  by 
stimulation  of  the  higher  nervous  centres,  the  coordinating  power,  and 
the  circulation,  as  Alcohol  and  Ether  in  small  doses,  Camphor,  Musk, 
Valerian,  etc.  ;  others  by  a  depressant  influence  on  the  motor  centres,  as 
the  Bromides ;  and  still  others  by  paralysis  of  the  end-organs  of  the  vaso¬ 
motor  nerves,  as  Amyl  Nitrite.  A  few  depress  all  the  vital  functions,  as 
Aconite,  Tobacco,  Lobelia,  Hellebore,  and  Prussic  Acid ;  and  a  long  list 
stimulate  the  bowels  to  expel  gaseous  accumulations,  namely,  Asafetida, 
Cajuput,  Valerian,  Musk,  Aromatic  Oils,  etc.  They  are  used  in  convul¬ 
sive  affections,  especially  asthma  and  other  spasmodic  diseases  of  the 
respiratory  organs,  hysteria,  chorea,  angina  pectoris,  epilepsy,  etc.  The 
principal  antispasmodics  are  as  follows,  viz. — 


Alcohol. 

Aconite. 

Ammoniac. 

Ether. 

Lobelia. 

Castor. 

Chloroform. 

Tobacco. 

Musk. 

Amyl  Nitrite. 

Hellebore. 

Galbanum. 

Nitrites. 

Opium. 

Sumbul. 

Bromides. 

Belladonna. 

Ipecac. 

Potassium  Iodide. 

Stramonium. 

Senega. 

Potassium  Nitrate. 

Hyoscyamus. 

Silver  Salts. 

Arsenic. 

Prussic  Acid. 

Zinc  Salts. 

Valerian. 

Physostigma. 

Copper  Salts. 

Conium. 

Curare. 

Asafetida. 

The  Cerebellum  is  affected  by  a  few  drugs,  their  action  upon  its 
several  lobes  producing  various  disturbances  of  equilibrium. 

Alcohol  is  the  principal  agent  acting  upon  this  portion  of  the  brain,  and  different  pro¬ 
ducts  of  the  still  seem  to  affect  different  portions  of  the  cerebellum.  For  instance,  intoxi¬ 
cation  by  wine  or  beer  is  said  to  cause  lateral  falling,  that  by  whiskey  an  inclination  to  fall 
face  downwards,  cider  a  backward  tendency  (Brunton).  Apomorphine  in  large  doses 
produces  a  tendency  to  move  in  a  circle,  and  therefore  probably  affects  the  cerebellum  or 
the  corpora  quadrigemina. 


Agents  Acting  on  the  Organs  of  Special  Sense. 

Mydriatics  (meudos,  moisture), — are  agents  which  produce  dilatation 
of  the  pupil  of  the  eye  (mydriasis).  Some  act  locally,  others  when  given 
internally,  and  the  principal  ones  (Atropine  and  its  congeners)  act  both 
locally  and  internally,  producing  at  the  same  time  paralysis  of  the  ciliary 


AGENTS  ACTING  ON  ORGANS  OF  SPECIAL  SENSE. 


29 


muscle  resulting  in  temporary  loss  of  accommodation,  the  eye  remaining 
focussed  for  distant  objects,  and  the  intra-ocular  tension  being  increased. 


The  dilating  action  of  Atropine  and  its  congeners  is  due  to  stimulation  of  the  end- 
organs  of  the  sympathetic  nerve,  increasing  the  power  of  the  radiating  muscular  fibres  of 
the  iris,  and  also  to  paralysis  of  the  end-organs  of  the  motor  oculi  (3d  cranial)  nerve, 
lessening  the  power  of  the  circular  fibres  or  sphincter  iridis.  When  administered  inter¬ 
nally  the  drug  is  carried  by  the  circulation  to  the  eye,  acting  thereon  locally  as  if  instilled 
directly  upon  the  conjunctiva.  The  principal  mydriatics  are  those  named  in  the  following 
list,  viz. : 


Belladonna,  Atropine. 
Hyoscyamus,  Hyoscyamine. 
Stramonium,  Daturine. 
Duboisia,  Duboisine. 


Belladonnine  (internally  only). 
Homatropine. 

Gelsemine  (locally  only). 
Anaesthetics  (at  last). 

Cocaine. 


Atropine,  Duboisine  and  Homatropine  are  the  mydriatics  used  by  ophthalmologists. 


Myotics  ( meuo ,  I  close), — are  agents  which  produce  contraction  of 
the  pupil.  The  alkaloid  of  Physostigma,  Eserine ,  is  the  chief  local 
myotic,  and  the  only  one  used  in  ophthalmic  practice.  It  acts  by  stimu¬ 
lating  the  circular  muscular  fibres  of  the  iris,  at  the  same  time  contracting 
the  ciliary  muscle  so  that  the  eye  is  accommodated  for  near  objects  only, 
and  diminishing  intra-ocular  tension ;  in  all  of  which  it  exactly  antago¬ 
nizes  the  action  of  Atropine. 


A/uscarine,  Pilocarpine  and  Nicotine  are  also  local  myotics,  acting  upon  the  end- 
organs  of  the  oculo-motor  nerve.  Anaesthetics  in  the  early  stage  of  their  action  cause 
contraction  of  the  pupil  by  lessening  reflex  action ;  later,  when  they  begin  to  paralyze 
respiration  the  accumulation  of  venous  blood  irritates  the  centres  and  produces  dilatation, 
which  is  a  sign  of  failing  respiratory  power  during  anaesthesia.  The  myotic  action  of 
Opium  is  of  central  origin,  probably  the  paralysis  of  the  local  reflex  excitability.  The 
chief  myotics  are  as  follows  : — 


Physostigma,  Eserine. 
Opium,  Morphine. 
Pilocarpus,  Pilocarpine. 
Muscarine. 


Gelsemine  (internally). 
Lobeline  (internally). 
Nicotine  (locally). 
Anaesthetics  (at  first). 


The  Sensibility  of  the  Eye  is  increased  by  Strychnine,  the  field  of 
vision  becoming  extended,  and  the  vision  rendered  more  acute.  If  the 
drug  be  administered  hypodermically  the  improvement  will  be  more 
marked  in  the  eye  corresponding  to  the  side  of  the  body  where  the  iujec- 
tion  was  made. 

The  sensibility  for  color  is  affected  by  drugs,  Strychnine  increasing  the  field  for  blue, 
Eserine  diminishing  it  for  red  and  green,  and  Santonin  causing  objects  to  appear  at  first 
of  a  violet  and  afterwards  of  a  greenish-yellow  color. 


Visions  are  produced  by  several  drugs,  their  action  being  probably 
on  the  cerebral  sight-centres  (angular  gyrus  and  occipital  lobes)  rather 
than  on  the  eye.  Alcoholic  delirium  is  a  familiar  instance,  while  Canna¬ 
bis  Indica  often  causes  pleasant  visions,  and  Sodium  Salicylate  in  some 
persons  produces  very  disagreeable  ones.  Digitalis  may  produce  subjec¬ 
tive  sensations  of  the  continued  presence  of  light.  Bromides  in  excess 


30 


AGENTS  ACTING  ON  RESPIRATION. 


may  produce  visions  of  such  intensity  that  their  subject  remembers  them 
distinctly  for  years  afterwards. 


Amblyopia,  or  impairment  of  vision  from  nerve-changes,  is  produced 
temporarily  by  Quinine,  and  may  be  permanently  induced  by  Tobacco, 
Alcohol,  Lead  and  Urea. 

v 

The  Ear  is  affected  by  several  drugs.  Strychnine  and  Morphine 
increase  the  excitability  of  either  the  auditory  nerve  or  the  centre  for 
hearing  (superior  temporo-sphenoidal  convolution),  making  that  faculty 
much  more  acute.  Quinine ,  Antipyi'ine  and  Salicylates  produce  hypere¬ 
mia  of  the  auditory  apparatus,  causing  subjective  noises,  as  humming, 
buzzing  or  ringing,  which  are  very  unpleasant.  Hydrobromic  Acid  and 
the  Bromides ,  also  Ergot ,  will  diminish  the  congestion  and  to  a  great 
extent  will  neutralize  or  prevent  these  noises. 

Quinine  in  large  doses  is  believed  by  some  to  have  produced  permanent  injury  of  the 
sight  and  the  hearing,  but  authentic  cases  of  such  action  are  extremely  rare,  if  indeed 
they  can  be  found  at  all.  Temporary  deafness  is  often  caused  by  Quinine,  but  it  usually 
disappears  soon  after  the  administration  of  the  drug  is  stopped. 


The  Sense  of  Smell  is  also  increased  by  Stiychnine,  and  decreased 
by  all  cerebral  depressants  and  by  those  agents  which  produce  changes 
in  the  nasal  mucous  membrane,  e.  g. ,  Potassium  Iodide. 

The  cerebral  centre  for  this  faculty  is  situated  at  the  tip  of  the  temporo-sphenoidal 
lobe,  and  the  terminal  branches  of  the  olfactory  nerve  are  distributed  upon  the  mucous 
lining  of  the  upper  portion  of  the  nasal  fossae.  Strychnine  probably  stimulates  the 
former,  and  all  drugs  acting  upon  the  latter  region  would  have  more  or  less  effect  upon 
the  power  of  distinguishing  smells. 


The  Taste  is  not  much  affected  by  drugs  except  as  each  makes  its 
peculiar  impression  on  the  nerves  of  taste,  and  may  overcome  that  of 
another  agent.  Smell  has  much  to  do  with  taste  in  many  instances,  the 
expedient  of  holding  the  nose  while  swallowing  Castor  Oil  being  familiar 
to  every  one. 

The  “  after-taste  ”  of  drugs  is  often  different  to  their  original  taste  ;  thus  Bitters  are  said  to 
leave  a  sweet  after-taste,  and  the  same  is  claimed  for  Quinine  if  given  in  acid  solution  so 
as  to  be  entirely  dissolved,  and  if  washed  out  of  the  mouth  with  water  immediately  after 
swallowing.  Substances  which  are  excreted  from  the  system  in  the  saliva  (as  Iodides) 
leave  a  very  persistent  after-taste. 

Agents  Acting  on  Respiration. 

The  Respiratory  Centre  is  situated  in  the  medulla  oblongata,  close  to 
the  termination  of  the  calamus  scriptorius.  It  probably  consists  of  thoracic 
and  diaphragmatic  Inspiratory  centres,  the  act  of  expiration  being  consid¬ 
ered  normally  a  passive  one,  due  to  the  natural  contraction  of  the  walls  of 
the  air-vesicles,  and  the  return  of  the  diaphragm  and  thoracic  walls  to  the 


AGENTS  ACTING  ON  RESPIRATION. 


31 


position  from  which  they  were  moved  by  the  inspiratory  effort.  An  Expi¬ 
ratory  Centre  must  also  exist  for  the  initiation  of  forced  expiration,  as  in 
the  production  of  voice,  cough,  sneezing,  etc.  The  chief  Inspiratory 
Nerves  are  the  pulmonary  branches  of  the  vagus.  The  Expiratory  Nerves 
are  the  nasal  branches  of  the  fifth,  the  superior  and  inferior  laryngeal,  and 
the  cutaneous  nerves  of  the  chest  and  abdomen. 


Respiratory  Stimulants  exalt  the  function  of  the  respiratory  centre, 
quickening  and  deepening  the  breathing.  Such  agents,  besides  Opium  in 
small  doses,  are — 


Chloralamid. 

Strychnine. 

Atropine. 

Duboisine. 


Brucine. 

Thebaine. 

Apomorphine. 

Emetine. 


Digitalis. 
Zinc  salts. 
Copper  salts. 
Ammonia. 


Quebracho. 
Tobacco  (briefly). 
Alcohol  (briefly). 
Ether  (briefly). 


Strychnine  also  stimulates  the  vagus  tract.  Electricity  applied  to  the  nerve-trunks  or 
to  the  inspiratory  muscles,  is  a  direct  respiratory  stimulant.  Veratine ,  Eserine ,  and  Mus¬ 
carine  stimulate  the  vagus  terminations,  quickening  the  respiration,  but  afterwards  slow  it 
by  depressing  the  respiratory  centre.  Aconite  stimulates  the  end-organs  of  the  vagus 
when  given  in  small  doses. 


Respiratory  Depressants  lower  the  activity  of  the  respiratory  centre, 
rendering  the  respirations  slow  and  shallow.  The  chief  agents  of  this  class 
are — 


Cold. 

Opium. 

Physostigma. 

Muscarine. 

Lobeline. 


Gelsemium. 
Aconite. 
Veratrine. 
Prussic  Acid. 
Conium. 


Alcohol. 

Ether. 

Chloroform. 

Chloral. 

Saponine. 


Caffeine. 

Colchicine 

Nicotine. 

Quinine. 

Camphor. 


The  ten  last  named  first  excite  the  centre  for  a  brief  period  and  then  depress  it. 


Pulmonary  Sedatives  diminish  cough  and  dyspnoea  by  lessening 
the  irritability  of  the  respiratory  centre  or  the  nerves  of  respiration.  Some 
act  by  directly  depressing  the  respiratory  centre,  as  those  enumerated 
under  the  preceding  head ;  others  by  removing  some  irritant  from  the 
passages,  or  by  lessening  local  congestion,  as  the  expectorant  group;  and 
others  by  lowering  the  excitability  of  the  vagus  end-organs  in  the  lungs, 
and  other  afferent  filaments  throughout  the  respiratory  tract. 


Opium  has  the  most  powerful  influence  as  a  sedative  to  the  respiratory  centre,  and  muci¬ 
laginous  or  saccharine  substances  soothe  the  local  irritation,  hence  the  latter  are  so  fre¬ 
quently  used  as  vehicles  for  the  former  in  cough  mixtures.  Hydrocyanic  Acid  has  a 
similar  sedative  action,  hence  the  use  in  coughs  of  Prunus  Virginiana  and  other  substances 
containing  it.  Belladonna  stimulates  the  respiratory  centre,  but  at  the  same  time  lessens 
the  excitability  of  the  vagus  terminations  in  the  lungs,  and  completely  arrests  secretion 
from  the  bronchi.  Stramonium  acts  similarly.  The  principal  pulmonary  sedatives  may 
be  enumerated  as  follows  : — 


Opium. 

Belladonna. 

Stramonium. 

Hyoscyamus. 


Prussic  Acid. 
Amyl  Nitrite. 
Quebracho. 
Cannabis. 


Turpentine. 
Ethyl  Iodide. 
Conium. 
Tobacco. 


32 


AGENTS  ACTING  ON  RESPIRATION. 


Errhines  and  Sternutatories  ( en ,  in,  rhin ,  the  nose;  sternuto ,  I 
sneeze), — are  agents  which  produce  increased  nasal  secretion  and  sneezing, 
when  locally  applied  to  the  mucous  membrane  of  the  nose.  The  first  term 
is  usually  applied  to  substances  which  cause  increase  of  the  mucus  without 
sneezing,  the  latter  to  those  which  invariably  produce  sneezing.  The  drugs 
should  be  in  powder  for  application.  The  stimulus  produced  by  these 
agents  is  transmitted  by  the  nasal  branches  of  the  fifth  nerve  to  the  respi¬ 
ratory  centre,  exciting  the  sudden  and  forcible  expiratory  effort  called 
sneezing ;  also  to  the  vasomotor  centre,  contracting  the  smaller  vessels 
throughout  the  body  and  producing  a  general  rise  in  the  blood-pressure. 
The  principal  agents  of  this  class  are — 


Tobacco,  as  snuff. 
Ipecacuanha. 
Sanguinaria. 
Veratrum  Album. 


Euphorbium. 
Sassy  Bark. 
Saponine. 
Ginger. 


Capsicum. 

Hellebore. 

Ammonia. 

Cubebs. 


The  last  two  named  may  be  used  as  simple  Errhines,  as  the  vapor  of  dilute  Ammonia- 
water  or  the  smoke  of  burning  Cubebs  do  not  excite  sneezing  generally. 


Expectorants  (<?jr,  out  of,  pectus,  the  breast), — are  remedies  which 
modify  the  secretion  of  the  broncho-pulmonary  mucous  membrane,  and 
promote  its  expulsion.  They  may  be  divided  into — 

Nauseating Expectora?its, — in  large  doses  act  mechanically  by  expelling 
the  mucus  in  the  act  of  vomiting,  in  small  doses  by  increasing  osmosis 
from  the  inflamed  mucous  membrane.  The  members  of  this  subdivision 
generally  increase  secretion  and  tend  to  lower  the  blood-pressure.  The 
chief  of  them  are  the  following  named  :  — 


Antimony,  Tartar  Emetic. 
Ipecacuanha,  Emetine. 
Lobelia,  Lobeline. 
Pilocarpus  (Jaborandi). 


Apomorphine. 
Quebracho. 
Potassium  Iodide. 
Alkalies. 


Stimulant  Expectorants , — are  largely  eliminated  by  the  bronchial 
mucous  membrane  which  they  stimulate,  altering  the  secretion  and  facili¬ 
tating  expectoration.  These  remedies  generally  diminish  secretion  and 
increase  blood-pressure.  They  are — 


Acids. 

Ammonium  Chloride,  and  Carbonate. 
Ammoniac. 

Benzoin  and  Benzoic  Acid. 

Balsams  of  Peru  and  Tolu. 

Wood  Tar,  and  Tar. 

Oleum  Pini  Sylvestris. 

Turpentine. 


Squill. 

Garlic. 

Onion. 

Nux  Vomica,  Strychnine. 
Senga,  Saponin. 

Sulphur. 

Liquorice. 

Saccharine  Substances. 


Besides  the  above  many  other  remedies  may  act  as  expectorants,  some  by  relieving 
bronchial  spasm,  as  Opium,  Stramonium  and  Tobacco, — others  by  soothing  the  irritable 
respiratory  centre,  as  Opium  and  Chloral, —  and  the  ciliary  excitants  by  reflex  action 
through  their  impression  on  the  nerves  of  the  mouth. 


AGENTS  ACTING  ON  THE  CIRCULATION. 


33 


Ciliary  Excitants, — promote  the  expectoration  of  bronchial  mucus 
by  their  reflex  excitation  of  the  tracheal  and  bronchial  cilia,  when  dis¬ 
solved  in  the  mouth.  Gum  Acacia,  Ammonium  Chloride,  Potassium 
Chlorate,  and  native  Chloride  of  Sodium  have  this  action. 


Agents  Acting  on  the  Circulation. 

Cardiac  Stimulants  rapidly  increase  the  force  and  frequency  of  the 
pulse  in  depressed  conditions  of  the  cardiac  apparatus.  One  of  the  most 
useful  agents  of  this  class  is  Alcohol  in  some  form,  its  action  being  largely 
due  to  a  reflex  influence  excited  through  the  nerves  of  the  mouth  and 
stomach.  It  should  therefore  be  given  in  but  slightly  diluted  form,  and 
in  small  quantities  frequently.  Ether  is  next  in  value  and  still  more  rapid 
in  action,  and  Heat  is  one  of  the  most  powerful  and  available  of  the  class. 
Ammonia  has  an  energetic  action  as  a  stimulant  to  the  vaso-motor  centre,, 
as  well  as  a  reflex  one  upon  the  heart  similar  to  that  of  Alcohol.  The  list 
of  cardiac  stimulants  includes  the  following,  viz  :  — 


Alcohol. 
Ammonia. 
Atropine. 
Nitroglycerin. 
Counter  irritation. 


Cocaine. 

Ether. 

Chloroform. 

Heat. 

Continuous  Galvanic  Current. 


Sparteine. 

Camphor. 

Aromatic  Oils. 
Turpentine. 

Opium,  and  Morphine,  in 
small  doses. 


Cardiac  Tonics,  when  given  in  moderate  doses,  stimulate  the  cardiac 
muscle,  slowing  and  strengthening  its  contractions.  In  large  doses  they 
are  apt  to  produce  irregular  action  of  the  heart,  and  some  of  them  have 
more  or  less  of  a  tendency  to  cause  sudden  death  by  syncope  if  pushed  to 
any  great  extent.  The  most  important  of  these  agents  are — 


Digitalis. 

Convallaria. 

Cimicifuga. 


Squill. 

Erythrophlceum. 

Caffeine. 


Strophanthus. 
Strychnine. 
Helleborein. 
Adonis  vernalis. 


Digitalis  acts  partly  by  stimulation  of  the  vagus  end-organs  in  the  heart,  thus  increasing 
cardiac  inhibition,  and  partly  by  direct  stimulation  of  the  cardiac  centre  in  the  medulla,  as 
well  as  by  a  direct  influence  on  the  heart  muscle  itself.  Convallaria ,  Erythrophlceum , 
Squill  and  Cimicifuga  act  similarly  but  less  powerfully,  and  are  correspondingly  safer. 
Strophanthus  is  still  better,  as  it  does  not  affect  the  vessels,  and  therefore  does  not  raise 
the  blood-pressure. 


Cardiac  Sedatives  lessen  the  force  and  the  frequency  of  the  heart’s 
action  and  are  used  to  control  palpitation  of  that  organ,  and  to  slow  the 
pulse  in  febrile  conditions  in  sthenic  subjects,  especially  when  local  inflam¬ 
mation  is  the  exciting  cause.  The  chief  cardiac  sedatives  are — 


Aconite. 
Antimony. 
Veratrum  Viride. 
Muscarine. 
Pilocarpine. 


Digitalis. 

Senega,  Saponin. 
Prussic  Acid. 
Potassium  Salts. 
Cold. 


34 


AGENTS  ACTING  ON  THE  DIGESTIVE  SYSTEM. 


Aconite ,  Veratrum,  Muscarine ,  Pilocarpine ,  Saponin  and  Prussic  Acid  are  direct 
cardiac  poisons,  depressing  the  heart  muscle  and  the  cardiac  motor  ganglia ;  Muscai-ine 
and  Pilocarpine  also  stimulate  the  inhibitory  ganglia ;  Digitalis  stimulates  the  vagus 
centre  and  the  cardiac  muscle,  and  acts  as  a  sedative  in  many  cases  by  slowing  the  rate 
and  giving  it  a  regular  rhythm.  Aconite  is  said  by  some  authorities  to  relax  inhibition, 
by  others  to  stimulate  the  vagus  centre.  Antimony  depresses  the  motor  ganglia,  Potassium 
the  cardiac  muscle. 


Vascular  Stimulants  produce  dilatation  of  the  peripheral  vessels, 
and  increase  the  rapidity  of  the  circulation,  thus  equalizing  the  blood- 
pressure  and  preventing  internal  congestions.  The  most  useful  are 
Alcohol  and  Ether ,  as  they  stimulate  the  action  of  the  heart  simultaneously 
with  the  vascular  dilatation.  The  chief  members  of  this  group  are — 


Alcohol. 

Ether. 

Nitrous  Ether. 
Nitroglycerin. 


Amyl  Nitrite. 

Liq.  Ammonii  Acetatis. 
Opium,  as  Dover’s  Powder. 
Heat,  as  Poultices,  etc. 


The  dilating  action  of  Amyl  Nitrite  and  other  Nitrites  is  due  to  weakening  either  of 
the  muscular  walls  of  the  arterioles  or  to  paralysis  of  the  vaso-motor  ganglia  in  them. 
Alcohol ,  Ether  and  Opium  probably  depress  the  vaso-motor  centre. 


Vascular  Tonics  produce  increased  contraction  of  the  arterioles  and 
consequently  increased  blood-pressure.  The  most  important  are — 

Digitalis.  Iron.  Strychnine. 

Squill.  Ergot.  Lead  and  Silver. 

Opium,  in  small  doses. 

These  agents  act  upon  the  local  vaso-motor  mechanism  in  the  walls  of  the  vessels,  which 
are  also  directly  stimulated  by  cold  produced  in  any  way,  as  by  Ether  spray,  or  evaporat¬ 
ing  lotions  containing  Alcohol,  Vinegar  or  Ammonium  Chloride. 


Vascular  Sedatives  increase  the  contraction  of  the  vessels  and  lessen 
the  circulation  through  them.  They  are  employed  to  check  hemorrhage 
and  to  cut  short  a  local  inflammation.  The  chief  agents  belonging  to 
this  group  are — 

Cold.  Hamamelis.  Opium. 

Ergot.  Digitalis.  Acetate  of  Lead. 


Agents  Acting  on  the  Digestive  System. 

Dentifrices  {dens,  a  tooth,  frico ,  I  rub), — are  medicated  powders  or 
pastes  employed  to  cleanse  the  teeth  and  gums.  Chalk  is  the  basis  gener¬ 
ally  used,  for  its  mechanical  action  and  its  alkaline  quality.  Antiseptics, 
as  Borax,  Quinine ,  Carbolic  Acid,  etc.,  should  also  be  employed  so  as  to 
prevent  the  acid  fermentation  of  food  products  between  the  teeth  and  the 
consequent  decay  of  the  dentine.  Tincture  of  Myrrh  is  an  excellent 
ingredient,  being  an  aromatic  local  stimulant  and  disinfectant. 

Many  drugs  affect  the  teeth  injuriously,  such  being  the  Mineral  Acids,  Persalts  of  Iron 
and  Alum.  The  first  two  should  be  taken  through  a  glass  tube,  and  the  mouth  should 


AGENTS  ACTING  ON  THE  DIGESTIVE  SYSTEM. 


35 


be  afterwards  rinsed  with  a  weak  alkaline  wash.  Opium,  Chloral,  Cocaine,  Carbolic  Acid, 
Creasote,  Chlorate  of  Potassium  and  Aconite  are  the  agents  used  as  local  anodynes  in 
toothache  from  caries  exposing  a  nerve  filament.  Chloral  should  never  be  used  for  this 
purpose,  as  in  solution  sufficiently  strong  to  be  of  any  service,  it  will  cause  sloughing  of  the 
gum,  especially  if  injected  thereinto  with  a  hypodermic  syringe,  as  is  frequently  done  by 
ignorant  dentists. 


Sialogogues  ( seealon ,  saliva,  ago ,  I  carry  off) — are  agents  which  in¬ 
crease  the  secretion  and  flow  of  saliva  and  buccal  mucus,  either  by  reflex 
action  from  the  local  irritation  produced  when  anything  is  taken  into  the 
mouth,  or  by  stimulating  the  glands  during  their  elimination.  The  prin¬ 
cipal  sialogogues  are  divided  into  two  classes,  the  first  (topical)  acting  by 
reflex  stimulation,  the  second  (general)  acting  through  their  systemic 
influence  on  the  glands  or  their  secretory  nerves.  They  are  as  follows :  — 


Topical  Sialogogues. 

Acids  and  Alkalies. 
Ether,  Chloroform,  etc 
Mustard,  Ginger. 
Pyrethrum,  Mezereon. 
Tobacco,  Cubebs. 
Capsicum,  Rhubarb. 
Horse-radish. 


General  Sialogogues. 

Pilocarpus  (Jaborandi). 
Muscarine. 
Physostigma. 
Mercurials. 

Iodine  compounds. 
Antimonials. 

Tobacco,  Ipecac. 


Antisialics  (anti,  against,  seealon,  saliva), — are  remedies  which  dimin¬ 
ish  the  secretions  of  the  salivary  glands.  Atropine  is  the  principal  agent 
of  this  group,  acting  by  paralyzing  the  terminations  of  the  nerves  of  secre¬ 
tion.  Physostigma  counteracts  this  paralysis,  but  in  large  doses  acts  as 
an  antisialic  by  lessening  the  blood  supply  to  the  glands.  Opiui7i  dimin¬ 
ishes  the  reflex  excitability  of  the  reflex  centre  and  also  diminishes  the 
secretion.  Others  acting  locally  are — 

Borax.  Soda.  Lithia. 

Potassium  Chlorate.  Lime.  Magnesia. 

Insipid  or  nauseous  articles  of  food  or  medicine. 


Refrigerants  ( refrigero ,  I  cool), — are  remedies  which  allay  thirst  and 
impart  a  sensation  of  coolness.  They  include  the  Vegetable  Acids,  the 
Mineral  Acids  (greatly  diluted),  Ice,  Water,  if  cold,  Effervescing  drinks, 
Fruit  juices,  and  many  diaphoretics. 

Gastric  Tonics  or  Stomachics, — are  agents  which  increase  the  ap¬ 
petite  and  promote  gastric  digestion.  They  include  a  number  of  sub¬ 
stances,  dietetic  and  medicinal,  some  acting  by  stimulation  of  the  produc¬ 
tion  of  gastric  juice,  others  by  stimulating  the  local  circulation,  and  several 
by  exciting  the  activity  of  the  nervo-muscular  apparatus  of  the  stomach. 

The  first  indication  is  met  by  the  use  of  dilute  alkaline  solutions  before  meals, — the 
second  by  administering  any  of  the  pungent  carminatives,  as  the  Aromatic  Oils,  Pepper, 
Mustard,  etc.,  or  by  Alcohol  and  Ether  in  small  doses,  or  by  the  Aromatic  Bitters,  as  Gen¬ 
tian,  Orange,  etc.,  or  the  simple  bitters,  as  Calumba; — while  the  third  desideratum  is 


36 


AGENTS  ACTING  ON  THE  DIGESTIVE  SYSTEM. 


secured  by  the  use  of  such  agents  as  Nux  Vomica,  Hydrastis,  Arsenic,  the  dilute  Mineral 
Acids,  and  the  Volatile  Oils.  Adjuvants  to  gastric  digestion  are  the  various  digestion- 
ferments,  Pepsin,  Ingluvin  and  dilute  HC1  Acid,  which  may  be  used  to  supplement  the 
gastric  juice  when  deficient  in  quantity  or  quality. 


Acids, — considered  therapeutically  and  physiologically,  are  medicines 
which  in  concentrated  form  act  usually  as  caustics,  and  when  given  in 
medicinal  doses  internally  check  the  secretions  of  organs  producing  acid 
secretions  with  which  they  come  in  contact,  and  increase  those  of  organs 
producing  alkaline  secretions.  Thus  a  dilute  acid  given  before  meals  will 
check  the  production  of  the  acid  gastric  juice,  but  will  stimulate  that  of 
the  alkaline  pancreatic  juice. 


The  chief  members  of  this  group  are  the 
dilute  form : — 

Acidum  Aceticum. 

Acidum  Citricum. 

Acidum  Benzoicum. 

Acidum  Hydrochloricum. 


following,  which  should  be  given  in  very 

Acidum  Nitricum. 

Acidum  Phosphoricum. 

Acidum  Sulphuricum. 

Acidum  Nitro-hydrochloricum. 


Ant-acids  or  Alkalies, — from  the  same  stand-point,  are  remedies 
which  neutralize  acids,  check  alkaline  secretions  and  stimulate  acid  secre¬ 
tions,  when  in  contact  with  the  ducts  of  the  organs  producing  them.  Thus 
a  dilute  alkali  given  before  meals  will  stimulate  the  production  of  the  acid 
gastric  juice  and  if  applied  to  the  mouth  of  the  pancreatic  duct  will 
check  the  secretion  of  the  alkaline  pancreatic  juice.  The  principal 
articles  which  belong  to  this  group  are  the  following,  which  should  always 
be  administered  in  dilute  solution  :  — 


Liquor  Potassje,  Liquor  Sodas. 

Carbonates  and  Bicarbonates  of  Potassium, 
Sodium,  Lithium,  Magnesium  and  Am¬ 
monium. 

Calcined  Magnesia  (Magnesia). 
Lime-water,  Chalk. 

Aromatic  Spirit  of  Ammonia. 


Potassium  Acetate. 
Potassium  Citrate. 
Potassium  Tartrate. 
Potassium  Bitartrate. 
Sodium  Acetate. 
Sodium  Citrate. 
Lithium  Citrate. 


The  substances  in  the  first  list  are  direct  antacids,  lessening  the  acidity  in  the  stomach, 
and  many  of  them  also  acting  as  remote  antacids,  lessening  the  acidity  of  the  urine,  as 
Potash  and  Soda,  and  their  Carbonates  and  Bicarbonates.  Ammonia  and  its  Carbonates 
after  absorption  are  eliminated  as  urea,  and  do  not  lessen  the  acidity  of  the  urine.  The 
salts  in  the  second  list  are  remote  antacids,  do  not  lessen  acidity  in  the  stomach  but  do 
that  of  the  urine,  being  oxidized  in  the  blood  and  excreted  as  Carbonates. 


Emetics  ( eemeo ,  I  vomit), — are  agents  which  produce  vomiting. 
They  may  be  subdivided  into  two  groups,  (i)  Local  Emetics ,  or  those 
which  act  by  irritating  the  end-organs  of  the  gastric,  pharyngeal  or  oeso¬ 
phageal  nerves,  and  (2)  General  or  Systemic  Emetics,  which  act  through 
the  medium  of  the  circulation.  Both  these  classes  produce  the  emetic 
action  by  irritation  of  the  vomiting  centre  in  the  medulla,  the  first  by 
reflex,  the  second  by  direct  stimulation.  The  principal  emetics  are  the 
following  named  : — 


AGENTS  ACTING  ON  THE  DIGESTIVE  SYSTEM. 


3  7 


Local  Emetics. 

Alum,  Mustard,  Salt. 
Ammonium  Carbonate. 

Zinc  and  Copper  Sulphates. 
Subsulphate  of  Mercury. 
Tepid  Water,  in  quantity. 
Vegetable  Bitters,  as  Quassia, 
in  strong  infusions. 


General  Emetics. 

Ipecacuanha. 

Emetine. 
Apomorphine. 
Tartar  Emetic. 
Veratrine. 

Senega. 

Squill. 


Tartar  Emetic ,  Ipecacuanha  and  probably  Apomorphine,  act  locally  as  well  as  systemi- 
cally,  for  if  injected  subcutaneously  they  are  excreted  by  the  stomach  in  part,  thus  irritat¬ 
ing  the  gastric  nerves  as  well  as  the  vomiting  centre.  Pilocarpus  is  a  local  emetic,  and 
Digitalis  and  its  congeners,  also  Muscarine ,  are  systemic  emetics,  but  none  of  these  agents 
are  used  medicinally  for  that  purpose.  Opium ,  Morphine  and  Codeine  usually  produce 
emesis  as  one  of  their  after-effects. 


Anti-emetics, — are  agents  which  diminish  nausea  and  vomiting,  some 
by  a  local  sedative  action  upon  the  end-organs  of  the  gastric  nerves, 
others  by  reducing  the  irritability  of  the  vomiting  centre  in  the  medulla. 
The  most  efficient  of  the  local  sedatives  is  Ice,  swallowed  in  small  pieces. 
Astringents  are  very  useful  when  there  is  congestion  of  the  gastric  mucous 
membrane,  as  in  the  vomiting  of  alcoholism  and  phthisis,  where  Silver 
Nitrate  and  Alum  are  respectively  effective.  The  most  important  anti¬ 
emetics  are  the  following,  viz.  : — 


Local  Gastric  Sedatives. 


Alcohol. 

Alum. 

Arsenic. 

Belladonna. 

Bismuth. 

Carbonic  Acid. 
Cerium  Oxalate. 
Chloroform. 
Carbolic  Acid. 
Potassium  Nitrate. 


Creasote. 

Ether. 

Ice. 

Opium. 

Prussic  Acid. 
Silver  Nitrate. 
Calomel  j  small 
Ipecac  J  doses. 
Hot  Water. 
Cocaine. 


General  Sedatives. 

Opium. 

Morphine. 
Prussic  Acid. 
Bromides. 
Chloral. 
Nitre-glycerin. 
Food. 

Alcohol. 

Amyl  Nitrite. 


Vomiting  being  set  up  by  irritation  of  many  afferent  nerves  from  various  regions  of  the 
body,  or  by  impulses  from  the  brain  excited  through  impressions  on  the  nerves  of  special 
sense,  the  measures  for  combating  it  are  very  diversified.  (Compare  the  title  Vomiting 
in  Part  III.) 

Gastric  Pain  is  best  treated  by  such  local  sedatives  as  Bismuth,  Hydrocyanic  Acid,  or 
small  doses  of  Morphine,  Arsenic  and  Belladonna.  Cocaine  is  one  of  the  most  efficient 
agents  of  this  class,  in  5  to  6  minim  doses  of  a  4  per  cent,  solution,  every  hour.  As  its 
general  action  is  opposed  to  that  of  Opium,  Bromides,  etc.,  it  must  act  locally,  and 
therefore  should  be  given  by  the  mouth. 


Carminatives  ( Carmino ,  I  soothe), — aid  the  expulsion  of  gas  from 
the  stomach  and  intestines,  by  increasing  peristalsis,  stimulating  the 
circulation,  and  relaxing  the  cardiac  and  pyloric  orifices  of  the  stomach. 
They  also  act  as  diffusible  stimulants,  both  of  the  bodily  and  mental 
faculties.  The  principal  carminatives  belong  to  the  aromatic  oils,  alcohols 
or  ethers,  and  are  embraced  in  the  following  list :  — 


Asafetida. 

Capsicum. 

Cardamom. 

Chloroform 


Mustard. 

Pepper. 

Spirits. 

Oil  of  Anise. 


Oil  of  Eucalyptus. 
Oil  of  Fennel. 

Oil  of  Peppermint. 
Oil  of  Spearmint. 


38 


AGENTS  ACTING  ON  THE  DIGESTIVE  SYSTEM. 


Ether. 

Fennel. 

Ginger. 

Horse-radish. 

Mace. 


Oil  of  Cajuput. 
Oil  of  Caraway. 
Oil  of  Cinnamon. 
Oil  of  Cloves. 

Oil  of  Coriander. 


Oil  of  Nutmeg. 
Oil  of  Pimento. 
Oil  of  Valerian. 
Camphor. 
Serpentaria. 


Cathartics  or  Purgatives  ( kaihairo ,  purgo,  I  cleanse), — are  agents 
which  increase  or  hasten  the  intestinal  evacuations.  According  to  their 
respective  degrees  and  direction  of  action  they  are  subdivided  into  several 
groups,  as  follows:  — 

Laxatives  ( laxo ,  I  loose),  or  Aperients  ( aperio ,  I  open), — include 
those  which  excite  moderate  peristalsis,  and  produce  softened  motions 
without  irritation.  Sulphur  is  the  typical  laxative. 

Simple  Purgatives, — increase  peristalsis  actively,  and  stimulate  the 
secretions  of  the  intestinal  glands,  producing  one  or  more  copious  and 
semifluid  motions  with  some  irritation  and  griping.  Senna  is  the  type  of 
this  group. 

Drastic  Purgatives  ( drao ,  I  act), — act  still  more  intensely,  producing 
violent  peristalsis  and  watery  stools,  with  much  griping  pain,  tenesmus  and 
borborygmi.  They  irritate  the  intestinal  mucous  membrane,  cause  exos¬ 
mosis  of  serum  from  its  vessels,  and  in  large  dose  set  up  inflammation  and 
symptoms  of  irritant  poisoning.  Jalap  is  a  typical  drastic. 

Saline  Purgatives, — consist  of  the  neutral  salts  of  metals  of  the  alkalies 
or  alkaline  earths.  They  stimulate  the  glands,  increase  peristalsis,  promote 
osmosis  and  cause  free  watery  evacuations.  Magnesium  Sulphate  is  a 
typical  saline. 

Hydragogue  Purgatives  (heudore,  water,  ago,  I  bring  away), — include  the 
most  active  of  the  drastic  and  saline  groups,  those  which  remove  a  large 
quantity  of  water  from  the  vessels.  Elaterium  is  a  typical  hydragogue. 

Cholagogue  Purgatives  ( kohlay ,  bile,  ago,  I  bring  away), — are  those 
agents  which  stimulate  the  flow  of  bile  and  produce  free  purgation  at  the 
same  time,  the  stools  being  green-colored,  or  “bilious,”  and  liquid. 
Podophyllin  is  the  type  of  this  group. 

The  principal  Cathartics  are  the  following  named  : — 


Laxatives. 

Sulphur. 

Magnesia. 

Cassia. 

Manna. 

Figs. 

Prunes. 

Tamarinds. 

Honey. 

Olive  Oil. 

Cascara  Sagrada. 

Physostigma. 

Ergot. 

Belladonna. 

Stramonium. 


Laxatives. 

Hyoscyamus. 

Soap. 

Almond  Oil. 
Taraxacum. 

Glycerin. 

Oatmeal. 

Bran  Biscuit. 

Brown  Bread. 

Simple  Purgatives. 

Senna. 

Aloes. 

Rhubarb. 

Castor  Oil. 


Simple  Purgatives. 

Rhamnus  Frangula. 

Ox-gall. 

Calomel. 

Small  doses  of  drastics,  sa¬ 
lines  or  cholagogues. 

Saline  Purgatives. 

Magnesium  Sulphate. 
Magnesium  Citrate. 

Potassium  Sulphate. 
Potassium  Tartrate. 

Potassium  Bitartrate. 

Sodium  Sulphate. 

Sodium  Phosphate. 


AGENTS  ACTING  ON  THE  DIGESTIVE  SYSTEM. 


39 


Saline  Purgatives. 
Sodium  Chloride. 

Pot.  et  Sodium  Tartrate. 
Manganese  Sulphate. 

Drastics. 

Jalap. 

Colocynth. 

Elaterium. 

Scammony. 


Drastics. 

Gamboge. 

Croton  Oil. 

Cathartic  Acid,  hypodermi¬ 
cally. 

Hydragogues. 

Elaterium. 

Gamboge. 

Potas,  Bitartrate. 


Hydragogues. 

Croton  Oil. 

Salines  in  large  doses. 

Cholagogues. 

Mercurials. 

Aloes. 

Rhubarb. 

Euonymin. 

Podophyllin. 

Iridin. 


Intestinal  Astringents,  contract  the  walls  of  the  intestinal  vessels, 
diminishing  the  exudation  therefrom,  and  lessening  the  fluidity  of  the 
faecal  discharges.  The  more  powerful  members  of  this  group  have  also  a 
constringing  action  on  the  intestinal  mucous  membrane.  The  principal 
agents  of  this  class  are  the  following  : — 


Astringents. 
Phosphoric  Acid. 
Nitric  Acid. 
Sulphuric  Acid. 
Acetic  Acid. 
Acetate  of  Lead. 
Nitrate  of  Silver. 


-  Diluted. 


Constringents. 
Tannic  Acid. 
Vegetable  Astringents. 
Alum. 

Oxide  of  Zinc. 
Sulphate  of  Copper. 
Persalts  of  Iron. 


Hepatic  Stimulants  and  Cholagogues  ( kohlay ,  bile,  ago,  I  bring 
away), — are  two  groups  of  agents  acting  upon  the  biliary  secretion,  the 
first-named  increasing  the  functional  activity  of  the  liver  and  the  amount 
of  bile  formed,  the  second  removing  the  bile  from  the  duodenum  and 
preventing  its  reabsorption  into  the  portal  circulation.  Some  hepatic 
stimulants  are  also  cholagogues,  others  are  not,  while  cholagogues  proper 
generally  act  as  hepatic  stimulants  by  carrying  off  the  bile  and  so  indirectly 
urging  the  liver  to  secrete  more.  The  discovery  of  the  entero-hepatic 
circulation  of  bile  has  cleared  up  many  of  the  discrepancies  formerly 
existing  with  regard  to  the  action  of  drugs  upon  this  gland  and  its  secre¬ 
tion.  The  following  list  includes  the  principal  drugs  belonging  to  both 


groups : — 

Hepatic  Stimulants. 


Aloes. 

Podophyllin. 

Mercuric  Chloride. 
Sodium  Benzoate. 

Phosphate. 

Salicylate. 

Nitro-hydrochloric  Acid. 
Euonymin. 

Iridin. 

Phytolaccin. 

Sanguinarin. 

Antimony. 

Arsenic. 

Ipecacuanha. 

Colchicine. 

Colocynth. 

Rhubarb. 


Potassium  Sulphate. 
Sodium  Sulphate. 

Bicarbonate. 
Ammonium  Benzoate. 

Chloride. 

Nitric  Acid  (dilute). 
Benzoic  Acid. 
Baptisin. 

Hydrastin. 

Juglandin. 

Leptandrin. 

Jalapin. 

Scammony. 

Guaiac. 

Sarsaparilla. 

Physosligma. 

Rochelle  Salt. 


Cholagogues. 

Aloes. 

Podophyllin. 
Mercurous  Chloride. 
Pil.  Hydrargyri. 
Mercury  with  Chalk. 
Sodium  Phosphate. 
Sulphate. 

Potassium  Sulphate. 

Colchicum. 

Colocynth. 

Rhubarb. 

Arsenic. 

Euonymin. 

Scammony. 

Baptisin. 

Jalapin. 

Iridin. 


40 


AGENTS  ACTING  ON  THE  DIGESTIVE  SYSTEM. 


Those  in  the  first  column  are  the  most  powerful  of  the  stimulant  group,  the  second 
column  including  the  less  efficient  agents.  To  secure  the  best  cholagogue  effect  it  is 
advisable  to  combine  an  hepatic  stimulant  with  an  intestinal  stimulant  which  shall  pro¬ 
duce  increased  secretion  from  the  intestinal  mucous  membrane  and  excite  peristalsis. 


The  Glycoge?iic  Function  of  the  liver,  and  the  production  of  urea  are 
stimulated  by  the  following-named  drugs  :  — 


Increasi ng  Glycogen . 

Nitrite  of  Amyl. 

Sodium  Bicarbonate. 
Nitro-hydrochloric  Acid. 


Increasing  Urea. 
Arsenic.  Iron. 

Antimony.  Phosphorus. 

Ammonium  Chloride. 


Hepatic  Depressants  are  agents  which  lower  the  functional  activity 
of  the  liver,  reducing  the  quantity  of  bile  secreted,  and  lessening  the 
production  of  glycogen  and  urea.  They  are  as  follows,  viz.  : — 


Lessening  Bile. 

Opium.  Morphine. 
Many  Purgatives. 
Acetate  of  Lead. 
Quinine  (?) 

Alcohol  (?) 


Diminishing  Glycogen. 
Opium. 

Morphine.  Codeine. 
Phosphorus. 

Arsenic. 

Antimony. 


Lessening  Urea. 

Opium. 

Morphine. 

Colchicum. 

Alcohol. 

Quinine. 


Many  purgatives  act  as  hepatic  depressants  and  diminish  the  secretion  of  bile  by  lower¬ 
ing  the  blood  pressure  in  the  liver,  and  by  carrying  off  the  materials  from  which  bile 
might  be  formed. 


Pancreatic  Stimulation  may  be  obtained  by  the  administration  of 
Ether ,  or  by  Galvanism  of  the  gland  itself.  The  secretion  is  depressed 
by  Atropine  and  by  inducing  nausea  and  vomiting. 


Anthelmintics  (anti,  against,  helmins ,  a  worm), — are  agents  which 
destroy  (vermicides)  or  cause  the  expulsion  of  intestinal  worms  (vermi¬ 
fuges).  The  chief  vermifuges  are  Castor  Oil,  Jalap  and  Scammony, 
while  the  vermicides  may  be  enumerated  as  follows,  viz : — 


Thread  Worms 
( Oxyuris  Vermicularis.) 

Alum. 

Sulphate  of  Iron. 

Lime  Water. 

Quassia. 

Eucalyptol. 

Sodium  Chloride. 
Tannin. 

Veg.  Astringents. 


Round  Worms 
(Ascaris  Lumbricoides. ) 

Santonica. 

Santonin. 

Spigelia. 

Chenopodium. 

Azedarach. 

Senna.  I  with  the 
Calomel.  j  above. 


Tape  Worms 
(  Tcenice ,  etc.) 

Filix  Mas. 
Kamala. 
Kousso. 
Granatum. 

Pelletierine. 

Pepo. 

Turpentine. 

Chloroform. 


The  substances  enumerated  in  the  first  column  are  all  used  locally  by  enema.  Adjuncts 
to  these  remedies  are  such  agents  as  prevent  the  excessive  secretion  of  intestinal  mucus, 
which  affords  a  nidus  for  the  worms.  Such  are  Bitter  Tonics  and  preparations  of  Iron, 
abo  Ammonium  Chloride  and  Sodium  Chloride. 


AGENTS  ACTING  ON  METABOLISM. 


41 


Agents  Acting  on  Metabolism. 

Restoratives, — are  agents  which  promote  constructive  metamorpho¬ 
sis,  including  the  Foods,  Haematics,  and  Tonics,  as  well  as  many  agents 
called  Stimulants  in  other  classifications. 

Foods , — are  substances  which,  when  introduced  into  the  body,  supply 
material  to  renew  some  structure  or  to  maintain  some  vital  process;  being 
distinguished  from  medicines  in  that  the  latter  modify  some  vital  action 
but  supply  no  material  to  sustain  such. 

The  food  of  man  is  derived  from  all  three  of  the  kingdoms  of  nature,  viz.,  the  mineral, 
vegetable  and  animal,  and  includes  many  substances  treated  of  in  the  Materia  Medica, 
as  Oils  and  Fats,  Sugar,  Starch,  Gum,  Alcohol,  Beverages  like  Coffee  and  Tea,  Water, 
Phosphate  of  Lime,  Chloride  of  Sodium,  etc. 

Hcematics  (Jiaima ,  the  blood), — are  medicines  which  augment  the  quan¬ 
tity  of  hsematin  in  the  blood,  and  thus  restore  the  quality  of  that  tissue 
by  enriching  its  red  corpuscles.  They  consist  chiefly  of  Iron  and  Man¬ 
ganese  and  their  compounds. 

Tonics  ( tounos ,  tension), — are  agents  which  improve  the  tone  of  the 
tissues  on  which  they  have  specific  action,  restoring  energy  and  strength 
to  debilitated  subjects,  by  a  scarcely  perceptible  stimulation  of  all  the 
vital  functions,  their  effects  being  apparent  in  an  increased  vigor  of  the 
entire  system.  The  chief  tonics  are  enumerated  in  the  foregoing  lists 
under  the  heads  of  the  organs  or  tissues  particularly  affected  by  them. 
(Compare  the  titles  Stimulants,  Respiratory  Stimulants,  Cardiac 
Tonics,  Vascular  Tonics,  Gastric  Tonics,  etc.) 

The  most  typical  medicinal  agents  which  impart  a  general  sense  of  tone  and  strength 
are  Strychnine,  Quinine,  Iron  and  Vegetable  Bitters.  Those  especially  acting  upon  the 
stomach,  are  Arsenic,  Bismuth,  Cinchona,  Hydrastis  and  Nux  Vomica, — on  the  spinal  cord 
and  general  circulation,  Strychnine, — on  the  heart,  Digitalis,  Squill,  Convallaria  and  Cimi- 
cifuga, — on  the  nervous  system,  Phosphorus,  Quinine  and  the  Valerianates, — on  muscular 
tissue,  Tannin, — on  the  blood,  Iron,  Manganese,  Cod-liver  Oil,  and  other  fats. 


Alteratives, — are  certain  remedies  which  alter  the  course  of  morbid 
conditions  in  some  way  not  yet  understood,  perhaps  by  promoting  meta¬ 
bolism.  They  certainly  modify  the  nutritive  processes  and  thereby  cure 
many  diseases  of  chronic  type.  Mercury  and  Iodine  are  the  most  promi¬ 
nent  agents  of  this  class,  the  former  being  endowed  with  the  power  of 
breaking  up  newly  deposited  fibrin,  and  disorganizing  syphilitic  deposits, 
while  the  latter  acts  energetically  upon  the  lymphatic  system  and  promotes 
absorption.  Arsenic  also  is  almost  specific  in  many  chronic  skin  affec¬ 
tions,  and  has  remarkable  power  over  chronic  pulmonary  consolidations, 
probably  producing  fatty  degeneration  and  softening  of  the  effusion,  so 
that  it  may  be  absorbed  or  expectorated.  The  principal  alteratives  are  :  — 


42 


AGENTS  ACTING  ON  METABOLISM. 


Arsenic. 

Antimony. 

Aurum. 

Mezereum. 

Sulphur. 

Sulphides. 


Mercury. 

Colchicum. 

Guaiacum. 

Sangu  inaria. 
Xanthoxylum. 
Calcium  Chloride. 


Iodine. 

Iodides. 

Stillingia. 

Sarsaparilla. 

Cod-liver  Oil. 

Phosphorus. 


Certain  therapeutists  of  laboratory  type  have,  of  late  years,  seen  fit  to  denounce  the 
term  Alterative  as  “  a  cloak  for  ignorance,”  but  have  never  been  able  to  present  a  better 
designation  for  a  class  of  agents  whose  effects  are  among  the  most  thoroughly  established 
of  clinical  facts. 


A  subdivision  may  be  made  of  the  Resolvents  or  Discutients  (. Resolvo , 
I  unbind,  Discutio,  I  dissipate), — agents  which  promote  the  absorption 
of  inflammatory  products  or  other  materials  of  morbid  origin,  apparently 
by  stimulation  of  the  lymphatic  system.  They  include  Mercury,  Arsenic, 
Iodine,  and  Cadmium,  as  well  as  such  local  measures  as  Poulticing  and 
Counter-irritation. 


The  Destructive  Metamorphosis  of  the  tissues  is  promoted  by 
a  number  of  agents,  most  of  which  are  classed  as  Alteratives  or  as  Astrin¬ 
gents ,  the  most  important  of  which  are  the  following-named : — 

Alkalies.  Sulphides  and  Iodides. 

Vegetable  Acids.  Sarsaparilla. 

Metals  and  their  salts.  Stillingia. 

Colchicum.  Xanthoxylum. 

Tannic  and  Gallic  Acids,  and  substances  containing  them. 

On  the  other  hand,  Metabolism  may  be  diminished  by  many  substances, 
the  following  named  being  the  chief  ones  : — 

Alcohol.  Salicin.  Resorcin. 

Glycerin.  Salicylates.  Chinoline. 

Oils  and  Fats.  Quinine.  Kairine. 


Antipyretics  {anti,  against,  peuritos ,  fever),  are  agents  or  measures 
which  reduce  the  body-temperature  when  abnormally  high.  This  may  be 
done  by  two  principal  methods,  and  the  agents  doing  either  accomplish 
the  result  by  different  actions,  as  follows,  viz.  : — 


„  T  .  ,  tt  j  l  f  I.  Diminishing  tissue-change. 

By  Lessening  the  Production  of  Heat,  by  j  ^  Reducing  ,ge  drculation5. 

or  by 


Promoting  the  Loss  of  Heat,  by 


f  3.  Dilating  cutaneous  vessels,  and  producing  increased 
radiation. 

4.  Producing  perspiration,  and  its  evaporation. 

[5.  Abstracting  heat  from  the  body. 


The  following  list  contains  nearly  all  the  antipyretics,  the  number 
following  each  referring  to  its  proper  method  of  action,  as  enumerated 
above : — 


Quinine.1 
Quinidine.1 
Cinchonine.1 
Cinchonidine.1 
Berberine. 1 


Chinoline.1 

Resorcin.1 

Kairine.1-4 

Kairoline.1-4 

Antipyrine.1’4 


Acetphenitidin.1’4 
Aconite.2 
Antimonials.2’4 
Veratrine. 2 
Colchicum.2 


AGENTS  ACTING  UPON  EXCRETION. 


43 


Benzoic  Acid.1 
Carbolic  Acid.1 
Picric  Acid.1 
Salicin. 1 
Salicylic  Acid.1 
Sodium  Salicylate.1,4 
Quinine  Salicylate.1 
Methyl  Salicylate.1 

(Oil  of  Gaultheria.) 
Trimethylamine.2 
Antifebrin.1*4 


Hydroquinone.1 

Thallin.1-4 

Pyrocatechin.1 

Pheno-resorcin.1 

Camphor.1 

Eucalyptol. 1 

Thvmol  1 

j 

Other  Essential  Oils.1 

Alcohol.1-3 

Digitalis.2 

Salol.1 


'Leeching. 2 
Cupping. 2 
Blistering.2 
Poulticing.2 
Nitrous  Ether. 3 '4 
Dover’s  Powder.4 
Cold  Bath.5 
Cold  Drinks.5 
Ice  to  Surface.5 
Cold  Sponging.5 
Wet  Packing.5 


Purgation  and  Venesection  produce  antipyretic  results,  but  their  mode  of  action  is  doubt¬ 
ful  (Brunton). 


Antiphlogistics  (anti,  against,  pfleggo ,  I  burn), — are  measures  and 
medicines  which  are  supposed  to  have  some  specific  power  in  reducing 
inflammation.  The  term  is  becoming  obsolete,  but  frequent  references 
are  seen  yet  to  the  influence  of  Mercury  and  Opium  in  inflammations  of 
serous  membranes,  Antimony  and  Aconite  in  inflammations  of  the  respi¬ 
ratory  tract  and  organs,  and  to  the  power  of  Veratrum  Viride  over  puer¬ 
peral  metritis.  The  chief  antiphlogistics  are  the  following  :  — 


Aconite. 

Veratrum  Viride. 
Tartar  Emetic. 
Mercury. 

Opium. 

Gelsemium. 


Digitalis. 

Ergot. 

Ipecacuanha. 

Potassium  Nitrate. 

Rest,  recumbent  position. 


Venesection. 
Local  Depletion. 
Purgation. 
Counter-irritation. 
Cold. 


Antiperiodics  are  remedies  which  affect  certain  periodical  febrile 
diseases,  lessening  the  severity  of  their  paroxysms  or  preventing  their 
return.  They  act  probably  by  arresting  the  development  in  the  blood  of 
successive  crops  of  pathogenic  organisms,  upon  which  the  disorders  are 
supposed  to  depend.  The  principal  antiperiodics  are  :  — 

Cinchona  Bark  and  its  Alkaloids.  Arsenic. 

Bebeeru  Bark  and  its  Alkaloid.  Eucalyptol. 

Salicin,  Salicylic  Acid,  Salicylates.  Iodine. 


Agents  Acting  upon  Excretion. 

Diuretics  (deeouraysis,  urination), — are  remedies  which  increase  the 
renal  secretion.  They  may  act  in  several  ways,  namely  :  — 

1.  By  raising  the  general  blood- pressure  by  contraction  of  efferent  vessels  or  vessels  in 

other  regions  of  the  body. 

2.  By  dilating  the  renal  arteries  and  increasing  the  renal  blood-supply,  raising  the  pres¬ 

sure  in  the  glomeruli. 

3.  By  stimulating  the  secreting  nerves  or  cells  of  the  kidney. 

4.  By  simply  washing  out  the  kidneys,  as  by  Water  in  quantity. 

The  following  list  contains  the  most  important  agents  of  this  class, 
which  are  usually  subdivided  into  the  two  groups  indicated  by  the  sub¬ 
titles.  The  numbers  refer  to  the  action  of  the  drug  in  the  above  synopsis  : 


44 


AGENTS  ACTING  UPON  EXCRETION. 


Refrigerant  Diuretics.  Stimulant  Diuretics. 


Potassium  Acetate.3 

Alcohol.2 

Gin.2 

Potassium  Bitartrate.3 

Cantharides  3 

Carrot.3 

Potassium  Citrate.3 

Turpentine.3 

Fennel.3 

Potassium  Chlorate.3 

Juniper.3 

Mustard.3 

Potassium  Nitrate  3 

Savine.3 

Asparagus  3 

Sodium  Acetate.3 

Copaiba.3 

Uva  Ursi.3 

Calomel. 1 

Cubebs.3 

Buchu.3 

Digitalis.1 

Pepper.3 

Sarsaparilla.3 

Erythrophloeum,1 

Matico.3 

Pareira.3 

Caffeine  3 

Kava.3 

Chimaphila.3 

Broom.8 

Guaiac.3 

Santonica.3 

Squill.1’2 

Parsley.3 

Lobelia.3 

Nitrites.2 

Taraxacum.3 

Aconite.3 

Colchicum.3 

Jaborandi.3 

Tobacco.1-3 

Strychnine.1 

Dulcamara.3 

Volatile  Oils.3 

Stigmata  Maidis.1’2 

Bryonia.3 

Oleo-resins.3 

Diuretics  are  employed  for  the  following  purposes,  namely,  (i)  to  re¬ 
move  the  excess  of  fluid  in  dropsies, — (2)  to  hasten  the  elimination  of 
waste  products  and  other  poisonous  substances  from  the  blood, — (3)  to 
dilute  the  urine.  In — 

Cardiac  Dropsy , — or  other  dropsies  due  to  venous  congestion,  the  best  diuretics  are 
those  which  act  on  the  general  vascular  system,  as  Digitalis,  Squill,  etc.  Calomel  is  very 
efficient  here. 

Dropsy  from  Renal  Disease , — Broom,  Nitrous  Ether,  Oil  of  Juniper,  Digitalis  and  Squill 
are  the  most  reliable  diuretics  in  the  order  named. 

Hepatic  Dropsy , — Copaiba  is  considered  especially  suitable.  In  this  and  the  previous 
farm  a  little  Pil.  Hydrargyri  occasionally  often  aids  the  diuretic  action  of  other  agents. 

To  Eliminate  Solids, — Potassium  Nitrate  and  Bitartrate,  Turpentine,  Juniper,  Caffeine, 
etc.,  are  the  most  efficient.  [Compare  Antilithics.] 

To  Dilate  the  Urine, — Water  is  the  best  diuretic,  and  the  most  efficient  form  is  Dis¬ 
tilled  Water  acidified  with  Carbonic  Acid  Gas. 


Renal  Depressants, — are  such  agents  as  directly  diminish  the  ac¬ 
tivity  of  the  renal  cells,  and  lessen  or  suspend  the  secretion  of  urine. 
Morphine,  Quinine  and  Ergot  act  in  this  way  through  the  circulation, 
and  Digitalis,  instead  of  acting  as  a  diuretic,  may  arrest  the  renal  circu¬ 
lation  by  stimulating  the  vaso-motor  centre  and  thus  by  contracting  the 
vessels  may  stop  the  secretion  altogether  (Brunton).  The  same  is  true  of 
Caffeine  and  Strychnine,  hence  it  is  well  to  combine  these  with  other 
diuretics  (Nitrous  Ether,  Alcohol),  which  dilate  the  renal  arteries. 

Alkalinizers  of  the  Urine, — are  agents  which  produce  an  alkaline 
reaction  to  the  urine  when  taken  internally.  They  include  the  alkalies, 
particularly  Potassium  and  Lithium  salts,  but  excepting  Ammonia,  which 
is  broken  up  in  the  organism.  Sodium  salts,  being  partly  excreted  by 
the  bile  and  the  bronchial  mucus,  and  partly  locked  up  in  the  system  as 
the  neutral  chloride,  while  the  Urate  of  Sodium  is  insoluble,  are  not  as 
efficient  in  this  regard  as  are  other  alkalies.  Fruits,  milk  and  fish  also 
act  in  the  same  manner  by  means  of  the  salts  which  they  convey  into  the 
economy. 


AGENTS  ACTING  UPON  EXCRETION. 


45 


Acidifiers  of  the  Urine, — are  Benzoic  and  Salicylic  Acids,  and 
Vegetable  Acids  in  excess,  also  excess  of  proteids,  sugar  and  starch  in 
the  food,  and  certain  wines  and  spirits.  The  Mineral  Acids  have  little  or 
no  influence  on  the  acidity  of  the  Urine,  being  excreted  as  neutral  sul¬ 
phates,  chlorides,  phosphates,  etc. 

Vesical  Sedatives, — are  substances  which  lessen  irritability  of  the 
bladder,  relieving  pain  and  decreasing  the  desire  to  micturate.  Opium, 
Belladonna,  Hyoscyamus,  Stigmata  Maidis,  Cannabis,  etc.,  lessen  the 
irritability  of  the  nerves,  Carbonate  of  lime  that  due  to  the  presence  of 
calculi, — and  mucilaginous  drinks,  such  as  Barley-water  or  Linseed  tea, 
also  astringents  like  Buchu,  Uva  Ursi,  Pareira,  etc.,  diminish  the  irrita¬ 
tion  due  to  chronic  cystitis,  and  antiseptics,  as  Copaiba,  and  Cubebs,  also 
act  in  like  manner. 

Vesical  Tonics, — increase  the  contractile  power  of  the  muscular 
fibres  in  the  wall  of  the  bladder.  Cantharides,  Potassium  Bromide, 
Strychnine  and  Belladonna  are  the  most  prominent  members  of  this  class. 

Urinary  Sedatives  and  Astringents, — act  sedatively  upon  the 
whole  extent  of  the  urinary  tract  through  the  medium  of  the  urine  charged 
with  them  when  administered  internally.  Some  of  the  members  of  this 
class  may  be  administered  locally,  but  only  to  the  urethral  and  vesical 
mucous  membranes,  which  are  accessible  to  direct  local  medication. 

Instances  of  the  application  of  these  agents  are  in  the  use  of  Potassium  and  Lithium 
Salts  to  diminish  the  acidity  of  the  secretion, — Cubebs,  Copaiba  and  Sandal-wood  Oil  as 
antiseptics  and  astringents, — and  urethral  injections  of  Alum,  Acetates  of  Zinc  and  Lead, 
Boracic  Acid,  Chloral  and  Zinc  Chlorides,  etc.,  for  a  simple  purpose.  Copaiba  is  one  of 
the  most  efficient  agents  for  rendering  the  urine  antiseptic,  and  should  be  more  employed 
in  cystisis  and  urethritis  than  it  is.  Oil  of  Eucalyptus  is  nearly  as  efficient,  and  Stigmata 
Maidis  (Corn  Silk),  in  tincture,  is  beginning  to  be  well  thought  of  for  a  general  alterative 
influence  on  the  urinary  tract. 

Antilithics  or  Lithontriptics  ( anti ,  against,  leethos ,  a  stone,  treebo ,  I 
wear  down), — are  agents  supposed  to  prevent  the  formation  of  concretions 
in  the  excretory  passages  (antilithics)  or  to  dissolve  them  when  formed 
(lithontriptics.)  The  terms  are  generally  restricted  to  remedies  affecting 
the  urinary  calculi,  but  those  directed  against  the  biliary  form  are  in¬ 
cluded  in  this  arrangement  for  the  sake  of  consistent  classification.  The 
chief  agents  coming  under  this  title  are — 


Biliary  Calculi . 


Uric  Acid  or  Urates. 

Distilled  Water. 

Alkalies,  Potash  or  Lithia. 
Potassium  Salts. 

Lithium  Salts. 

Potassium  Tartraborate. 
Magnesium  Citroborate. 


Ether  and  Turpentine. 


(Durande’s  Solvent.) 

Sodium  Bicarbonate. 

Sodium  Salicylate. 

Sodium  Phosphate. 

Castile  Soap. 

Alkaline  Waters,  especially  Vichy. 


46 


AGENTS  ACTING  UPON  EXCRETION. 


Oxalate  of  Calcium. 

Dilute  Nitro-Hydrochloric  Acid. 
Carbonated  Water. 

Lactic  Acid  (for  digestion). 


Phosphatic  Calculi. 

Ammonium  Benzoate. 
Benzoic  Acid. 

Dilute  Nitric  Acid. 


There  is  probably  little  or  no  solvent  value  to  the  agents  recommended  for  biliary 

calculi.  In  the  case  of  Uric  Acid  the  administration  of  Potash  or  Lithia  is  based  on 

their  combining  with  the  acid  forming  the  calculus,  and  forming  Urate  of  Potassium  or 

Lithium,  which  salts  are  more  soluble  than  the  Uric  Acid  itself. 

7  • 


Diluents  ( Diluo ,  I  dilute), — are  agents  which,  after  their  absorption 
dilute  the  excretory  fluids  and  enable  the  latter  to  hold  more  solid  ma¬ 
terial  in  suspension.  Water  is  the  one  true  diluent,  whatever  form  it  may 
be  disguised  in,  as  teas,  weak  fluid  foods,  acid  drinks,  etc. 


Diaphoretics  and  Sudorifics  ( deeaphohreeo ,  I  carry  through;  sudor , 
sweat,  facio ,  I  make), — are  remedies  which  increase  the  action  of  the 
skin  and  promote  the  secretion  of  sweat.  When  they  act  energetically, 
so  that  the  perspiration  stands  in  beads  upon  the  surface  they  are  known 
as  Sudorifics.  They  may  be  subdivided  into  the  following  groups,  viz. — 

1.  Simple  Diaphoretics ,  which  enter  the  circulation  and  are  eliminated  by  the  sudori¬ 
ferous  glands,  which  they  stimulate  to  increased  action. 

2.  Nauseating  Diaphoretics ,  which  produce  relaxation  and  the  dilatation  of  the  super¬ 
ficial  capillaries. 

3.  Refrigerant  Diaphoretics ,  which  reduce  the  circulation,  at  the  same  time  acting 
directly  on  the  sweat  centres  in  the  spinal  cord  and  medulla. 


The  principal  diaphoretics  are  enumerated  as  follows,  the  figures  refer¬ 
ring  to  their  supposed  mode  of  action  as  indicated  above,  viz.  : — 


Jaborandi.1’3 

Pilocarpine.1-3 

Salicylic  Acid.1 

Salicylates.1 

Ipecacuanha.2 

Tartar  Emetic.2 

Sulphur.1 

Opium.  2>3  (large  doses) 
Camphor. 1 
Tobacco.2-3 
Cocaine.3 


Ether.2-3 
Alcohol.2-3 
Nitrous  Ether.2-3 
Ammonium  Acetate.1 
Ammonium  Citrate.1 
Dover’s  Powder.2 
Aconite.3 
Veratrum  Viride.3 
Potassium  Salts.3 
Mezereon.1 


Lobelia.2-3 
Sarsaparilla.1 
Guaiacum.1 
Serpentaria.1 
Sassafras.1 
Senega.1 
Vapor  Bath. 2 
Turkish  Bath.2 
Wet  Pack.2 
Warm  Drinks.2 


Anhidrotics  (an,  without,  hidroce ,  sweat),  are  agents  which  check  per¬ 
spiration.  They  may  act — 

1.  By  depressing  the  action  of  the  sweat-glands. 

2.  By  depressing  the  excitability  of  the  sweat-centres. 

2.  By  reducing  the  circulation  in  the  skin. 


The  most  important  agents  of  this  class  are  the  following-named,  the 
figures  indicating  their  mode  of  action  as  above  arranged,  viz.  :  — 


Belladonna.1 

Atropine.1 
Hyoscyamus.1 
Stramonium.1 
Muscarine. 2 
Agaricus  Albus.2 
Salvia  (Sage). 


Acids,  locally.3 

Jaborandi. 

Pilocarpine. 

Nux  Vomica. 

Strychnine. 

Ergot.3 

Sulphuric  Acid. 


Chloralamid. 

Quinine  ? 

Picrotoxin. 

Dover’s  Powder. 
Opium. 2  (small  doses) 
Zinc  Salts.3 
Local  Cold.3 


AGENTS  ACTING  ON  THE  GENERATIVE  APPARATUS. 


47 


Strychnine,  Atropine,  Dover’s  Powder,  Jaborandi,  Picrotoxin  and  Zinc  Salts  are  all 
respiratory  stimulants,  and  very  efficient  against  the  sweating  of  phthisis,  though  most  of 
them  are  classed  as  diaphoretics.  This  is  explained  on  the  theory  of  accumulation  of 
Carbonic  Acid  in  the  blood  by  depressed  respiration  caused  by  severe  coughing,  this 
stimulating  the  sweat  centres,  and  being  opposed  by  agents  which  stimulate  the  respiratory 
centre. 


Agents  Acting  on  the  Generative  Apparatus. 


Aphrodisiacs  (Aphrohdeetay ,  Venus),  are  medicines  which  stimulate 
the  sexual  appetite  and  power.  They  act  by  reflex  or  central  action  upon 
either  the  cerebral  or  the  spinal  genital  centre.  Tonics  are  indirectly 
aphrodisiac,  as  are  all  measures  which  promote  the  general  bodily  nutri¬ 
tion.  The  chief  agents  used  as  direct  aphrodisiacs  may  be  enumerated  as 
follows,  viz.  : — 


Nux  Vomica. 

Strychnine. 

Cannabis. 

Cantharis. 

Phosphorus. 

Aurum. 


Cimicifuga. 
Serpentaria. 
Sanguinaria. 
Opium  (at  first). 
Camphor  (at  first). 
Damiana  (?). 


Ergot. 

Iron. 

Alcohol. 
Bitter  Tonics. 
Flagellation. 
Meat  Diet. 


Strychnine  acts  by  increasing  general  nutrition  and  exalting  the  reflex  excitability  of  the 
genital  centres.  Hemp  probably  only  causes  a  mild  delirium  which  may  or  may  not  take 
a  sexual  direction.  Cantharides  acts  by  direct  irritation  of  the  mucous  lining  of  the 
urethra,  and  is  dangerous  in  aphrodisiac  doses.  Alcohol  in  small  doses  excites  the  genital 
centre  in  the  brain;  so,  also  Opium  and  Ca?7iphor,  the  latter  being  decidedly  anaphro- 
disiac  after  a  time.  The  power  of  Dat?iiana  is  doubtful.  Urtication  and  Flagellation  of 
the  nates  produce  priapism  by  irritation  of  the  genital  centre  in  the  cord  through  the 
sensory  nerves  of  the  part.  Ergot  is  considered  useful  by  contracting  the  dorsal  vein  of 
the  penis,  preventing  its  emptying  too  rapidly. 


Anaphrodisiacs  (an,  without  Aphrohdeetay ,  Venus), — are  medicines 
and  measures  which  lower  the  sexual  function  and  diminish  the  sexual 
appetite.  They  act  by  lessening  the  excitability  of  the  nerves  of  the 
genital  organs,  by  depressing  the  genital  centres  in  the  brain  and  cord, 
or  by  decreasing  the  local  circulation.  The  principal  anaphrodisiacs 
are  enumerated  as  follows,  viz  :  — 


Potassium  Bromide. 
Ammonium  Bromide. 
Potassium  Iodide. 
Camphor  (at  last). 
Opium  (at  last). 
Lupulin. 

Cocaine. 


Tobacco. 

Digitalis. 

Conium. 

Belladonna. 

Stramonium. 

Gelsemium. 


Nauseants. 
Purgation. 
Venesection. 
Ice,  locally. 
Cold  Baths. 
Vegetable  Diet. 


Emmenagogues  ( emmayneeah ,  the  menses,  ago ,  I  move) — are  reme¬ 
dies  which  restore  the  menstrual  function,  either  directly  by  stimulation 
of  the  uterine  muscular  fibre,  or  indirectly  by  improving  the  blood  and 
toning  up  the  nervous  system.  The  direct  emmenagogues  are  ecbolic 
in  large  doses.  The  principal  members  of  this  class  are  enumerated  in 
the  following  list,  viz. : — 


48 


AGENTS  ACTING  ON  THE  GENERATIVE  APPARATUS. 


Direct  Emmenagogucs.  Indirect  Emtnenagogues. 


Ergot. 

Rue. 

Iron. 

Quinine. 

Apiol. 

Manganese. 

Savine. 

Borax. 

Cinnamon. 

Digitalis. 

Myrrh. 

Strychnine. 

Cantharis. 

Guaiacum. 

Aloetic  Purgatives. 

Pulsatilla. 

Polygonum  Hydrop. 

Cod-liver  Oil. 

Asafetida. 

Potass.  Permang. 

Hot  Hip-baths. 

Alcohol. 

Cimicifuga. 

Leeching  the  genitals. 

Indigo. 

Oxalic  Acid. 

Rubefacients  to  thighs. 

Hydr.  Biniod. 

Hedeoma. 

Tonic  Remedies. 

Caulophyllum. 

Origanum. 

Tansy. 

Viscum  Flavescens. 

Oxytocics  or  Ecbolics  (ockseus,  quick,  tokos,  childbirth ;  ekbolay, 
abortion), — are  agents  which  stimulate  the  muscular  fibres  of  the  gravid 
uterus  to  contraction,  and  produce  abortion.  In  small  doses  the  same 
remedies  are  emmenagogue  as  a  rule.  Their  mode  of  action  has  not  been 
clearly  made  known,  but  it  is  generally  believed  to  be  due  in  some  cases 
to  direct  stimulation  of  the  uterine  centre  in  the  cord,  in  others  to  con¬ 
gestion  of  the  uterus  producing  reflex  stimulation.  The  principal  oxytocics 
are  those  enumerated  in  the  following  list,  viz.  :  — 

Ergot.  Quinine.  Oil  of  Rue. 

,  Ustilago.  Borax.  Pilocarpine. 

Savine.  Cotton-root  Bark.  Viscum  Flavescens. 

Any  drastic  purgative,  or  gastro-intestinal  irritant,  may  produce  abortion  by  reflex 
action.  The  Volatile  Oils  act  in  this  manner,  also  Colocyiith  and  many  other  agents  used 
by  women  to  produce  abortion,  as  Tansy ,  Pennyroyal ,  etc.,  all  of  which  are  dangerous  to 
life  in  doses  sufficient  to  excite  the  action  of  the  gravid  uterus. 


Uterine  Depressants  lower  the  activity  of  the  nervo-muscular  appa¬ 
ratus  which  controls  the  uterine  contractions.  The  most  important  of 
these  agents  are  : — 


Opium, 

Bromides. 

Cannabis. 

Viburnum  Prunifolium. 


Chloral. 
Chloroform. 
Tartar  Emetic. 


Tobacco. 

Sulphate  of  Copper. 
Emetics. 

Piscidia  Erythrina. 


Uterine  Tonics  and  Alteratives, — are  medicines  which  are  con¬ 
sidered  to  have  such  specific  influence  over  the  uterus.  Authorities  differ 
very  much  regarding  the  value  of  these  agents,  but  those  enumerated  in 
the  following  list  are  generally  considered  to  have  considerable  value  in 
uterine  therapeutics,  viz.  :  — 


Uterine  Tonics. 

Potassium  Bromide. 
Potassium  Chlorate. 
Pulsatilla. 

Helonias  Dioica. 
Cimicifuga. 

Savine. 

Astringents  (locally. 


Uterine  Alteratives. 

Iodine. 

Iodoform. 

Iodized  Phenol. 

Glycerin. 

Hydrastis. 

Silver  Nitrate. 
Galvanism. 


Those  in  the  first  list,  except  Astringents,  are  used  internally ;  those  in  the  second  col¬ 
umn  as  topical  applications  to  the  uterine  cavity  or  cervix. 


AGENTS  ACTING  ON  THE  CUTANEOUS  SURFACE. 


49 


Galactagogues  ( galla ,  milk,  ago,  I  bring  away), — are  medicines 
which  increase  the  lacteal  secretion,  as  Ricinus,  Tea,  Anise,  Fennel, 
Potassium  Chlorate,  etc.  The  value  of  many  so-called  galactagogues  is 
extremely  doubtful,  the  best  being  the  local  application  of  the  leaves  of 
the  Castor-oil  plant  { Ricinus  communis),  and  a  good  black  Tea  internally, 
with  Milk,  Beer  or  Porter  as  a  beverage.  Pilocarpus  comes  the  nearest 
to  being  a  true  galactagogue,  but  its  influence  is  very  transient.  (Com¬ 
pare  Lactation  in  Part  III.) 


Agents  Acting  on  the  Cutaneous  Surface. 

Irritants  are  substances  which,  when  applied  to  the  skin,  produce  a 
greater  or  less  degree  of  vascular  excitement.  When  used  to  produce  a 
reflex  influence  on  a  part  remote  from  their  site,  they  are  termed  Coun¬ 
ter-Irritants,  and  may  be  subdivided  into  the  following  groups,  viz. : — 

Rubefacients  (. Rubefacio ,  I  make  red), — produce  temporary  redness  and 
congestion  of  the  skin,  unless  left  too  long  in  contact  with  the  surface, 
when  they  may  cause  exudation  between  the  cuticle  and  the  true  skin 
(vesicants),  or  may  destroy  the  tissue  and  form  a  slough  (escharotics). 
They  may  induce  muscular  atrophy. 

Vesicants ,  Epispastics  or  Blisters , — produce  decided  inflammation  of 
the  skin,  and  outpouring  of  serum  between  the  epidermis  and  derma. 
Cantharides  is  the  agent  generally  used  for  this  purpose. 

Pustulants , — affect  isolated  parts  of  the  skin,  as  the  orifices  of  the  sudo¬ 
riferous  glands,  giving  rise  to  pustules. 

The  following  list  embraces  the  principal  agents  and  measures  belong¬ 
ing  to  these  groups,  viz.  : — 


Rubefacients . 

Rubefacients. 

Vesicants. 

Mustard. 

Oil  of  Cajuput. 

Cantharides. 

Capsicum. 

Oil  of  Turpentine. 

Euphorbium. 

Camphor. 

Volatile  Oils. 

Mezereon. 

Ammonia. 

Pitch. 

Iodine. 

Mezereon. 

Friction. 

Rhus  Toxicodendron. 

Arnica. 

Hot  Water. 

Ammonia  (the  confined  vapor). 

Alcohol. 

Glacial  Acetic  Acid. 

Ether. 

Pustulants. 

Volatile  Oil  of  Mustard. 

Chloroform. 

Croton  Oil. 

/  Boiling  Water. 

\  Corrigan’s  Hammer. 

Iodine. 

Tartar  Emetic. 

Menthol. 

Ipecacuanha. 

Silver  Nitrate. 

Escharotics  or  Caustics  ( eskahrah ,  a  slough  or  scab ;  kaioh ,  I 
burn),  are  agents  which  destroy  a  tissue  to  which  they  are  applied,  and 
produce  a  slough.  They  act  usually  in  one  of  three  modes,  viz.  :  — 

1.  By  abstracting  the  water  of  the  tissue. 

2.  By  combining  with  the  albumen  of  the  part. 

3.  By  corrosive  oxidation. 

4 


50 


AGENTS  ACTING  ON  THE  CUTANEOUS  SURFACE. 


The  principal  escharotics  are  enumerated  in  the  following  list,  the 
numbers  affixed  to  each  pointing  out  its  mode  of  action  as  stated  above. 


Mineral  Acids.1 
Glacial  Acetic  Acid.1 
Carbolic  Acid.1 
Chromic  Acid.3 
Arsenious  Acid.1 
Antimony  Chloride.1 


Caustic  Potash.1 
Caustic  Soda.1 
Lime. 1 

Dried  Alum.2 
Silver  Nitrate.2 
Copper  Sulphate.2 


Mercuric  Chloride.2 
Mercuric  Oxide.2 
Mercuric  Nitrate.2 
Zinc  Sulphate.2 
Zinc  Chloride.2 
Bromine.3 


Astringents  (ad,  to,  stringo,  I  bind), — are  agents  which  produce 
contraction  of  muscular  fibre  and  condensation  of  other  tissues,  the  first 
probably  by  direct  irritation,  the  second  by  precipitating  its  albumen  and 
gelatin.  They  also  lessen  secretion  from  mucous  membranes.  The 
principal  astringents  may  be  enumerated  as  follows,  viz.  :  — 


Acids. 

Alcohol. 

Alum. 

Chalk. 

Lime. 
Creasote. 
Carbolic  Acid. 


Tannic  Acid. 
Gallic  Acid. 
Catechu. 
Galls. 

Kino. 

Oak-bark. 

Uva-Ursi. 


Bismuth  Subnitrate,  etc. 
Cadmium  Sulphate. 
Copper  Sulphate. 

Ferric  Chloride. 

Lead  Acetate. 

Silver  Nitrate. 

Zinc  Sulphate. 


Sulphuric  Acid,  Gallic  Acid  and  Acetate  of  Lead  are  examples  of  Remote  Astringents, 
acting  on  internal  organs  through  the  blood.  Those  which  affect  the  part  to  which  they 
are  applied  are  Local  Astringents,  and  include  most  of  those  enumerated  above. 


Styptics  and  Hemostatics  ( steuphoh ,  I  contract;  haimah ,  blood, 
stahsis,  a  standing), — are  agents  which  arrest  hemorrhage,  Styptics  being 
those  which  are  applied  locally,  and  Hemostatics  those  which  are  ad¬ 
ministered  internally.  Some  of  the  former  act  mechanically,  by  promoting 
the  formation  of  a  clot  in  the  mouths  of  the  bleeding  vessels ;  others  cause 
the  vessels  themselves  to  contract,  checking  the  flow  of  blood.  The 
principal  members  of  this  class  are  the  following-named  :  — 


Styptics. 

Acids. 

Alum. 

Cautery. 

Collodion. 

Ferric  Chloride. 

Ferric  Sulphate. 

Silver  Nitrate. 


Cold. 

Matico. 

Spider’s-web. 

Tannic  Acid. 

Lead  Acetate. 

Zinc  Sulphate. 
Vegetable  Astringents. 


Hemostatics. 

Ergot. 

Digitalis. 

Gallic  Acid. 

Lead  Acetate. 

Dilute  Sulphuric  Acid. 

Ipecacuanha, 

Hamamelis. 

Oil  of  Turpentine. 


Emollients  ( Emollio ,  I  soften), — are  substances  which  soften  and  relax 
the  tissues  to  which  they  are  applied.  They  relieve  tension,  dilate  vessels, 
diminish  pressure  on  the  nerves,  and  protect  inflamed  surfaces  from  the 
air  and  from  friction.  The  principal  articles  which  may  classed  under 
this  heading  are  the  following  :  — 


Hot  Fomentations.  Linseed  Oil. 

Poultices.  Olive  Oil. 

Glycerin.  Spermaceti. 

Lard.  Almond  Oil. 


Petroleum. 
Soap  Liniment. 
Starch. 

Cacao  Butter. 


AGENTS  ACTING  ON  MICROBES,  GASES,  FERMENTS. 


51 


Demulcents  (. Demulceo ,  I  soothe), — are  substances  generally  of  a 
mucilaginous  nature,  which  soothe  and  protect  the  parts  to  which  they 
are  applied.  This  term  is  generally  used  for  substances  employed  for 
mucous  membranes,  and  the  term  Emollients  for  similar  agents  used  on  the 
skin.  The  chief  agents  belonging  to  this  class  are  :  — 


Acacia. 

Cetraria. 

Barley. 

Liquorice. 


Starch. 

Glycerin. 

Flaxseed. 

Gelatin. 


Honey. 

Marsh -mallow. 
White  of  Egg. 
Almond  Oil. 


Olive  Oil. 
Isinglass. 
Tragacanth. 
Bland  Oils. 


Protectives, — are  agents  of  a  mechanical  nature  employed  to  cover 
and  protect  an  injured  part  from  the  air,  water,  etc.  Collodion  and 
Gutta-percha  are  those  in  general  use,  but  certain  plasters,  as  the  Adhesive, 
the  Lead  or  the  Soap  Plaster,  may  be  employed  for  this  purpose,  also 
Cotton  Wool. 


Agents  Acting  on  Microbes,  Gases,  Ferments,  etc. 


Antizymotics  (anti,  against,  zeumohsis ,  fermentation), — are  agents 
which  arrest  fermentative  processes,  which  may  depend  upon  the  action 
of  organic  fer??ients  (enzymes),  as  disease,  ptyalin,  pepsin,  etc.,  or  upon 
that  of  organized  ferments,  as  the  yeast-plant,  bacteria,  etc.  The  Anti- 
zymotics  may  be  subdivided  into  two  groups,  Antiseptics  and  Disinfectants. 

Antiseptics  (anti,  against,  saypteekos,  putrefaction), — prevent  or  retard 
septic  decomposition,  by  destroying  the  bacilli  which  produce  it,  or  by 
arresting  their  development.  The  chief  antiseptics  are  :  — 


Mercuric  Chloride. 

Mercuric  Iodide. 

Mercuric  Oxide. 

Potassium  Permanganate. 
Sulphurous  Acid. 

Sulphites  and  Hyposulphites. 
Sulpho-  carbolates. 


Potassium-Chlorate. 
Zinc  Chloride. 
Carbolic  Acid. 
Creasote. 

Alcohol. 

Eucalyptol. 


Quinine. 

Salicin. 

Thymol. 

Borax. 

Chlorine. 

Hydronaphthol, 

etc. 


Disinfectants  destroy  the  specific  germs  of  communicable  diseases, 
many  of  which  belong  to  the  microbe  class,  hence  many  antiseptics  are 
also  disinfectants.  They  act  in  several  modes,  some  as  oxidizants,  others 
by  combining  with  albumen,  others  by  chemical  combination  forming 
substitution-compounds,  others  by  arresting  molecular  changes,  and  still 
others  by  altering  the  reaction  of  the  media  containing  the  germs.  The 
principal  disinfectants  are  : — 


Heat,  230°-250°  F. 
Sulphurous  Acid  Gas. 
Nitrous  Acid  Gas. 
Chloride  of  Lime. 
Mercuric  Chloride. 
Aluminium  Chloride. 


Zinc  Chloride. 

Carbolic  Acid. 

Potass.  Bichromate. 
Potass.  Permanganate. 
Iodine. 

Chlorine. 


Bromine. 

Lime. 

Osmic  Acid. 
Ferrous  Sulphate. 
Zinc  Sulphate. 


Condy's  Fluid  is  an  aqueous  Solution  of  Potassium  Permanganate,  2  parts  in  100,  or 
gr.  176  in  25  xx.  Burnett' s  Fluid  is  a  solution  of  Zinc  Chloride,  containing  about  50  per 
cent,  of  the  salt,  and  equivalent  to  the  official  Liquor  Zinci  Chloridi.  Labarraque' s 
Solution  is  the  official  Liquor  Sodce  Chloratae. 


52 


AGENTS  ACTING  UPON  EACH  OTHER. 


Deodorants, — are  agents  which  destroy  foul  odors.  The  Volatile 
Deodorants  are  chiefly  oxidizing  and  deoxidizing  substances,  acting 
chemically  on  the  obnoxious  gases ;  while  the  Non-volatile  ones  are  mainly 
absorbents,  which  condense  and  decompose  the  effluvia.  The  deodorants 
in  general  use  are  the  following  named  :  — 

Chlorine  Gas.  Peroxide  of  Hydrogen.  Charcoal. 

Sulphurous  Acid  Gas.  Potassium  Permanganate.  Earth,  Lime. 

Nitrous  Acid  Gas.  Ozone.  Ferrous  Sulphate. 


Parasiticides  ( parrahseetos ,  a  parasite,  ccedo,  I  kill), — are  agents 
which  destroy  the  animal  and  vegetable  parasites  found  upon  the  human 
body.  They  are  generally  applied  in  the  form  of  lotions,  ointments  or 
oleates,  and  include  the  following  substances,  viz. :  — 


Sulphur. 
Sulphides. 
Sulphurous  Acid. 
Iodide  of  Sulphur. 
Iodine. 


Mercury. 

Ammoniated  Mercury. 
Mercuric  Chloride. 
Mercuric  Nitrate. 
Mercuric  Oxide. 


Carbolic  Acid. 
Petroleum. 
Storax. 
Staphisagria. 
Balsam  of  Peru. 


Agents  Acting  upon  Each  Other. 

Antidotes  and  Antagonists  are  terms  frequently  confounded  with 
each  other,  and  rarely  defined  with  sufficient  lucidity  to  enable  a  clear 
distinction  to  be  drawn  between  them.  An  Antidote  is  a  substance  which 
affects  a  poison  either  physically  or  chemically,  or  both,  and  in  such  a 
manner  as  to  remove  the  poison  from  the  body  or  to  form  with  it  an 
insoluble  salt  or  an  inert  compound,  with  the  object  of  preventmg  its 
toxic  action  upon  the  organism. 

Thus,  Tannic  Acid  is  an  antidote  to  Digitalis ,  as  it  forms  therewith  a  compound  (tan- 
nate),  which  is  soluble  with  difficulty  and  therefore  comparatively  innocuous.  But  as 
this  tannate  is  not  wholly  inert,  another  antidotal  measure  must  be  employed,  viz. : — evacu- 
tion  of  the  stomach,  which  may  be  accomplished  by  the  administration  of  Zinc  Sulphate 
or  any  other  emetic,  or  by  the  use  of  a  stomach  pump. 

Antagonists,  on  the  other  hand,  are  agents  which  directly  oppose  each 
other  in  some  or  all  of  their  physiological  actions,  and  may  be  used 
against  each  other  to  cowiteract  their  effects  on  the  system.  Antidotal 
action  takes  place  in  the  alimentary  canal,  and  is  applicable  to  vegetable 
as  well  as  mineral  poisons.  Antagonism  takes  place  in  the  blood  and 
tissues,  and  so  far  as  antagonistic  drugs  are  concerned,  is  applicable 
almost  wholly  to  vegetable  poisons,  as  these  produce  their  effects  after 
absorption.  The  heart  and  respiratory  apparatus  are  the  principal  objec¬ 
tive  points  for  the  antagonism  of  drugs,  but  the  spinal  cord,  the  cerebrum, 
muscular  tissue  and  the  glandular  system  are  also  affected  by  most  of 
them. 

Antagonistic  Measures  are  such  proceedings  as  may  tend  to  antagonize 
certain  effects  of  poisons,  and  include  Artificial  Respiration, — Faradism 
of  the  respiratory  muscles, — Constant  motion, — Douching, — Rest,  etc. 


AGENTS  ACTING  UPON  EACH  OTHER. 


53 


Thus,  to  refer  to  the  case  of  Digitalis  again,  Saponin  and  Senegin  are  its  most  complete 
physiological  antagonists,  their  counteraction  extending  throughout  the  whole  range  of  its 
effects.  Aconite  and  Alorphine  antagonize  its  cardiac  action,  the  former  being  considered 
the  best  antagonist  to  the  effects  of  large  doses,  and  the  latter  to  those  of  its  long-con¬ 
tinued  use.  Alcohol  is  also  indicated  in  Digitalis-poisoning,  and  absolute  Rest  in  the 
recumbent  posture  is  an  antagonistic  measure  of  great  importance,  by  reason  of  the  liability 
of  the  heart  to  cease  its  action  on  assuming  the  erect  position,  when  much  lowered  by  the 
drug. 

In  the  treatment  of  poisoning,  whether  from  mineral  or  vegetable  sub¬ 
stances,  the  first  indication  is  to  administer  the  appropriate  chemical  anti¬ 
dote,  so  as  to  render  the  poison  harmless  or  comparatively  so.  Next,  the 
stomach  should  be  emptied  and  washed  out,  lest  the  newly-formed  com¬ 
pound  be  absorbed  after  a  time,  and  to  remove  any  of  the  poison  which 
may  have  escaped  the  action  of  the  antidote.  Next,  the  antagonist  should 
be  administered,  in  order  to  counteract  the  effects  of  such  portion  of  the 
poison  as  may  have  been  absorbed.  Lastly,  the  appropriate  antagonistic 
measures  should  be  employed  to  sustain  the  action  of  any  organic  function 
which  may  show  signs  of  failure.  In  most  cases  of  alkaloidal  poisoning 
absorption  has  proceeded  so  far  before  assistance  is  obtained  that  antidotes 
are  of  no  value,  and  reliance  can  only  be  placed  upon  the  physiological 
antagonist  and  such  supporting  measures  as  will  tend  to  maintain  vitality 
until  the  poison  has  been  eliminated  by  the  natural  channels. 

In  the  following  pages  the  antidotes  and  antagonists  for  each  poisonous 
substance  in  the  Materia  Medica  are  enumerated  under  their  proper  titles, 
and  in  the  Appendix  the  same  agents  are  tabulated  in  a  suitable  form  for 
reference.  A  few  examples  are  appended  below,  to  illustrate  the  princi¬ 
ples  above  stated,  and  to  point  out  some  of  the  most  prominent  instances 
of  physiological  antagonism  at  present  known. 

Atropine ,  Belladonna ,  etc. 

Antidotes , — Tannic  Acid,  to  form  an  insoluble  tannate.  Zinc  Sulphate,  as  an  emetic, 
or  Apomorphine  hypodermically,  or  the  stomach-pump.  Purgation.  Antagonists, — 
Muscarine.  Physostigmine.  Pilocarpine.  Morphine.  Quinine.  Aconite.  A?iiagonistic 
Measures , — Artificial  respiration.  Faradism  of  respiratory  muscles. 

Strychnine ,  Nux  Vomica  and  Ignatia. 

Antidotes, — Animal  Charcoal  suspended  in  water.  Emesis,  as  above-mentioned.  An¬ 
tagonists, — Chloral,  or  Chloroform,  to  muscular  relaxation.  Curare.  Nitrite  of  Amyl. 
Bromide  of  Potassium.  Antagonistic  Measures, — Artificial  respiration.  Perfect  quiet. 

Morphine  and  Opium. 

Antidotes,—  Emesis  or  stomach-pump.  Antagonists, — Atropine.  Strychnine.  Black 
Coffee.  Caffeine.  Ammonia,  inhaled.  Amyl  Nitrite.  Antagonistic  Measures, — Cold 
douche.  Artificial  respiration.  Continued  movement. 

Potassium  Cyanide. 

Antidotes, — Sulphate  of  Iron,  to  form  Prussian  Blue.  Emesis.  Antagonists, — Atro¬ 
pine.  Ammonia.  Alcohol.  Antagonistic  Measures, — Artificial  respiration.  Faradism. 

Arsenic  and  its  Compou?ids. 

Antidotes, — Hydrated  Oxide  of  Iron.  Dialyzed  Iron.  Magnesia.  Chalk.  Lime-water. 
Emetics,  or  stomach-pump.  Oil  or  Mucilage  to  protect  the  mucous  membranes.  Diluents. 
Iodide  of  Potassium,  to  promote  elimination.  Antagonists, — none. 


DOSAGE  OF  MEDICINES. 


The  Doses  given  throughout  this  book  are  for  adults ;  for  children  the 
following  rule  (Young’s)  will  be  found  the  most  convenient.  Add  12  to 
the  age  and  divide  by  the  age,  to  get  the  denominator  of  a  fraction,  the 
numerator  of  which  is  1.  Thus,  for  a  child  two  years  old,  2+2u  =  7, 
and  the  dose  is  one-seventh  of  that  for  an  adult.  Of  powerful  narcotics 
scarcely  more  than  one-half  of  this  proportion  should  be  used.  Of  mild 
cathartics,  two  or  even  three  times  the  proportion  may  be  employed. 

Children  bear  Opiates  badly : — but  on  the  other  hand  they  stand  comparatively  large 
doses  of  several  other  drugs;  such  being  Arsenic,  Belladonna,  Calomel,  Ipecacuanha, 
Squills,  Rhubarb,  and  several  other  purgatives. 

For  Hypodermic  Injection,  the  dose  should  be  two-thirds  or  three-fourths  of  that 
used  by  the  mouth  ;  by  rectum  five-fourths  of  the  same.  Strychnine  acts  more  actively 
when  given  per  rectum  than  by  the  stomach. 

Conditions  which  modify  the  action  of  medicines,  and  therefore 
affect  their  dosage,  are — age,  body-weight,  temperament  and  idiosyncrasy, 
drug-habits,  intervals  between  doses,  time  of  administration,  condition  of 
the  stomach,  temperature  of  the  body,  cumulative  drug-action,  mode  and 
form  of  drug-administration,  disease,  climate,  race,  etc. 

The  Dosage  of  Medicines  is  the  weakest  part  of  the  therapeutic  armament,  the  flaw  in 
our  weapons  which  may  be  the  cause  of  their  failure  at  any  moment,  perhaps  the  most 
critical  one  for  a  life.  If  the  accumulated  rubbish  of  ages,  which  has  been  called  thera¬ 
peutical  knowledge,  is  ever  to  be  given  scientific  shape,  ever  placed  in  process  of  becoming 
a  science,  the  question  of  dosage  must  form  one  of  the  principal  corner-stones  in  the 
foundation.  Drugs  have  widely  differing  actions  on  the  human  organism  in  health  and 
in  disease,  according  as  they  are  administered  in  different  doses,  in  different  menstrua,  and 
during  different  conditions  of  the  subject’s  health.  This  difference,  when  between 
extremes  of  dosage,  is  often  so  wide  as  to  separate  actions  directly  contrary  to  each  other, — 
that  of  the  very  large  one  opposing  the  action  of  the  very  small  dose  : — a  truth  hidden  by 
one  set  of  dogmatists  under  their  former  “  doctrine,”  now  “  rule,”  of  “  similars,”  and 
avoided  by  the  great  mass  of  the  medical  profession,  through  dread  of  the  bogy-name, 
“  irregular.” 

A  thoroughly-prepared  materia  medica  of  half-a-dozen  standard  drugs,  such  as  Aconite, 
Arsenic,  Belladonna,  Mercury,  Opium  and  Quinine, — based  upon  their  actions  and  uses 
in  different  doses  and  under  different  states  of  the  organism, — would  be  of  more  real 
value  to  the  physician,  who  wishes  to  do  his  work  accurately  and  with  his  eyes  open,  than 
all  the  contents  of  the  dispensatories,  plus  the  entire  literature  of  the  “  new  remedies,” 
and  every  symptom  in  the  ten  quarto  volumes  of  the  largely  discredited  and  partly 
repudiated  homoeopathic  Materia  Medica. 

If  our  medical  students  would  each  devote  but  one  month,  of  his  annual  college 
vacation,  to  the  personal  investigation  of  some  one  feature  of  the  action  of  some  one 
drug,  under  such  safe-guards  against  error  as  would  secure  the  acceptance  of  the  resulting 
observations, — what  a  mine  of  therapeutic  gold  would  soon  yield  its  solid  truth  to  eager 
eyes!  Formally  laid  down  by  Haller  fsee  ante,  page  1 8 )  in  1755,  cultivated  to  some 
extent  by  Alexander  in  1768,  Crumpe  in  1793.  Thommassina,  Curtis,  etc., — urged  by 
John  Hunter,  Sir  Thos.  Watson,  Dr.  King  Chambers,  and  many  other  luminaries  of  the 
medical  profession, — the  scientifically  guarded  proving  of  drugs  on  the  human  organism 
has  lain,  like  the  similar  work  of  Jenner,  neglected  all  these  years,  waiting  for  another 
Koch,  to  re-inaugurate  the  work. 


54 


PART  I. 


MATERIA  MEDICA  AND  THERAPEUTICS. 


ABRUS,  Jequirity  (Unofficial), — is  the  seed  of  Abrus precatorius ,  or 
Wild  Liquorice,  a  plant  of  the  nat.  ord.  Leguminosae,  indigenous  in 
India,  but  growing  wild  in  most  tropical  countries.  The  seeds  are  small, 
hard,  of  a  bright  scarlet  color,  with  a  black  spot  around  the  hilum,  and 
contain  an  alkaloid,  some  fixed  oil,  sugar,  a  principle  resembling  Gly- 
cyrrhizin,  and  Abide  Acid ,  C12H24N30  ;  but  neither  of  these  is  believed  to 
be  the  active  principle. 

Preparation. 

Infusum  Abri,  Infusion  of  Jequirity  (Unofficial), — prepared  by  macerating  three  pow¬ 
dered  seeds  in  g  ss  of  cold  water  for  twelve  hours,  adding  g  ss  of  boiling  water,  and 
filtering  when  cold.  It  should  be  used  while  fresh,  as  after  two  or  three  days  it  is 
worthless. 

Another  formula  contains  gr.  ix  of  Jequirity  to  the  g ,  with  gr.  iv  of  Boric  Acid  to 
prevent  decomposition. 


Physiological  Action  and  Therapeutics. 

Jequirity  seeds,  when  moistened  with  water,  become  highly  poisonous. 
If  applied  to  the  conjunctiva,  a  severe  inflammation  is  set  up,  with  oedema 
and  false  membrane,  ulceration  of  the  cornea,  and  extension  to  the  lids, 
face,  neck  and  submaxillary  glands.  Inserted  into  a  wound  in  cattle, 
they  cause  death  in  a  few  hours.  The  irritant  action  is  believed  to  result 
from  the  presence  in  the  seeds  of  some  ferment,  or  perhaps  great  numbers 
of  gonidia,  which  develop  rapidly  on  a  suitable  tissue.  The  infusion,  in 
a  short  time,  swarms  with  bacteria. 

Jequirity  is  used  for  the  purpose  of  producing  a  purulent  or  croupous 
conjunctivitis,  by  which  to  destroy  old  granulations  (trachoma)  and  pan- 
nus.  A  mild  infusion  is  applied  to  the  eye  two  or  three  times  a  day  for 
two  days,  and  followed  by  weak  solutions  of  Alum  or  Borax.  This  should 
be  repeated  after  three  weeks  if  necessary.  An  emulsion  of  the  seeds  in 
water  is  a  useful  application  to  unhealthy  ulcers  and  lupus. 

55 


56 


ABSINTHIUM - ACETANILIDE. 


ABSINTHIUM,  Wormwood, — the  leaves  and  tops  of  Artemisia 
Absinthium ,  a  perennial  garden  herb  of  the  nat.  ord.  Composite, 
indigenous  in  Europe,  but  cultivated  in  the  United  States.  The  leaves 
are  about  2  inches  long,  hoary,  silky-pubescent,  petiolate,  pinnately  two 
or  three-cleft ;  heads  numerous,  with  small,  pale-yellow  florets,  odor 
aromatic,  taste  persistently  bitter.  It  contains  a  volatile  oil  and  a  bitter 
principle,  Absinthin.  Dose,  gr.  xx-xl,  in  infusion.  There  are  no  official 
preparations,  except  Vinum  Aromaticum  (see  Alcohol),  of  which  Absin¬ 
thium  constitutes  one  per  cent. 

Absinthe ,  the  French  liqueur,  is  an  alcoholic  solution  of  the  oil,  containing  also  extracts 
of  Anise,  Marjoram,  and  Angelica.  Its  continued  use  produces  various  nervous  symptoms, 
morning  nausea  and  vomiting,  also  a  tendency  to  epileptiform  convulsions. 

The  bitter  constituent  of  Absinthium  is  stimulant  to  the  digestive 
organs,  but  the  oil  is  a  narcotic  poison,  increases  the  cardiac  action,  and 
produces  tremor,  stupor, epileptiform  convulsions,  involuntary  evacuations, 
and  stertorous  breathing.  It  is  but  little  used  in  medicine,  and  only  as  a 
stomachic  tonic  in  dyspepsia. 


ACACIA,  Gum  Arabic, — is  a  gummy  exudation  from  A cacia  Verek, 
a  small  tree  of  the  nat.  ord.  Leguminosae,  indigenous  in  Africa — also  from 
other  species  of  Acacia.  It  occurs  in  spheroidal  tears  of  various  sizes, 
breaking  with  a  glassy,  sometimes  iridescent  fracture  ;  insoluble  in  alcohol, 
but  soluble  in  water,  forming  a  thick  and  mucilaginous  liquid.  It  consists 
of  Arabia  or  Arabic  Acid ,  C12H22On,  combined  with  calcium,  potassium, 
and  magnesium. 

Preparations. 

Mucilago  Acacia , — has  of  Acacia  34,  Water  to  100  parts.  It  should  not  be  prescribed 
with  tinctures  or  spirits  except  in  very  small  quantity.  Dose,  indefinite. 

Syrupus  Acacia , — has  of  the  Mucilage  25,  Syrup  75.  Should  be  freshly  made.  Dose, 
indefinite. 

Acacia  enters  into  the  composition  of  Mistura  Amygdalae,  Mistura  Glycyrrhizae  Com- 
posita,  Pulvis  Cretae  Compositus,  Trochisci  Cretae,  Trochisci  Cubebae,  and  Trochisci 
Glycyrrhizae  et  Opii. 

Gum  Arabic  has  no  activity  except  the  negative  one  of  a  demulcent, 
and  is  chiefly  used  in  coughs,  sore  throats,  catarrhal  inflammation  of  the 
stomach  and  intestines,  and  irritant  poisoning.  It  is  much  employed  in 
pharmacy  to  suspend  insoluble  powders  in  mixtures,  for  which  purpose 
the  mucilage  is  generally  used. 

ACETANILIDE, — Antifebrin.  Like  the  major  number  of  the 
newest  antipyretics,  which  are  related  either  to  Chinoline  or  to  Phenol, 
Acetanilide  is  a  derivative  of  Anilin ,  from  which  it  is  obtained  by  the 
action  thereon  of  glacial  acetic  acid,  substituting  the  organic  radical 


ACETANILIDE.  5  J 

Acetyle  for  an  atom  of  hydrogen.  Chemically,  it  has  the  name  Acetani¬ 
lide  or  Phenyl-acetamide ,  and  the  formula  C6H5.C2H3O.NH. 

The  name  Antifebrin  is  copyrighted  by  its  original  promoters  for  trade  purposes,  and 
therefore  should  be  dropped  from  professional  usage. 

It  is  a  pure  white  and  crystalline  powder,  of  neutral  reaction,  odorless, 
but  of  slightly  burning  taste.  It  melts  at  2350  F.,  and  distils  at  5 5 70  F., 
— is  soluble  freely  in  alcohol,  wine,  etc., — but  very  sparingly  (1  in  190) 
in  cold  water,  and  a  little  more  readily  in  hot  water.  It  is  a  neutral  sub¬ 
stance,  being  unaffected  by  hydrochloric  or  sulphuric  acids,  and  ordinarily 
so  by  alkalies. 

The  dose  ranges  from  gr.  ij  to  gr.  xv,  repeated  twice,  but  not  exceeding  gr.  xxx  in  the 
24  hours.  As  much  as  5jj  has  been  swallowed  without  ill  effects  supervening.  It  may 
be  administered  in  the  very  convenient  form  of  compressed  tablets; — also  in  powders,  or 
in  dilute  alcoholic  solution,  gj  may  be  dissolved  in  3  ivss  of  brandy,  to  which,  if  we 
add  3  vj  each  of  simple  syrup  and  water,  we  get  a  six-ounce  mixture,  of  which  a  table¬ 
spoonful  ( ,3  ss)  contains  5  grains  of  Acetanilide,  a  fair  adult  dose.  As  an  antipyretic,  gr. 
iij  may  be  administered  every  ^  to  ]/2  hour,  until  12  or  15  grains  have  been  given,  which 
will  usually  be  a  sufficient  quantity,  especially  if  given  at  the  acme  of  the  febrile  move¬ 
ment. 


Physiological  Action. 

Acetanilide  is  a  very  efficient  antipyretic,  besides  being  strongly  anal¬ 
gesic  and  antispasmodic,  lessening  the  reflex  action  of  the  spinal  cord,  and 
inhibiting  the  sensibility  of  sensory  nerves.  It  raises  the  arterial  tension 
somewhat,  and  slows  the  heart  in  a  corresponding  degree. 

Compared  with  the  action  of  Antipyrine,  the  effect  of  Acetanilide  on 
the  body-temperature  is  manifested  more  slowly  (1  hour  against  */£  hour), 
— but  lasts  a  longer  time  (6  against  2  hours).  It  is  markedly  diuretic, 
somewhat  diaphoretic ;  is  a  cerebral,  muscular  and  vaso-motor  stimulant, 
and  leaves  no  ill  after-effects ; — while  Antipyrine  is  powerfully  diaphoretic, 
a  cerebral  sedative,  and  produces  great  depression.  Furthermore,  Ace¬ 
tanilide  produces  the  same  degree  of  reduction  of  body-temperature  as 
Antipyrine,  with  the  ingestion  of  but  th  the  dose;  and,  like  the  latter 
agent,  it  has  little  or  no  effect  on  the  normal  temperature,  and  its  con¬ 
tinued  use  begets  tolerance  of  its  action. 

Its  Antipyretic  action  corresponds,  in  degree  and  in  duration,  to  the 
size  of  the  dose, — the  pulse  is  slowed,  and  quiet  sleep  often  follows.  There 
is  neither  vomiting  nor  diarrhoea  afterwards,  but  there  is  a  tendency,  in 
some  few  cases,  to  collapse,  with  chills  and  cyanosis,  especially  the  latter, 
during  the  period  of  depressed  temperature. 

A  toxic  dose  destroys  the  ozonizing  function  of  the  blood,  decolorizing 
it,  and  forming  methyl-haemoglobin.  The  heart,  liver  and  kidneys  are 
found  in  a  state  of  acute  fatty  degeneration,  in  animals  poisoned 
thereby.  Its  continued  use  in  large  doses  is  highly  injurious  to  the  blood, 
especially  in  diseases  (as  typhoid  fever)  which  are  themselves  destructive 
to  the  blood. 


58 


ACIDUM  ACETICUM. 


Therapeutics. 

Besides  being  one  of  the  most  efficient  antipyretics,  this  drug  has 
marked  analgesic  and  antispasmodic  powers;  and  these,  together  with  its 
great  advantages  of  a  small  dose,  efficiency  and  safety,  and  the  absence  of 
the  severe  rigors  and  cardiac  depression  which  mark  the  chinoline  deriva¬ 
tives, — combine  to  make  it  one  of  a  wider  therapeutical  range  than  most 
of  its  analogues.  It  is  especially  useful  in  phthisis  and  typhoid  fever,  for 
the  hyperpyrexia,  thereby  relieving  wakefulness,  lessening  delirium,  and 
upholding  a  failing  heart ;  but  if  long  used  in  large  doses  in  the  latter 
disease  it  may  increase  the  liability  to  serious  sequelae,  especially  periostitis 
of  the  ribs,  gangrene  of  tissues,  etc.  For  the  pains  of  locomotor  ataxia, 
and  in  those  of  rheumatic  origin,  sciatica,  lumbago,  etc.,  it  is  a  most 
efficient  remedy.  In  acute  rheumatism,  it  is  highly  praised  ;  though  its 
efficiency  is  herein  disputed  by  Salol.  In  epilepsy,  it  is  being  tried,  with 
the  view  of  moderating  reflex  excitability. 

ACIDUM  ACETICUM,  Acetic  Acid, — is  a  liquid  composed  of 
36  per  cent,  of  absolute  Acetic  Acid,  HC2H30.2,  and  64  per  cent,  of  water. 
It  is  a  clear,  colorless  liquid,  of  a  distinctly  vinegar  odor,  a  purely  acid 
taste,  and  a  strongly  acid  reaction;  sp.  gr.  1.048  at  590  F.  ;  miscible  in 
all  proportions  with  water  and  alcohol,  and  wholly  volatilized  by  heat. 
It  is  prepared  from  wood  by  destructive  distillation  and  purification. 
Acetic  Acid  is  also  official  in  two  other  degrees  of  concentration,  viz.  :  — 

Acidum  Aceticum  Glaciate,  Glacial  Acetic  Acid,  HC2H302, — is  nearly  or  quite  abso¬ 
lute  Acetic  Acid,  solid  below  590  F.,  above  that  temperature  a  colorless  liquid  of  sp.  gr. 
1.056  to  1.058.  Is  strongly  escharotic  and  only  used  locally. 

Acidum  Aceticum  Dilutum ,  Diluted  Acetic  Acid, — consists  of  Acetic  Acid  17,  Dis¬ 
tilled  Water  83  parts,  contains  6  per  cent,  of  absolute  Acetic  Acid,  and  has  a  sp.  gr.  of 
1.0083.  Dose,  3j-ij. 

Acetum ,  Vinegar  (Unofficial), — is  an  impure  diluted  Acetic  Acid,  produced  by  the 
acetous  fermentation  of  any  liquid  susceptible  of  the  vinous  fermentation. 

Diluted  Acetic  Acid  is  used  in  the  preparation  of  the  four  official  Aceta  (Vinegars). 

Physiological  Action. 

Acetic  Acid,  like  the  other  vegetable  acids,  in  concentrated  form  is 
escharotic  and  produces  gastro-enteritis  if  swallowed.  In  dilute  form  it 
acts  as  a  refrigerant,  diminishing  thirst  and  allaying  restlessness.  It 
forms  salts  in  the  stomach,  thus  enters  the  blood,  and  is  there  oxidized, 
producing  carbonic  acid,  and  thereby  increasing  the  acidity  of  the  urine. 
It  is  also  diuretic.  Long  used,  it  causes  emaciation  and  poverty  of  the 
blood,  producing  a  general  scorbutic  condition.  It  is  hemostatic  and 
anthelmintic,  and  the  vapor  inhaled  causes  reflex  contraction  of  the  vessels 
and  raises  the  blood-pressure. 

Therapeutics. 

The  glacial  acid  is  used  as  a  caustic  in  many  skin  affections,  as  warts, 
condylomata,  etc.,  and  to  destroy  the  parasite  in  ringworm  and  pityriasis. 


ACIDUM  BORICUM. 


59 


It  has  been  employed  locally  in  carcinoma,  with  the  view  of  dissolving 
the  supposed  cancer-cells.  The  dilute  acid  is  used  locally  in  superficial 
inflammations  of  the  skin,  and  may  be  sponged  over  the  body  to  check 
perspiration  and  reduce  the  surface  temperature  in  fevers.  It  is  often 
administered  internally  to  reduce  obesity,  which  it  does  by  impairing 
digestion.  Locally,  it  may  be  employed  to  arrest  slight  hemorrhages, 
as  epistaxis ;  and  is  occasionally  used  by  enema  for  the  destruction  of 
ascarides. 


ACIDUM  BORICUM,  Boric  or  Boracic  Acid,  H2Bo3, — is  a 

weak  acid  occurring  in  transparent,  colorless,  six-sided  plates,  of  unctuous 
touch,  odorless,  of  a  cooling  and  slightly  bitter  taste,  soluble  in  25  of 
water  and  in  15  of  alcohol  at  590  F.,  in  3  of  boiling  water  and  in  5  of 
boiling  alcohol.  It  is  produced  from  Borax  by  the  action  of  Sulphuric 
Acid.  Dose,  gr.  v-xx.  There  is  only  one  official  Borate,  viz.  :  — 

Sodii  Boras,  Borate  of  Sodium,  Borax,  Na2B407,  ioH20, — colorless, 
transparent  prisms,  of  cooling  and  sweetish,  afterwards  alkaline  taste  and 
alkaline  reaction,  soluble  in  16  of  water  at  590  F.,  and  in  0.5  of  boiling 
water ;  insoluble  in  alcohol.  Occurs.native  in  ancient  lake  beds  in  various 
parts  of  the  world.  Dose,  gr.  v-xl. 

Unofficial  Preparations. 

Boro-glyceride , — is  a  solid  chemical  compound,  prepared  by  heating  together  Boracic 
Acid  and  Glycerin.  It  is  soluble  in  water,  but  is  generally  used  in  solution  of  equal  parts 
of  pure  Glycerin  and  Boro-glyceride.  It  combines  readily  with  Chrysarobin,  Carbolic 
Acid,  Atropine  and  Morphine,  and  is  used  as  a  local  application  in  eye  diseases  and  skin 
affections. 

Boracic  Ointment , — has  of  Boracic  Acid  1,  White  Wax  1,  Paraffin  2,  Almond  Oil  2, 
thoroughly  mixed  together. 

Boracic  Lotion , — is  a  saturated  solution  of  the  acid  in  water. 

Boracic  Lint , — prepared  by  steeping  lint  in  a  boiling  saturated  solution  and  drying.  It 
contains  nearly  one-half  its  weight  of  the  acid. 

Magnesii  Boro-citras,  Borocitrate  of  Magnesium, — prepared  extemporaneously  thus, — 
R.  Magnesii  Carbonatis  gj,  Acidi  Citrici  ^ij,  Sodii  Biborat.  gij,  Aqurn  Bullientis  ^viij. 
A  tablespoonful  three  or  four  times  daily  as  a  solvent  of  uric  acid  calculi. 

Polassii  Tartra-boras,  Tartraborate  of  Potassium, — is  a  better  solvent  of  uric  acid 
calculi  than  the  Magnesium  salt,  and  is  soluble  in  2  parts  of  cold  water.  Prepared  by 
heating  together  Boracic  Acid  1,  Potassii  Bitrartras  4,  Water  10  parts.  Dose,  gr.  xx, 
largely  diluted  with  water,  three  or  four  times  a  day. 


Physiological  Action  and  Therapeutics. 

Boracic  Acid  is  an  efficient  antiseptic,  disinfectant  and  deodorant, 
arresting  fermentation  and  putrefaction,  and  very  destructive  to  low 
organisms.  A  solution  of  1  in  133  arrests  the  activity  of  bacteria.  It  is 
feebly  acid  and  but  slightly  irritant,  and  is  used  as  a  surgical  dressing  for 
its  antiseptic  and  unirritating  qualities.  Its  lotion  and  ointment  have 
been  successfully  employed  in  ulcers,  eczema,  burns  and  scalds,  pruritus 
ani,  fetid  perspiration,  wounds,  tinea  tonsurans,  and  tinea  circinata. 


6o 


ACIDUM  CARBOLICUM. 


The  Borate  of  Sodium  is  antiseptic  and  disinfectant,  as  it  also  destroys 
low  vegetable  organisms.  It  removes  the  epidermis  when  locally  applied, 
has  power  to  increase  uterine  contraction,  and  aids  the  solution  of  Benzoic 
Acid.  It  is  employed  as  a  wash  to  remove  the  epidermis  from  the  skin, 
and  as  a  lotion  in  acne,  freckles,  chloasma,  leucorrhcea,  aphthae,  etc.,  and 
to  allay  itching  in  urticaria,  psoriasis,  impetigo,  and  in  pruritus  pudendi, 
scroti  et  ani.  It  has  been  used  internally  in  amenorrhoea,  dysmenorrhoea, 
puerperal  fever  and  puerperal  convulsions,  for  its  supposed  specific  action 
on  the  uterus. 

Boro-glyceride  in  solution  (i  to  40)  is  also  a  powerful  antiseptic,  and 
is  used  as  a  lotion  in  purulent  ophthalmia  and  in  the  treatment  of  wounds, 
also  as  a  local  application  to  diphtheritic  membranes.  It  is  an  efficient 
preservative  of  milk  and  food  against  putrefactive  changes,  and  is  entirely 
harmless. 

An  elegant  cosmetic  cream  may  be  made  by  dissolving  Boracic  Acid  in 
Glycerin,  and  then  incorporating  it  with  White  Wax  and  Almond  Oil. 

ACIDUM  CARBOLICUM,  Carbolic  Acid,  Oxy-benzene, 
Phenic  Acid,  Phenylic  Alcohol,  Phenol,  C6H5HO, — is  an  alcoholic 
product  of  the  distillation  of  coal-tar  between  the  temperature  of  356° 
and  3740  F.  It  occurs  in  needle-shaped  crystals  of  tarry  odor  and  burn¬ 
ing  taste,  is  liquefied  by  about  5  per  cent,  of  water,  soluble  in  20  of  water  at 
590  F.,  and  very  soluble  in  alcohol,  ether,  chloroform,  glycerin,  oils,  etc. 

Peculiarities  about  Carbolic  Acid  are  that  about  5  per  cent,  of  water  liquefies  it,  a  further 
addition  of  water  renders  it  turbid,  until  2000  parts  of  water  to  100  of  the  acid  have  been 
added,  when  a  stable  and  clear  solution  is  formed.  One  volume  of  liquefied  Carbolic 
Acid  containing  5  per  cent,  of  water  forms  with  one  volume  of  Glycerin  a  clear  mixture 
which  is  not  rendered  turbid  by  the  addition  of  three  volumes  of  water  (absence  of  Crea- 
sote  and  Cresylic  Acid).  It  does  not  redden  blue  litmus  paper,  but  combines  freely  with 
alkalies  and  other  salifiable  bases,  the  products  having  an  alkaline  reaction  and  being 
decomposed  by  the  feeblest  acids  (carbonic,  etc.)  Dose,  gr. 

Acidum  Carbolicum  Crudum,  Impure  Carbolic  Acid, — is  obtained  as 
above  stated,  but  at  a  lower  heat  (338°  to  3740  F.),  and  contains  Carbolic , 
Xylic  and  Cresylic  Acids  in  varying  proportions,  together  with  other 
impurities.  It  is  used  as  a  disinfectant. 

Preparations. 

Unguentum  Acidi  Carbolici, — strength  10  per  cent.,  Ointment  90. 

Glyceritum  Acidi  Carbolici  (Unofficial), — Carbolic  Acid  I,  Glycerin  4- 

Aqua  Acidi  Carbolici  (Unofficial), — has  of  the  Glycerite^  x  to  Aquoe  Oj.  Dose  gj- 3  ss. 

Carbolic  Acid  Gauze  (Unofficial), — medicated  with  Ac.  Carbol.  I,  Resin  5,  Paraffin  7. 

Carbolic  Acid  Plaster  (Unofficial), — has  of  Carbolic  Acid  25,  Shellac  75,  coated  with 
Gutta-Percha  dissolved  in  Carbon  Disulphide. 

Carbolic  Acid  Solutions ,  for  antiseptic  surgery,  are  :  — 

5  per  cent,  in  Water,  as  a  spray  or  wash. 

2^/2  per  cent,  in  Water,  for  sponges,  hands,  or  as  a  lotion. 

5  per  cent,  or  less  in  Olive  Oil,  as  a  special  dressing. 

Phenol  Sodique  is  composed  of  Carbolic  Acid  gr.  188,  Caustic  Soda  gr.  31,  Distilled 
Water  3  iv. 


ACIDUM  CARBOLICUM. 


6  I 


Official  Derivative  Salts. 

Sodii  Sulpho-Carbolas,  Sulpho-Carbolate  of  Sodium,  NaCfiH5S04.2H20, — prepared  by 
dissolving  Carbolic  Acid  i,  in  strong  Sulphuric  Acid  I,  thus  forming  Sulpho-carbolic  Acid, 
which  is  then  neutralized  with  Carbonate  of  Sodium.  Transparent,  rhombic  prisms, 
soluble  in  5  of  water  at  590  F.,  less  freely  in  alcohol  and  glycerin.  Dose,  gr.  x-xxx. 

Analogues. 

Creasotum,  Creasote, — is  a  similar  product,  obtained  from  wood-tar,  but  by  the  action 
of  Nitric  Acid  it  is  converted  into  Oxalic  Acid  chiefly,  while  by  the  same  reagent  Carbolic 
is  converted  into  Picric  Acid.  Creasote  does  not  coagulate  albumen  (?)  or  collodion, 
Carbolic  Acid  does.  Creasote  is  described  under  its  own  title. 

Resorcin  (Unofficial),  C6H602, — is  also  a  phenol,  obtained  from  certain  resins  by  the 
action  of  fusing  alkalies.  [Described  under  its  own  title.] 


Physiological  Action. 

Carbolic  Acid  is  a  powerful  antiseptic  and  antiferment,  being  destruc¬ 
tive  to  all  low  forms  of  life.  It  is  a  local  anaesthetic  and  a  superficial 
escharotic,  coagulating  albumen  and  also  the  blood  when  out  of  the  body. 
Taken  internally  undiluted  it  produces  violent  gastritis,  rtp  vj  of  the  pure 
acid  having  caused  dangerous  symptoms.  It  stimulates  the  cardiac  inhibi¬ 
tion,  first  slowing,  then  depressing,  and  finally  paralyzing  the  heart.  Respi¬ 
ration,  at  first  increased,  is  soon  depressed,  the  pupils  are  contracted,  and 
both  brain  and  spinal  cord  are  directly  affected  ;  stupor,  coma,  suspended 
reflexes,  impaired  motility  and  sensibility  being  produced.  It  is  rapidly 
absorbed  and  diffused,  many  fatal  cases  having  occurred  from  its  external 
use.  It  is  partly  oxidized  in  the  blood,  and  partly  eliminated  by  the 
lungs  and  kidneys,  imparting  to  the  urine  a  peculiar  olive-green  or  smoky 
color. 

Locally  applied  Carbolic  Acid  produces  on  the  skin  or  mucous  membrane 
a  white  superficial  eschar  which  succeeds  to  burning  pain  of  short  duration. 

Antidotes  and  Antagonists. 

Liquor  Calcis  Saccharatus,  or  the  official  Syrupus  Calcis,  given  freely;  or  Sulphate  of 
Sodium  or  Magnesium  to  form  a  Sulpho-carbolate,  are  the  chemical  antidotes.  Vegetable 
demulcents  (but  no  oils  or  glycerin)  to  protect  the  mucous  surfaces.  Atropine  is  a  very 
complete  physiological  antagonist  to  the  systemic  symptoms,  maintaining  the  heart  and 
respiration  until  elimination  occurs.  Of  Magnesium  Sulphate  nearly  3  ozs.  were  used  in 
a  case  where  x/2  oz.  of  95  per  cent,  acid  had  been  taken,  resulting  in  full  recovery  from 
an  apparently  hopeless  condition.  Cider  Vinegar  may  prove  to  be  an  antidote,  as  it 
removes  the  effects  of  the  local  application  of  the  strong  acid.  Soap ,  in  strong  watery 
mixture  (suds),  is  said  to  be  almost  a  perfect  antidote. 

Therapeutics. 

Carbolic  Acid  owes  its  prominence  to  its  having  been  the  principal 
agent  used  in  the  antiseptic  method  of  treating  wounds ;  but  lately  its 
employment  in  that  connection  has  become  much  restricted,  and  many 
of  the  most  prominent  surgeons  have  abandoned  it  altogether  in  favor  of 
other  germicides.  •  For  nausea  and  vomiting  it  is  an  excellent  remedy  in 

-grain  doses,  and  in  many  chronic  pulmonary  affections  it  is  used  with 
benefit  by  spray.  It  may  be  employed  locally  in  acute  and  chronic 


62 


ACIDUM  CHROMICUM. 


catarrhs,  parasitic  skin  diseases,  uterine  and  other  ulcers,  abscesses,  boils, 
and  carbuncles,  endo-metritis,  and  perhaps  in  pulmonary  phthisis.  It  has 
proven  of  temporary  benefit  in  diabetes  of  hepatic  origin.  It  has  been 
injected  parenchymatously  (2  per  cent,  solution)  in  erysipelas,  pleuro¬ 
pneumonia,  intermittents,  synovitis,  lupus,  chancroid,  hydrocele,  etc. 

The  Sulpho-carbolates  of  Sodium,  Potassium,  Calcium,  and  Magnesium,  have  been 
employed  advantageously  in  the  septic  diseases  (as  the  exanthemata,  diphtheria,  puerperal 
fever),  the  object  being  to  obtain  the  antiseptic  and  antipyretic  actions  of  Carbolic  Acid 
without  its  dangers.  They  may  be  used  locally  with  good  results  in  aphthae,  tonsillitis, 
otorrhoea,  gonorrhoea,  and  inflamed  mucous  membranes  generally. 


ACIDUM  CHROMICUM,  Chromic  Acid,  Cr03, — is  obtained 
by  the  action  of  Sulphuric  Acid  upon  Potassium  Chromate,  and  occurs  in 
small  crimson  needle-shaped  crystals,  deliquescent  and  very  soluble  in 
water.  Brought  in  contact  with  alcohol  mutual  decomposition  takes  place. 
A  similar  result  and  perhaps  sudden  combustion  results  when  it  is  placed 
in  contact  with  other  easily  oxidizable  substances,  such  as  Glycerin,  Spirit 
of  Nitrous  Ether,  etc.  It  is  not  used  internally. 

Potassii  Bichromas,  Bichromate  of  Potassium,  Iv2Cr207, — large,  orange-red  prisms  of 
disagreeable,  metallic  taste  and  acid  reaction,  soluble  in  10  of  water  at  590  F.,  and  in  1  y2 
of  boiling  water,  insoluble  in  alcohol.  Used  locally  in  aqueous  solution  (gr.  v-^j  to  the 
^ ),  and  internally  in  doses  of  gr.  TC- ij  in  trituration. 

Physiological  Action  and  Therapeutics. 

Chromic  Acid  is  a  powerful  escharotic,  penetrating  deeply,  but  slow 
of  action  and  not  very  painful.  It  coagulates  albumen  and  parts  readily 
with  its  oxygen,  oxidizing  organic  matter  and  decomposing  ammonia  and 
sulphuretted  hydrogen.  It  is  therefore  an  energetic  disinfectant  and 
deodorizer.  When  used  as  a  caustic  it  is  mixed  with  sufficient  water  to 
make  a  paste,  which  may  be  employed  for  the  destruction  of  warts,  hem¬ 
orrhoids  and  other  superficial  growths,  the  neighboring  parts  being  pro¬ 
tected  by  cotton  soaked  in  a  strong  alkaline  solution.  For  syphilitic  warts 
and  condylomata,  lupus,  tinea  tonsurans,  etc.,  a  solution  of  100  grains  to 
the  5  of  distilled  water  is  generally  used.  A  solution  of  1  in  40  is  an 
excellent  and  inexpensive  antiseptic  lotion  for  putrid  sores  and  wounds, 
syphilitic  affections  of  the  tongue,  mouth  and  throat,  ozaena,  leucorrhcea, 
and  gonorrhoea.  In  uterine  catarrh  and  hemorrhages  a  solution  of  120 
grains  to  the  5  has  been  injected  into  the  uterine  cavity  with  good  results. 

Bichromate  of  Potassium  is  a  good  antiseptic  and  an  escharotic  of 
milder  action  than  the  acid.  In  doses  of  o'j-iv  it  has  proved  fatal  to  life 
in  adults,  with  symptoms  of  gastro-enteritis,  suppression  of  urine,  and 
cardiac  paralysis.  It  is  chiefly  employed  as  a  local  application  in  satu¬ 
rated  solution  to  warts  and  venereal  condylomata ;  and  in  dilute  solution 
(gr.  j-x  to  the  5)  for  catarrhal  conditions  of  the  nasal,  buccal,  or  vaginal 


ACIDUM  FLUORICUM - ACIDUM  GALLICUM. 


63 


mucous  membrane.  Internally  it  has  been  employed  with  benefit  in  loco¬ 
motor  ataxia  and  in  dyspepsia  simulating  gastric  cancer ;  also  in  chronic 
gastric  catarrh,  the  tongue  having  a  thick  yellow  coat,  in  chronic  diarrhoea 
from  intestinal  ulceration,  and  in  chronic  ulcers  of  the  pharynx  and  mouth. 
It  is  a  good  remedy  in  syphilitic  sore  throat,  local  rheumatism  of  the 
fibrous  tissues,  periosteal  and  syphilitic  rheumatism,  and  acute  catarrh  and 
influenza,  chronic  nasal  catarrh  chronic  laryngitis,  and  chronic  catarrhal 
affections  of  the  bronchial  mucous  membrane,  especially  when  the  expecto¬ 
ration  is  tough  and  stringy.  It  has  also  been  used  with  some  success  in 
membranous  croup  and  diphtheria.  In  pharmacy  it  is  employed  in  the 
preparation  of  Chromic  Acid  and  Valerianic  Acid,  and  as  a  test  solution. 
Most  of  the  medical  galvanic  and  faradic  batteries  are  run  by  a  mixture 
of  this  salt  with  Sulphuric  Acid.  Poisoning  by  it  should  be  treated  as 
directed  for  that  by  mineral  acids. 


ACIDUM  FLUORICUM,  Fluoric  Acid,  HF  (Unofficial),— is  a 
strong  escharotic,  acting  deeply  and  leaving  a  dry  and  painful  slough. 
The  dilute  acid  (1  in  200)  is  prepared  by  acting  on  fluor  spar  by  Sulphuric 
Acid,  the  resulting  gas  being  dissolved  in  water.  Its  dose  is  n^xx-xxx, 
well  diluted. 

Dilute  Fluoric  Acid  has  been  successfully  used  as  an  internal  remedy  in 
goitre,  and  the  gas  has  been  inhaled  with  benefit  in  diphtheria  and  mem¬ 
branous  croup. 


ACIDUM  GALLICUM,  Gallic  Acid,  HC7H505.H,0,— is  a 
nearly  colorless  solid  in  long  needles  or  triclinic  prisms,  having  a  slightly 
acid  and  astringent  taste,  soluble  in  too  of  water  and  in  4^  of  alcohol 
at  590  F. ,  and  in  3  of  boiling  water.  It  is  prepared  from  a  paste  of  pow¬ 
dered  galls  (see  Galla),  by  fermenting  for  six  weeks,  boiling  and  reboil¬ 
ing  in  water,  filtering  and  crystallizing.  According  to  some  authorities  the 
Tannic  Acid  of  the  galls  is  split  up  into  Gallic  Acid  and  glucose  by  fer¬ 
mentation  ;  but  according  to  others  the  glucose  is  an  impurity  and  the 
Tannic  Acid  is  simply  converted  into  two  parts  of  Gallic  Acid,  CuH10O9  -f- 
H,0  =  (HC7H505)2.  Dose,  gr.  v-xv,  in  solution,  pill  or  powder. 

Acidum  Pyrogallicum,  Pyrogallic  Acid,  Pyrogallol,  Tri-hydroxv- 
benzene,  C6H3(HO)3  (Unofficial), — is  obtained  from  Gallic  or  Tannic 
Acid  by  careful  heating.  Dose  gr.  j-ij. 

Preparations. 

Unguentum  Acidi  Gallici , — is  a  10  per  cent,  ointment,  with  a  basis  of  Benzoinated 

Lard. 


64 


ACIDUM  HYDROBROMICUM  DILUTUM. 


Vegetable  Astringents  depend  for  their  medicinal  value  upon  the  Gallic  and  Tannic 
Acids  contained  in  them.  Such  are — 


Alnus,  Alder  Bark. 
Castanea,  Chestnut  Leaves. 
Catechu,  Catechu. 
Diospyros,  Persimmon. 
Galla,  Nut  Galls. 
Geranium,  Cranesbill. 
Granatum,  Pomegranate. 
Hamamelis,  Witch  Hazel. 
Hrematoxylon,  Logwood. 


Heuchera,  Alum  Root. 
Kino,  Kino. 

Krameria,  Rhatany. 
Myrica,  Wax  Myrtle. 
Nymphsea,  Pond  Lily. 
Quercus  Alba,  Oak  Bark. 
Rosa  Gallica,  Red  Rose. 
Rubus,  Blackberry . 
Statice,  Alarsh  Rosemary. 


Physiological  Action. 

Gallic  Acid,  and  its  congener  Tannic  Acid,  are  astringents,  the  former 
being  the  more  feeble  of  the  two.  They  differ  in  that  Tannic  Acid  coagu¬ 
lates  albumen  and  gelatin,  while  Gallic  does  not.  Tannic  Acid  is  con¬ 
verted  by  the  organism  into  Gallic  and  Pyrogallic  Acids,  in  which  forms 
it  is  absorbed  and  excreted.  According  to  some  authorities  the  difference 
between  Gallic  and  Tannic  Acids  is  one  of  oxidation,  according  to  others 
of  hydration ;  the  latter  assuming  Tannic  Acid  to  be  simply  Gallic  Acid 
Anhydride.  They  constringe  the  muscular  tissue  in  the  walls  of  the 
minute  vessels,  thus  checking  secretion  and  hemorrhages  and  cutting 
short  local  inflammations.  Except  in  enormous  doses  they  are  harmless. 
[Compare  Acidum  Tannicum.] 

Pyrogallic  Acid  may  act  as  an  intense  poison,  having  been  absorbed 
from  the  surface  with  fatal  results,  preceded  by  vomiting  and  diarrhoea, 
rigors,  and  fever,  black  urine  full  of  globulin,  and  disorganization  of  the 
blood-corpuscles.  It  has  great  affinity  for  oxygen  and  may  be  used  as  an 
antiseptic  and  disinfectant  in  i  to  2 per  cent,  solutions. 

Antagonists  and  Incompatibles. 

Mineral  acids,  alkalies,  per-salts  of  iron,  and  salts  of  antimony,  lead,  and  silver  are 
chemically  incompatible. 

Therapeutics. 

Gallic  Acid  is  preferred  to  Tannic  Acid  when  an  astringent  action  is 
desired  upon  remote  parts,  as  the  lungs,  kidneys,  etc.,  which  can  only  be 
reached  through  the  circulation.  In  hematuria,  distant  passive  hemor¬ 
rhages,  albuminuria,  diabetes  insipidus,  bronchorrhoea,  night-sweats, 
chronic  diarrhoea,  and  chronic  cystitis,  it  is  a  most  useful  remedy. 

Pyrogallic  Acid  has  been  used  internally  in  two-grain  doses  for  inter¬ 
nal  hemorrhages.  As  an  ointment  (5j_Sj)  it  is  next  to  Chrysarobin  as 
an  efficient  palliative  in  psoriasis,  and  has  been  used  with  good  results  in 
lupus  and  epithelioma,  being  supposed  to  attack  the  diseased  nodules  only,, 
leaving  the  adjacent  skin  uninjured. 


ACIDUM  HYDROCHLORICUM. 


65 


ACIDUM  HYDROBROMICUM  DILUTUM,  Diluted  Hy- 
drobromic  Acid, — is  composed  of  10  per  cent,  of  absolute  Hydro- 
bromic  Acid  (HBr),  and  90  per  cent,  of  water.  It  is  a  clear,  colorless, 
and  odorless  liquid,  of  a  pungent  acid  taste,  produced  by  decomposing 
Potassium  Bromide  by  Sulphuric  Acid  and  distilling.  Dose,  npxx-3ij, 
every  three  hours. 

Hydrobromic  Acid  has  identical  action  on  the  nervous  system  and  cir¬ 
culation  with  that  of  the  Bromides.  Added  to  a  mixture  of  Quinine  and 
water  (rr^ ij  to  each  grain  of  Quinine)  it  will  produce  a  clear  solution. 

In  hysteria,  congestive  headaches,  neuralgia,  and  nervous  exhaustion, 
Hydrobromic  Acid  has  been  found  useful.  Used  as  a  solvent  of  Quinine 
it  retards  cinchonism,  and  prevents  the  headache  resulting  from  the  full 
action  of  Quinine  and  Iron.  As  a  substitute  for  the  Bromides  of  Sodium 
and  Potassium  it  is  highly  recommended,  being  much  less  depressant. 
It  has  been  especially  recommended  in  tinnitus  aurium.  Fothergill  uses 
it  for  coughs  of  reflex  or  spasmodic  nature,  also  for  simple  continued  fever 
where  there  is  cerebral  disturbance. 


ACIDUM  HYDROCHLORICUM,  Hydrochloric  Acid, 
Muriatic  Acid, — is  a  liquid  composed  of  about  32  per  cent,  of  absolute 
Hydrochloric  Acid  Gas,  HC1,  and  68  per  cent,  of  water.  It  is  colorless 
and  fuming,  of  specific  gravity  1.160,  pungent  odor,,  intensely  acid 
reaction  and  taste,  and  is  obtained  by  the  action  of  Sulphuric  Acid  upon 
Sodium  Chloride,  the  resulting  gas  being  carried  through  water  which 
dissolves  it.  It  is  sometimes  used  as  a  caustic.  Its  union  with  basic 
substances  forms  salts,  called  Hydrochlorates  (Muriates),  of  which  four 
are  official,  viz.  :  the  Hydrochlorates  of  Apomorphine,  Morphine,  Pilo¬ 
carpine,  and  Quinine,  described  under  the  titles  of  their  respective  bases. 

Preparations. 

Acidum  Hydrochloricum  Dilntum, — is  a  10  per  cent,  solution  of  the  absolute  acid  in 
water.  Dose,  rrp  iij-x. 

Acidum  Ar itro -hydrochloricum, — see  under  Acidum  Nitricum. 


Physiological  Action  of  the  Mineral  Acids. 

The  mineral  acids  (Hydrochloric,  Sulphuric,  Nitric,  Nitro-hydrochloric, 
and  Phosphoric)  resemble  each  other  in  general  action  so  closely  that  they 
may  all  be  described  in  this  place. 

The  strong  acids  are  escharotic,  abstracting  the  water  of  the  tissues, 
combining  with  the  albumen  and  other  bases,  and  destroying  the  proto¬ 
plasm.  They  are  very  diffusible,  redissolving  the  albumen  after  precipi¬ 
tating  it  (except  Nitric  Acid).  Sulphuric  and  Phosphoric  have  a  strong 
affinity  for  water,  completely  decomposing  tissues  to  which  they  are 
5 


66 


ACIDUM  HYDROCHLORICUM. 


applied,  and  are  therefore  the  most  powerfully  escharotic.  Nitric  Acid 
does  not  readily  redissolve  the  albumen  precipitated  by  it,  which  thus 
forms  a  barrier  against  the  deep  action  of  the  acid.  Sulphuric  Acid 
chars  or  carbonizes  the  tissues  black,  while  Nitric  and  Hydrochloric  tan 
them  yellow. 

The  dilute  acids  produce  a  peculiar  taste  in  the  mouth  and  a  sensation 
of  roughness  on  the  teeth.  They  stimulate  the  flow  of  saliva  from  the 
parotid  and  submaxillary  glands,  but  have  no  action  on  the  sympathetic 
saliva.  They  promote  the  alkaline  intestinal  secretions  and  excite  the 
flow  from  ducts  having  an  alkaline  secretion  (bile,  etc.),  but  check  that 
from  those  whose  secretion  is  acid  (gastric,  etc.).  Secretion  generally  is 
promoted  by  Nitric  Acid,  and  lessened  by  Sulphuric,  Hydrochloric 
acting  between  the  other  two.  Given  before  meals,  in  small  doses,  they 
relieve  acidity  of  the  stomach  by  checking  the  production  of  the  acid 
gastric  juice.  At  first  they  aid  digestion,  being  synergistic  to  the  action 
of  pepsin,  but  if  continued  they  impair  digestion  by  lessening  the  produc¬ 
tion  of  the  gastric  juice.  They  check  fermentation  and  constipate  the 
bowels,  except  Nitric  Acid,  which  relaxes  them.  They  render  the  urine 
slightly  more  acid  than  its  normal  reaction,  but  do  not  acidify  alkaline 
urine  as  the  vegetable  acids  do.  They  are  all  astringent  to  the  tissues, 
Hydrochloric  being  weakest  and  Sulphuric  the  strongest  in  this  respect. 

Antagonists  and  Incompatibles. 

Alkalies  to  neutralize  the  acid  ;  oil,  albumen,  or  milk,  to  protect  the  mucous  membrane  ; 
stimulants,  Opium,  Ammonia  (intravenously)  to  combat  the  resulting  depression  of  the 
vital  powers. 


Therapeutics  of  the  Mineral  Acids. 

All  the  members  of  this  group  are  useful  in  fevers,  if  well  diluted, 
Hydrochloric  being  usually  preferred,  especially  in  typhoid.  In  atonic 
dyspepsia,  acidity  of  the  stomach,  and  locally  in  ulcerations  of  the  throat, 
Hydrochloric  Acid  is  best  used.  Nitric  is  the  acid  generally  preferred  as 
a  caustic,  its  action  being  effectual  and  superficial.  As  such  it  is  applied 
undiluted  to  phagedenic  ulcers  and  sloughs,  warty  growths,  and  to  the 
cavity  of  the  womb  in  chronic  inflammation  thereof.  Dilute  Nitric  Acid 
is  used  internally  in  oxaluria  and  lithemia,  intermittent  and  remittent 
fevers,  and  aphonia  of  singers.  Dilute  Nitro-hydrochloric  is  more  suitable 
in  chronic  hepatic  disorders  due  to  malaria;  Sulphuric  in  hemorrhages, 
diarrhoeas,  colliquative  sweating,  and  as  a  prophylactic  against  lead¬ 
poisoning.  Dilute  Sulphuric  Acid  is  used  as  an  acid  drink  in  fevers,  and 
before  meals  in  acidity  of  the  stomach.  It  is  very  doubtful  whether  the 
latter  has  any  special  influence  on  the  nervous  or  osseous  systems. 

All  these  acids  act  injuriously  on  the  teeth,  by  attacking  the  enamel. 
They  should  always  be  administered  largely  diluted,  taken  through  a  straw 


ACIDUM  HYDROCYANICUM  DILUTUM.  67 

or  glass  tube,  and  the  mouth  should  at  once  be  thoroughly  rinsed  with  an 
alkaline  solution. 


ACIDUM  HYDROCYANICUM  DILUTUM,  Diluted  Hy¬ 
drocyanic  Acid,  Prussic  Acid, — is  a  liquid  composed  of  2  per  cent, 
of  absolute  Hydrocyanic  Acid,  HCN,  and  98  per  cent,  of  alcohol  and 
water.  It  is  colorless,  faintly  acid,  of  peculiar  odor,  and  is  prepared 
by  distilling  solutions  of  Potassium  Ferrocyanide  and  Sulphuric  Acid 
together,  or  extemporaneously  by  adding  6  parts  of  Cyanide  of  Silver  to 
a  solution  of  5  parts  of  Hydrochloric  Acid  in  55  of  distilled  water,  shak¬ 
ing  together  and  pouring  off  the  supernatant  liquid,  npxl  have  proved 
fatal.  Dose,  npj-v. 

Preparations  containing  Hydrocyanic  Acid. 

Aqua  Laurocerasi ,  Cherry-laurel  Water  (Unofficial), — is  a  water  distilled  from  the 
fresh  leaves  of  Primus  laurocerasus ,  the  common  Laurel  or  Cherry  Laurel,  a  small  tree 
of  the  nat.  ord.  Rosacese,  sub-order  Amygdaleoe.  The  leaves  contain  a  variable  amount 
of  Hydrocyanic  Acid  and  a  volatile  oil.  Dose,  ttp  v-xxx,  cautiously. 

Scheele's  Dilute  Hydrocyanic  Acid  (Unofficial), — is  a  4  or  5  per  cent,  solution,  and  is 
highly  dangerous  even  by  inhalation. 

Amygdala  Amara,  Bitter  Almond  (see  its  title),  and  its  essential  oil;  also,  various 
other  members  of  the  sub-order  Amygdaleae,  including  the  official  Prunus  Virginiana , 
perhaps  the  unofficial  Prunus  laurocerasus ,  and  the  leaves  and  kernels  of  the  peach  and 
cherry  trees,  contain  a  proximate  principle  Amygdalin,  and  a  ferment  Emulsin,  which  in 
the  presence  of  water  react  with  each  other,  forming  Hydrocyanic  Acid,  a  volatile  oil, 
and  glucose.  C20H27NOU  (Amygdalin)  -|-  2H20  =  C7H60  (Oil  of  Bitter  Almond) 
HCN  (Hydrocyanic  Acid)  -f-  2C6H1206  (Glucose). 

Other  Cyanogen  Compounds. 

Potassii  Cyanidum ,  Cyanide  of  Potassium,  KCN, — a  white,  opaque  salt,  of  alkaline 
reaction,  bitter- almond  taste  and  a  peculiar  odor  when  moist ;  soluble  in  2  of  water  at 
590  F.,  sparingly  soluble  in  alcohol.  Dose,  gr.  2L-i.  Locally  a  solution  of  gr.  j-v  to 

the  o  • 

Potassii  Ferrocyanidum ,  Ferrocyanide  of  Potassium,  K4Fe(CN6)63H20, —  large, 
lemon-yellow  prisms  or  tablets,  efflorescent,  odorless,  of  sweetish  taste  and  neutral  reac¬ 
tion,  soluble  in  4  of  water,  insoluble  in  alcohol.  Employed  in  pharmacy  as  a  test  solu¬ 
tion,  and  in  the  preparation  of  Ferrocyanide  of  Iron,  Diluted  Hydrocyanic  Acid  and 
the  Cyanides  of  Potassium  and  Silver.  Rarely  used  medicinally.  Dose,  gr.  v-xv. 

Physiological  Action. 

Prussic  Acid  is  one  of  the  most  powerful  and  rapid  poisons  known, 
half  a  grain  having  proved  fatal.  Its  action  on  the  organism  is  one 
peculiar  to  itself,  the  inhalation  of  a  strong  preparation  producing  rapid 
insensibility  and  almost  immediate  exhaustion ; — death  from  a  full  dose 
occurring  by  sudden  paralysis  of  the  heart,  from  a  less  but  still  a  fatal 
dose,  by  paralysis  of  respiration.  The  symptoms  are  those  of  sudden 
and  complete  asphyxia,  and  some  volitional  movements  may  be  made 
before  death,  unless  the  dose  be  very  large.  In  cases  in  which  the  dose, 
though  fatal,  permitted  of  the  observance  of  its  effects,  they  were  usually 
divisible  into  two  marked  stages,  viz.  :  (t)  Dyspnoea,  slow  and  full  pulse, 
giddiness,  loss  of  muscular  power.  (2)  Vomiting,  dilated  pupils,  uncon- 


68 


ACIDUM  HYDROCYANICUM  DILUTUM. 


sciousness,  spasms,  muscular  rigidity,  and  cessation  of  the  heart’s  action. 
In  poisonous,  but  not  fatal  doses,  the  following  effects  have  been  observed  : 
feeble  pulse,  dilated  pupils,  turgid  and  dusky  face,  insensibility,  convul¬ 
sions  or  rigidity,  but  no  paralysis.  Large  medicinal  doses  may  produce 
salivation,  irritation  of  the  throat,  dizziness,  buzzing  in  the  ears,  head¬ 
ache,  numbness,  dusky  countenance,  staggering  gait,  sense  of  constriction 
of  the  chest,  palpitation  of  the  heart,  a  frequent  or  an  abnormally  slow 
pulse,  a  sense  of  great  weariness  and  drowsiness.  Post-mortem  examina¬ 
tion  shows  usually  dilated  pupils,  the  eyes  having  a  marked  glassy  lustre, 
the  cadaveric  rigidity  very  great.  The  blood,  in  cases  which  have  been 
rapidly  fatal,  may  show  the  arterial  color  in  both  the  arterial  and  the 
venous  systems ;  but  in  slower  cases  it  is  dark  and  fluid,  engorging  both 
sides  of  the  heart,  the  venous  trunks,  and  the  cerebral  sinuses.  The  par¬ 
alyzant  action  of  the  drug  is  chiefly  exercised  on  the  nerve-centres  in  the 
medulla;  next  on  the  peripheral  afferent  nerves,  the  spinal  cord,  the 
motor  nerves,  and  finally  on  the  muscular  tissue.  It  stops  the  heart  by 
irritation  of  the  vagus-roots  in  the  medulla,  as  well  as  by  paralyzing  the 
cardiac  motor  ganglia.  It  is  said  to  form  with  haemoglobin  a  compound 
(cyan-haemoglobin),  which  does  not  readily  give  up  oxygen.  The  odor 
of  the  acid  is  fragrant,  resembling  that  of  bitter  almonds  or  peaches,  and 
may  be  detected  in  the  lungs  shortly  after  death.  The  effects  of  a  medi¬ 
cinal  dose  pass  off  in  an  hour  at  farthest. 

Locally  applied  to  the  skin,  Hydrocyanic  Acid  penetrates  the  epider¬ 
mis  and  paralyzes  the  end -organs  of  the  sensory  nerves  in  the  derma.  It 
is  rapidly  absorbed  from  mucous  surfaces. 

Cyanide  of  Potassium  has  similar  action,  but  in  addition  has  some 
few  peculiar  to  itself.  Locally  used  it  produces  dermatitis,  with  an  ecze¬ 
matous  eruption,  and  if  applied  to  an  abraded  surface  freely  may  cause 
fatal  effects.  Internally  it  has  proved  fatal  in  doses  of  3  to  5  grains,  with 
all  the  symptoms  of  Prussic  Acid  poisoning,  but  its  action  is  less  rapid. 
It  is  much  used  in  photography,  and  many  cases  of  poisoning  by  it  have 
occurred  in  persons  employed  in  that  art. 

Antagonists  and  Antidotes. 

Atropnie  has  antagonistic  action,  but  is  too  slowly  diffused  to  be  of  any  value.  Ammonia 
by  inhalation,  by  the  stomach,  and  by  intra-venous  injection,  with  cold  affusion  to  the 
spine,  and  artificial  respiration,  are  the  measures  most  likely  to  avail  in  casesof  poisoning 
where  there  is  time  to  do  anything.  In  poisoning  by  Potassium  Cyanide  give  the  Sulphate 
of  Iron ,  producing  Ferrocyanide  of  Iron  (Prussian  Blue).  Then  evacuation  of  the 
stomach,  artificial  respiration,  and  Ammonia  by  intra-venous  injection. 


Therapeutics. 

Hydrocyanic  Acid  is  used  for  its  antispasmodic  and  sedative  effects. 
In  vomiting,  whooping-cough,  and  coughs  of  spasmodic  character,  in 
asthma  and  other  neuroses  of  the  respiratory  organs,  in  affections  involving 


ACIDUM  LACTICUM. 


69 


the  pneumogastric  nerve,  vertigo  and  headache  from  stomachal  derange¬ 
ments,  gastralgia,  painful  dyspepsia,  vomiting,  etc.,  it  is  very  efficient  as 
a  palliative.  In  acute  mania  and  melancholia  it  has  been  used  with 
advantage  ;  and  in  various  skin  diseases,  accompanied  by  itching,  tingling, 
etc.,  its  use  as  a  lotion  (n^xxx-5j  ad  3j  Aquae  Rosae)  to  the  unbroken 
surface  is  prompt  in  relieving  the  pruritus  and  other  distressing  sensations. 

Cyanide  of  Potassium  in  ointment  (gr.  v  ad  5j)  is  used  to  allay 
pruritus,  and  in  solution  (gr.  iij-v  ad  5j)  is  applied  locally  with  benefit 
in  reflex  headaches,  and  is  used  as  a  wash  to  remove  nitrate  of  silver  stains. 
It  has  been  used  internally  in  doses  of  gr.  j  for  acute  articular  rheumatism, 
but  such  employment  of  it  is  highly  dangerous. 

Ferrocyanide  of  Potassium  has  been  used  in  doses  of  8  to  15  grains 
as  an  astringent  and  anodyne,  but  it  is  seldom  employed  in  medicine. 

Cherry-laurel  Water  has  been  extensively  used  as  a  flavoring  agent, 
having  a  very  agreeable  taste.  It  is  official  in  the  British  Pharmacopoeia, 
and  is  supposed  to  be  a  rather  elegant  mode  of  administering  Prussic  Acid  ; 
but  the  uncertainty  of  its  strength  is  such  that  it  should  never  be  used 
internally,  except  in  very  small  quantities.  It  has  been  employed  as  an 
anaesthetic  injection  into  the  urethra  prior  to  catheterization,  and  was 
formerly  employed  by  ophthalmologists  as  an  eye-wash  in  painful  affections 
of  that  organ. 


ACIDUM  LACTICUM,  Lactic  Acid, — is  a  liquid  composed  of 
75  per  cent,  of  absolute  Lactic  Acid  (HC3H503)  and  25  per  cent,  of  water ; 
nearly  colorless,  syrupy,  odorless,  of  acid  taste  and  reaction,  freely  mis¬ 
cible  with  water,  alcohol  and  ether,  but  nearly  insoluble  in  chloroform. 
It  is  produced  by  the  fermentation  of  sugar  of  milk,  has  a  sp.  gr.  of  1.2 12, 
and  is  difficult  to  obtain  pure.  It  enters  into  Syrupus  Calcii  Lactophos- 
phatis.  .  Dose,  5ss-3ss,  well  diluted. 

Physiological  Action  and  Therapeutics. 

Lactic  Acid  is  found  in  the  stomach  as  a  product  of  the  food,  and  com¬ 
bines  with  bases  in  the  blood,  forming  lactates,  which,  being  oxidized, 
are  converted  into  carbonates.  It  aids  digestion  and  promotes  the  appe¬ 
tite,  but,  in  large  doses,  causes  flatulence  and  much  epigastric  pain. 
Injected  into  the  peritoneal  cavity  of  animals,  it  excites  endocarditis,  and 
given  in  diabetes,  it  has  produced  acute  rheumatism  and  rheumatic  endo¬ 
carditis.  Hence  its  supposed  causation  of  acute  rheumatism  when  in 
excess  and  free  in  the  blood.  It  dissolves  false  membranes  and  the 
phosphate  of  calcium. 

It  is  used  with  benefit  in  diabetes,  atonic  dyspepsia,  oxaluria,  and  in 
the  lithic  and  phosphatic  diatheses  when  due  to  imperfect  digestion  and 


70 


ACIDUM  NITRICUM. 


assimilation.  As  a  solvent  of  false  membrane  in  croup  and  diphtheria  it 
is  unquestionably  of  great  service.  In  chronic  cystitis  it  arrests  the 
ammoniacal  decomposition  of  the  urine.  As  the  acid  found  in  the  shops 
is  generally  of  poor  quality,  disappointment  in  its  use  may  be  expected. 

ACIDUM  NITRICUM,  Nitric  Acid, — is  a  liquid  composed  of 
69.4  per  cent,  of  absolute  Nitric  Acid,  HN03,  and  30.6  per  cent,  of  water. 
It  is  colorless,  fuming,  very  caustic  and  corrosive,  of  sp.  gr.  1.420,  strongly 
acid  in  reaction,  and  is  obtained  by  the  action  of  Sulphuric  Acid  on 
Nitrate  of  Potassium.  Is  only  used  externally  as  a  caustic. 

Preparations. 

Acidum  Nitricum  Dilutum ,  Diluted  Nitric  Acid, — has  of  the  above  I  part  in  6  of 
Distilled  Water,  and  contains  10  per  cent,  of  absolute  Nitric  Acid.  Dose  rip  iij-xv,  well 
diluted. 

Acidum  Nitrokydrochloricum,  Nitrohydrochloric  Acid,  Nitromuriatic  Acid,  Aqua 
Regia,— a  golden  yellow,  fuming,  corrosive  liquid,  composed  of  Nitric  Acid  4  parts, 
Hydrochloric  Acid  15  parts.  Is  wholly  volatilized  by  heat,  readily  dissolves  gold-leaf,  and 
a  drop  added  to  test-solution  of  Potassium  Iodide  liberates  Iodine  in  abundance.  Dose, 
rrpj-viij,  well  diluted. 

Aciduni  Nitrokydrochloricum  Dilutum ,  Diluted  Nitrohydrochloric  Acid, — consists  of 
Nitric  Acid  4,  Hydrochloric  Acid  15,  Water  76  parts.  Dose,  rtp  v-xx,  well  diluted. 

Physiological  Action  and  Therapeutics. 

The  action  and  uses  of  these  agents  are  herein  described  with  those  of 
the  other  mineral  acids,  under  the  title  Acidum  Hydrochloricum  (see 
ante ,  page  65).  Some  special  properties  are  as  follows  :  — 

Nitric  Acid  is  an  exceedingly  powerful  escharotic,  but,  as  it  coagulates 
and  does  not  redissolve  the  albumen  of  the  tissues,  it  forms  a  barrier  to 
its  own  excessive  action.  The  vapor  may  cause  oedema  of  the  glottis, 
intense  bronchitis,  etc.,  and  death  from  suffocation.  It  is  used  for  the 
destruction  of  chancres,  warts,  hemorrhoids,  phagedenic  ulcers,  etc.  ;  and 
internally  in  dilute  form  for  bilious  affections,  as  it  is  supposed  to  have  a 
selective  action  on  the  liver.  It  also  lessens  phosphatic  deposits  in  the 
urine,  and  acts  as  an  astringent  in  the  system,  diminishing  profuse  secre¬ 
tion  in  bronchorrhoea  and  phthisis. 

Nitrohydrochloric  Acid  is  also  supposed  to  specially  affect  the  liver. 
It  is  usefully  employed  in  jaundice,  dyspepsia,  and  the  so-called  bilious 
condition ;  also  in  frontal  headache,  situated  just  above  the  eyebrows, 
when  unaccompanied  by  constipation,  and  in  acidity  of  the  stomach. 
In  hepatic  disorders  it  may  be  used  in  dilute  form  as  baths,  or  applied  to 
the  hepatic  region  on  compresses.  The  official  dilute  acid  is  of  little  use 
therapeutically,  as  it  rapidly  deteriorates,  and  the  same  may  be  said  of  the 
strong  acid  when  standing  long  enough  for  the  color  to  change  to  a  lemon- 
yellow.  The  most  efficient  preparation  is  the  strong  acid  freshly  pre¬ 
pared,  when  it  is  of  an  orange-red  color.  This  should  be  properly  diluted 
when  required  for  use,  and  should  be  constantly  protected  from  light. 


ACIDUM  OLEICUM - ACIDUM  PHOSPHORICUM. 


71 


ACIDUM  OLEICUM,  Oleic  Acid,  HCI8H3302,  is  one  of  the 
constituent  acids  of  oils  and  fats,  obtained  commercially  as  a  secondary 
product  in  the  manufacture  of  stearin  candles.  It  is  a  yellowish  oily  liquid, 
semi-solid  at  570  F.,  odorless,  tasteless,  and  of  neutral  reaction,  insoluble 
in  water  but  soluble  in  alcohol,  chloroform,  benzol,  benzin,  turpentine, 
and  the  fixed  oils.  It  dissolves  most  of-  the  metallic  oxides  and  the  un¬ 
combined  alkaloids,  forming  the  so-called  Oleates,  which,  however,  are 
not  pure  chemical  compounds,  but  merely  compounds  of  the  oxides  or 
alkaloids,  as  the  case  may  be,  with  oleic  acid,  dissolved  in  great  excess 
of  the  latter.  Two  of  these  are  official,  viz. — 

Preparations. 

Oleatum  Hydrargyri,  Oleate  of  Mercury — has  10  per  cent,  of  the  Yellow  Oxide  of 
Mercury,  with  90  of  Oleic  Acid. 

Oleatum  Veratrince ,  Oleate  of  Veratrine — has  2  per  cent,  of  Veratrine  in  90  of  Oleic 
Acid. 

Unofficial  Preparations. 

Oleates  (Oleata)  of  Aconitine  (2  per  cent.),  Atropine  (2  per  cent.),  Morphine  (10  per 
cent.),  Morphine  and  Alerctiry  (2  per  cent,  morphine  and  20  per  cent,  mercuric  oxide), 
Quinine  (25  per  cent.),  Strychnine  (2  per  cent.),  Arsenic  ('gr.  xx  of  oleate  of  arsenic  to 
the  £  ),  Aluminium ,  Bismuth ,  Copper ,  Iron ,  Lead ,  Silver ,  Zinc ,  etc.,  are  prepared  by 
the  manufacturing  pharmacists,  and  are  to  be  obtained  in  the  shops.  Most  of  them  answer 
to  the  description  given  above,  but  several  are  Oleo-palmitates,  or  double  salts  of  Oleic 
and  Palmitic  Acids,  being  prepared  from  oils  which  yield  the  latter  acid  in  considerable 
quantity.  Drs.  Shoemaker  and  Wolff,  of  Philadelphia,  have  introduced,  under  the  above 
names,  several  solid  or  semi-solid  preparations,  which  they  claim  to  be  chemically  true 
oleates,  salts  having  no  excess  of  either  their  acid  or  basic  radicals.  They  are  produced 
by  the  double  decomposition  of  sodium  oleate  with  solutions  of  neutral  salts,  the  precipi¬ 
tates,  washed  and  dried,  being  the  oleates  required.  These  oleates  are  claimed  to  be  more 
stable  than  the  official  oleic  solutions,  and  using  less  oleic  acid  are  much  less  costly.  Many 
of  them  may  be  used  as  dusting  powders,  or  mixed  with  oil  or  lard  to  form  ointments. , 

Physiological  Action  and  Therapeutics. 

Oleic  Acid  is  only  used  in  making  the  Oleates,  which  were  introduced 
by  Marshall,  in  1872,  as  substitutes  for  ointments,  being  cleaner,  more 
elegant,  and  more  penetrating,  but  decidedly  more  irritating  if  applied  with 
friction.  Their  medicinal  properties  depend  upon  the  bases  employed, 
hence  their  actions  and  uses  will  be  described  under  the  corresponding 
basic  heads.  They  should  usually  be  diluted  with  an  equal  bulk  of  vase¬ 
line  or  olive  oil  before  being  rubbed  into  the  skin,  or  they  may  produce  a 
cutaneous  eruption  or  even  pustulation.  As  a  rule  they  should  be  lightly 
spread  over  the  surface  with  the  finger  or  a  brush.  As  parasiticides,  the 
Oleates  of  Copper  and  Mercury  are  most  efficient,  and  in  skin  diseases 
generally  these  preparations  are  rapidly  coming  into  favor. 


ACIDUM  PHOSPHORICUM,  Phosphoric  Acid,— is  a  liquid 
composed  of  50  per  cent,  of  Orthophosphoric  Acid,  H3P04,  and  50  per 
cent,  of  water,  and  is  obtained  by  oxidizing  Phosphorus  by  Nitric  Acid. 
It  is  strongly  acid,  odorless,  colorless,  and  of  sp.  gr.  1.347. 


72 


ACIDUM  PICRICUM - ACIDUM  SULPHURICUM. 


Preparations. 

Acidum  Phosphoricum  Dilution,  Diluted  Phosphoric  Acid,  has  of  Phosphoric  Acid 
20  parts  in  80  of  Distilled  Water,  sp.  gr.  1.057,  and  contains  10  per  cent,  of  Orthophos- 
phoric  Acid.  Dose,  Tip  v-xxx,  in  sufficient  water. 

Phosphates  of  Ammonium,  Ferrum,  and  Sodium,  and  the  Syrupus  Ferri,  Quininse  et 
Strychninae  Phosphatum,  are  described  under  Phosphorus. 

Physiological  Action  and  Therapeutics. 

The  action  and  uses  of  Phosphoric  Acid  are  described  with  those  of 
the  other  Mineral  Acids  under  Acidum  Hydrochloricum  (see  ante,  page 
65).  It  may  be  given  in  larger  doses  than  the  other  acids  without  derang¬ 
ing  digestion,  and  is  therefore  preferred  in  cases  requiring  acid  treatment 
for  a  long  period,  as  in  diabetes,  etc.  It  is  considered  of  especial  value 
in  strumous  affections,  and  it  is  thought  to  diminish  the  growth  of  osseous 
tumors,  and  to  dissolve  phosphatic  deposits.  As  it  contains  no  free  phos¬ 
phorus,  it  cannot  be  used  to  obtain  the  effects  of  that  drug. 

ACIDUM  PICRICUM,  Picric  Acid,  Carbazotic  Acid,  Trini- 
trophenol,  C6H:i(N02)^0  (Unofficial), — is  obtained  by  the  action  of 
Nitric  Acid  on  Carbolic  Acid,  or  many  other  substances.  It  has  recently 
been  introduced  as  a  test  for  albumen  and  sugar  in  the  urine.  A  saturated 
aqueous  solution  has  been  used  locally  in  erysipelas  with  some  advantage. 
Some  of  its  salts  (Picrates  of  Ammonium,  Iron,  etc.)  have  been  tried 
therapeutically,  without  any  particular  results.  Powers  as  an  antiperiodic 
and  anthelmintic  and  against  trichinae  have  been  urged  for  it,  but  expe¬ 
rience  has  not  supported  these  claims.  Dose,  gr.  v-xv  per  diem. 

Ammonium  Picrate,  in  doses  of  gr.  A  to  gr.  jss,  in  pill,  four  times  daily,  has  been  used 
in  the  malarial  fevers  of  India,  in  over  10,000  cases  with  most  effective  results. 


ACIDUM  SULPHURICUM,  Sulphuric  Acid,— is  a  strongly 
caustic  and  corrosive  liquid,  oily,  inodorous,  of  strong  acid  reaction, 
composed  of  not  less  than  96  per  cent,  of  absolute  Sulphuric  Acid 
(H2S04)  and  4  per  cent,  of  water.  It  is  obtained  by  the  combustion  of 
Sulphur  and  its  oxidation  by  nitrous  fumes.  Its  specific  gravity  should 
not  be  below  1.840,  and  it  is  miscible  in  all  proportions  with  water  and 
alcohol,  with  evolution  of  heat.  Occasionally  used  as  a  caustic. 

Preparations. 

Acidum  Sulphuricum  Dilution,  Diluted  Sulphuric  Acid, — has  of  the  strong  acid  I  part 
to  9  of  distilled  water.  Dose,  rr\,  v-xv,  well  diluted. 

Acidum  Sulphuricum  Aromaticum,  Aromatic  Sulphuric  Acid,  Elixir  of  Vitriol, — is 
Sulphuric  Acid  20  per  cent.,  diluted  with  Alcohol  and  flavored  with  Cinnamon  and 
Ginger.  It  is  not  an  acid,  but  rather  an  ether  formed  by  reaction  between  the  acid  and 
the  alcohol.  Dose,  Tip  v-xv,  well  diluted. 

Physiological  Action  and  Therapeutics. 

The  action  and  uses  of  Sulphuric  Acid  generally  are  described  with 
those  of  the  other  Mineral  Acids  under  Acidum  Hydrochloricum  (see 


ACIDUM  SULPHUROSUM. 


73 


ante,  page  65).  Its  chief  use  internally  is  in  lead-poisoning,  to  form  the 
insoluble  sulphate,  and  as  a  remote  astringent  in  diarrhoea,  hemorrhoids, 
hemorrhages,  night-sweats,  and  mucous  discharges.  In  choleraic  diar¬ 
rhoea  and  lead  poisoning  it  is  generally  administered  in  combination  with 
Opium.  The  hemorrhages  in  which  it  is  efficient  are  only  those  from 
mucous  surfaces.  It  is  exerted  chiefly  by  the  kidneys,  part  escaping  by 
the  bowels  as  sulphates,  part  also  by  the  skin.  Like  the  other  mineral 
acids,  it  does  not  increase  the  acidity  of  the  urine  to  any  considerable 
extent.  Its  principal  actions  are  those  of  an  astringent,  an  anhydrotic 
and  a  hemostatic. 


ACIDUM  SULPHUROSUM,  Sulphurous  Acid, — is  a  color¬ 
less  liquid,  of  sulphurous  taste  and  very  acid  reaction,  composed  of  about 
3^  per  cent,  of  Sulphurous  Acid  Gas  (S02)  and  96^  per  cent,  of  water. 
It  is  prepared  by  heating  Sulphuric  Acid  with  charcoal  and  dissolving  the 
gas  produced  in  distilled  water.  Dose,  rrp  v— oj>  largely  diluted  with  water. 

Preparations. 

Potassii  Sulphis,  Sulphite  of  Potassium,  Iv2S03.2H20. — white,  opaque,  octahedral 
crystals,  or  a  crystalline  powder,  somewhat  deliquescent,  of  bitter,  saline,  and  sulphurous 
taste,  and  a  neutral  or  feebly  alkaline  reaction  ;  soluble  in  4  of  water  at  590  F.,  and  in  5 
of  boiling  water;  sparingly  soluble  in  alcohol.  Dose,  gr.  iij-x. 

Sodii  Sulphis,  Sulphite  of  Sodium,  Na2S03.7H20,  colorless,  transparent,  monoclinic 
prisms,  efflorescent  in  dry  air,  of  cooling,  saline,  and  sulphurous  taste,  and  neutral  or 
feebly  alkaline  reaction;  soluble  in  4  of  water  at  590  F.,  and  in  0.9  of  boiling  water, 
very  slightly  soluble  in  alcohol.  Dose,  gr.  v-xx. 

Sodii  Bisulphis,  Bisulphite  of  Sodium,  NaHS03, — opaque  prismatic  crystals,  or  a 
crystalline  or  granular  powder,  slowly  oxidized  in  the  air;  of  faint,  sulphurous  odor,  a 
disagreeable  taste,  and  an  acid  reaction  ;  soluble  in  4  of  water  and  in  72  of  alcohol  at 
590  F.,  in  2  of  boiling  water,  and  in  49  of  boiling  alcohol.  By  strong  heat  it  is  con¬ 
verted  into  sulphur  and  sulphate  of  sodium.  Dose,  gr.  iij-x. 

Sodii  Hyposulphis,  Hyposulphite  of  Sodium,  Na2S2Q3.5H20, — large,  colorless,  mono¬ 
clinic  prisms  or  plates,  efflorescent  in  dry  air,  of  cooling  and  bitter  taste,  and  neutral  or 
faintly  alkaline  reaction;  soluble  in  1.5  of  water  at  590  F.,  and  in  0.5  of  boiling  water, 
which  partly  decomposes  it;  insoluble  in  alcohol.  Dose,  gr.  v-xx. 

Alagnesii  Sulphis,  Sulphite  of  Magnesium,  Mg,S03.6H20, — a  white,  crystalline  pow¬ 
der,  gradually  oxidized  in  the  air,  of  bitter  and  sulphurous  taste,  and  neutral  or  slightly 
alkaline  reaction ;  soluble  in  20  of  water  at  590  F.,  and  in  19  of  boiling  water  ;  insoluble 
in  alcohol.  Dose,  gr.  v-xxx. 


Antagonists  and  Incompatibles. 

All  oxidizing  substances  change  the  Sulphites  into  Sulphates,  and  the  mineral  acids 
decompose  them. 

Physiological  Action. 

Sulphurous  Acid  has  great  affinity  for  oxygen,  and  is  a  powerful  dis¬ 
infectant  and  deodorizer,  and  very  destructive  to  all  plant  life.  The  gas 
inhaled  is  irritant  to  the  glottis,  and  may  produce  dangerous  inflammation 
of  the  respiratory  passages. 

The  Sulphites  and  Hyposulphites  are  partly  decomposed  by  the  acid 
of  the  stomach,  sulphurous  acid  being  given  off,  and  the  balance  being 
converted  into  sulphates  act  as  purgatives,  and  are  absorbed,  undergoing 


74 


ACIDUM  TANNICUM. 


elimination  as  sulphates  by  the  kidneys  and  bowels.  They  were  formerly 
supposed  to  enter  the  blood  and  tissues  as  sulphites,  and  to  arrest  morbid 
processes  of  the  zymotic  character,  but  both  these  assumptions  have 
proven  erroneous. 

Therapeutics. 

Sulphurous  Acid  Gas  (Sulphurous  Anhydride)  is  extensively  used  as 
a  disinfectant,  being  the  most  powerful  and  convenient  agent  for  this  pur¬ 
pose.  Sulphur  is  burned  on  a  shovel  or  plate  in  the  room  to  be  fumigated, 
all  outlets  having  been  carefully  closed.  It  is  injurious  to  many  fabrics. 

Sulphurous  Acid  is  used  locally  in  many  throat  affections  as  a  spray 
or  by  a  mop.  In  diphtheria,  stomatitis,  aphthae,  ulcers  of  the  tonsils, 
syphilitic  and  tuberculous  laryngitis,  chronic  bronchitis,  etc.,  it  may  be 
thus  applied  with  great  benefit.  Morbid  fermentation  in  the  stomach  with 
growth  of  penicillium  and  sarcinae  is  quickly  stopped  by  5  to  60-minim 
doses  in  water,  or  by  the  sulphites  in  20-grain  doses.  In  parasitic  skin 
diseases  and  foul  wounds  these  agents  are  extremely  useful  as  local  appli¬ 
cations.  , 

The  Sulphites  were  used  in  zymotic  and  septic  fevers  as  internal  anti¬ 
septics  on  theoretical  grounds,  but  their  supposed  value  has  not  been 
realized. 

ACIDUM  TANNICUM,  Tannic  Acid,  Tannin,  CuH10O9,— is 
a  solid  body  in  light-yellowish  scales,  of  strongly  astringent  taste  and  acid 
reaction,  obtained  from  powdered  galls  (see  Galla),  by  exposure  for  three 
days  in  a  damp  atmosphere,  then  macerating  with  ether,  pressing,  and 
drying  the  liquid  portion.  It  is  soluble  in  6  parts  of  water,  in  0.6  of 
alcohol,  and  in  6  of  glycerin  at  590  F.  Dose,  gr.  j-xx  in  water,  pill  or 
capsule. 

Preparations. 

Unguentum  Acidi  Tannicii — is  a  10  per  cent,  ointment  made  with  Benzoinated  Lard. 

Trockisci  Acidi  Tannici, — each  troche  contains  one  grain  of  Tannic  Acid. 

Collodium  Stypticum. — Styptic  Collodion, — has  of  Tannin  20,  Alcohol  5,  Ether  20, 
Collodion  55  parts. 

Suppositoria  Acidi  Tannici  (Unofficial), — have  Tannin  I  part  to  5  of  Cacao  Butter. 

Glyceritum  Acidi  Tatinici  (Unofficial), — has  Tannin  1  part  in  4  of  Glycerin. 

Vegetable  Astringents  contain  some  form  of  tannic  acid,  as  Quercitanic  Acid  from 
Oak-bark ,  Rhatania-tannic  Acid  in  Rhatany,  etc.  (For  list,  see  page  64.)  The  official 
acid  is  Gallo-tannic  Acid ,  being  that  produced  from  Galls. 

Antagonists  and  Incompatibles. 

Mineral  acids,  alkalies,  persalts  of  iron,  and  salts  of  antimony,  lead  and  silver,  are 
chemically  incompatible.  Vegetable  alkaloids  and  gelatin  form  insoluble  precipitates 
with  Tannic  Acid. 

Physiological  Action. 

Tannic  Acid  is  a  powerful  astringent.  It  precipitates  pepsin  and 
coagulates  albumen,  impairs  digestion,  stops  peristalsis,  and  causes  con¬ 
stipation.  A  part  of  that  taken  into  the  stomach  unites  with  the  pepsin 


ACIDUM  TARTARICUM - ACONITUM. 


75 


and  albumen,  while  a  part  is  converted  into  Gallic  and  Pyro-gallic  Acids, 
and  in  this  form  is  both  absorbed  and  excreted.  It  is  a  crystalloidal  body, 
but  combines  with  colloids,  and  is  a  valuable  antidote  in  poisoning  by  the 
alkaloids  and  tartar  emetic,  with  which  it  forms  tannates  which  are  nearly 
insoluble.  Its  continued  use  disorders  digestion,  irritates  the  mucous 
membranes,  and  produces  emaciation.  Injected  into  the  veins  it  forms 
emboli  and  thus  may  cause  death,  but  by  the  stomach  it  is  non-toxic. 
Some  authorities  hold  that  Tannic  Acid  is  merely  Gallic  Acid  Anhydride  ; 
others  believe  that  the  difference  between  them  is  one  of  oxidation.  Gallic 
Acid  does  not  coagulate  albumen  or  gelatin,  while  Tannic  Acid  does. 

Therapeutics. 

Tannic  Acid  is  a  more  powerful  astringent  than  Gallic  Acid,  and  hence 
is  preferred  for  local  use  and  for  astringent  effect  on  the  intestinal  canal. 
It  is  well  employed  in  hemorrhoids  and  hemorrhages  from  the  lower  bowel, 
in  hematemesis,  epistaxis,  rectal  ulcers  or  fissures,  catarrhs  and  chronic 
affections  of  the  mucous  membranes,  endocervicitis,  conjunctivitis,  dysen¬ 
tery  and  diarrhoeas,  eczema,  impetigo  and  other  forms  of  skin-disease, 
otorrhoea,  bed-sores,  prolapsus  ani,  and  many  other  affections. 

Styptic  Collodion  is  used  to  stanch  the  bleeding  from  an  open  wound, 
to  unite  and  protect  incised  or  lacerated  wounds,  and  to  cover  and  change 
the  character  of  foul  ulcers. 

ACIDUM  TARTARICUM,  Tartaric  Acid,  H2C4H406 is  a 
crystalline  acid,  prepared  from  Acid  Tartrate  of  Potassium  (Cream  of 
Tartar),  by  neutralizing  a  solution  thereof  with  Chalk  and  Calcium  Chlor¬ 
ide,  then  decomposing  the  Tartrate  of  Lime  thus  formed  by  Sulphuric 
Acid,  evaporating  and  purifying.  It  occurs  in  colorless,  transparent 
prisms,  which  are  odorless,  of  acid  taste  and  reaction,  and  soluble  in  0.7 
of  water  and  in  2^  of  alcohol  at  590  F.  Twenty  grains  exactly  neutral¬ 
ize  27  of  Potassium  Bicarbonate,  22  of  Sodium  Bicarbonate,  or  15^  of 
Ammonium  Carbonate.  Dose,  gr.  x-xxx. 

Preparations. 

Tartaric  Acid  is  an  ingredient  of  the  Effervescing  Powders  (see  under  Potassium),  and 
is  used  in  making  all  the  preparations  of  Aconite.  Five  Tartrates  are  official  (see 
Index). 

The  actions  and  uses  of  Tartaric  Acid  are  similar  to  those  of  the  other 
Vegetable  Acids,  as  described  under  Acidum  Aceticum  {ante,  page  58). 
It  is  chiefly  employed  in  preparing  refrigerant  drinks. 

ACONITUM,  Aconite  , — is  the  tuberous  root  of  Aconitum  Napel- 
lus ,  a  perennial  plant  of  the  nat.  ord.  Ranunculaceae,  found  in  mountain- 


;6 


ACONITUM. 


ous  regions  of  Europe,  Asia  and  N.  America.  This  plant  has  deep-blue, 
helmet-shaped  flowers,  and  leaves  which  have  deeply-cut,  wedge-shaped 
segments,  exciting  slowly  when  chewed  a  sensation  of  tingling  in  the 
tongue  and  lips.  The  root  is  conical  and  tapering,  from  2  to  3  inches 
long,  dark-brown  externally,  whitish  internally,  having  a  thick  bark  enclos¬ 
ing  a  seven-rayed,  star-shaped  pith,  odorless,  taste  sweetish  at  first,  soon 
becoming  acrid.  A  minute  portion,  cautiously  chewed,  causes  prolonged 
tingling  and  numbness.  Its  active  principle  is  the  alkaloid  Aconitine  { see 
below),  which  it  contains  in  the  proportion  of  .03  per  cent.  It  also  con¬ 
tains  gum,  sugar,  Aconitic  Acid ,  and  several  other  principles,  viz. — Aco- 
nine ,  Napelline ,  Pseudaconitine ,  Lyctonine ,  etc.,  concerning  which  there 
is  much  diversity  of  opinion.  Dose,  gr.  y2- ij. 

Other  aconite-roots  are  those  of  A.  Cammarum ,  A.  ferox,  and  the 
Chinese  or  Japanese  Aconite,  A.  Chinense  vel  Japonicum.  From  the  latter 
an  alkaloid  is  obtained,  named  Japaconitinc ,  which  is  even  more  poisonous 
than  pseud-aconitine.  The  Indian  variety  (. A .  ferox )  contains  pseud¬ 
aconitine  but  does  not  yield  aconitine.  The  former  is  considered  to  be 
more  active  than  the  latter,  and  Japaconitine  more  so  than  either  the 
other  two. 

Preparations. 

Abstraction  Aconiti , — is  twice  the  strength  of  the  powdered  drug  or  its  fluid  extract. 
Dose,  gr.  %-).  . 

Extraction  Aconiti , — is  at  least  four  times  as  strong  as  the  extract  official  in  the  U.  S. 
P.,  1870,  which  was  prepared  from  the  leaves,  and  is  yet  to  be  found  in'the  shops.  Dose, 

£r-  Ve-'A- 

Extraction  Aconiti  Fluidum , — each  drop  represents  nearly  one  grain  of  the  powdered 
drug:  an  alcoholic  preparation.  Dose,  tty y^-ij. 

Tinctura  Aconiti, — Aconite  40,  Tartaric  Acid  0.4,  Alcohol  to  100  parts.  Is  about 
twenty-eight  times  as  strong  as  the  former  tincture  of  the  leaf.  Dose,  ttyy£-iv. 

Tinctures  of  Aconite  root  vary  greatly  in  strength.  In  Fleming’s  Tincture  79  parts  of 
aconite  are  used  in  preparing  100  of  the  tincture,  in  that  of  the  Br.  P.  16,  the  French  20, 
the  German  10,  while  the  Linimentum  Aconiti  (B.  P.)  is  really  a  very  strong  tincture,  of 
the  strength  of  1  to  I yz.  Probably  the  best  and  safest  preparation  for  ordinary  use  is  a 
10  per  cent,  tincture,  of  which  the  maximum  single  dose  lor  an  adult  is  stated  in  the  P. 
Ger.  at  tty  ix,  and  the  maximum  daily  dose  at  tty  xxxv. 

The  best  rule  for  the  administration  of  aconite  preparations  is  to  give  the  minimum  dose 
at  intervals  of  15  to  20  minutes,  until  the  desired  effect  is  produced. 

Unofficial  Preparations . 

Aconitina,  Aconitine,  C33H43N012, — a  white,  and  usually  amorphous  solid,  of  alka-  • 
ine  reaction,  soluble  in  150  of  cold  and  in  50  of  hot  water;  much  more  soluble  in  alco¬ 
hol  and  ether.  Is  difficult  to  obtain  of  constant  strength,  some  samples  being  all  but  inert, 
others  extremely  active.  As  obtained  in  the  shops  it  is  usually  a  mixture  of  several  alka¬ 
loids.  The  Aconitine  Crystalisee  of  Duquesnel,  which,  according  to  Squibb,  is  a  nitrate 

of  aconitine,  is  considered  to  be  the  most  active  of  those  in  the  market.  Dose,  gr. 

1  _  i_ 

2  0  6  _  t  .  .  . 

Oleatum  Aconitine?,  Oleate  of  Aconitine, — is  a  2  per  cent,  solution  in  Oleic  Acid,  for 

external  use.  Duquesnel’s  crystals  will  not  dissolve  in  Oleic  Acid  (Squibb). 

Napellina,  Napelline, — is  weaker  than  Aconitine,  and  has  been  used  in  doses  of  gr. 

It  has  lately  been  studied  by  Laborde,  who  claims  for  it  most  valuable  hypnotic 
properties,  and  proposes  to  use  it  as  a  substitute  for  opium  and  chloral. 

St.  Jacob's  Oil  (a  patent  medicine), — is  a  weak  Aconite  Liniment,  which  also  contains 
Ether,  Alcohol,  Turpentine,  red  coloring  matter  and  water  (Squibb).  See  Appendix. 


ACONITUM. 


77 


Physiological  Action. 

Aconite  is  a  powerful  depressant  of  the  sensory  nerve  ends,  the  heart, 
the  respiration  and  the  spinal  system.  It  is  also  antipyretic,  diaphoretic 
and  diuretic.  It  acts  chiefly  on  the  peripheral  ends  of  the  sensory  nerves, 
but  paralyzes  both  the  motor  and  sensory  nerves — the  sensory  being 
affected  first  and  from  the  periphery  inwards,  while  the  motor  nerves  are 
affected  from  the  centres  outwards.  It  relaxes  the  inhibitory  apparatus  of 
the  heart,  and  paralyzes  the  cardiac  muscle  and  its  contained  ganglia,  the 
respiratory  centres,  and  the  spinal  cord  in  all  its  functions — sensory,  reflex 
and  motor  ;  but  does  not  affect  the  cerebrum. 

Its  taste  is  bitter,  acrid  and  pungent.  Soon  after  the  ingestion  of  even 
a  small  quantity,  a  sensation  of  numbness  and  a  persistent  tingling  are 
felt  in  the  tongue  and  lips.  Full  medicinal  doses  cause  a  sense  of  con¬ 
striction  in  the  fauces,  irritation  of  the  gastro-intestinal  mucous  membrane 
with  increased  secretion ;  sometimes  nausea  and  vomiting,  and  severe 
pains  in  the  joints  and  muscles;  always  more  or  less  salivation,  diaphoresis 
and  diuresis  ;  reduced  respiratory  power,  cardiac  rate  and  force  ;  lowered 
arterial  tension  and  temperature. 

A  lethal  dose  produces  great  muscular  weakness,  dim  sight,  dilated 
(sometimes  contracted)  pupils;  shallow,  irregular,  and  labored  respiration, 
slow  and  weak  pulse,  cold  surface,  clammy  sweat,  great  anxiety,  numbness 
and  tingling  in  the  extremities,  lowered  body-temperature  (20  to  30), 
abolished  sensation,  impaired  reflexes  and  motility,  and  finally  death  from 
paralysis  of  the  heart  and  respiration,  with  or  without  convulsions,  con¬ 
sciousness  being  preserved  until  near  the  end,  when  C02  narcosis  sets  in. 

Aconite  is  rapidly  diffused  and  slowly  excreted,  the  effects  of  a  full 
medicinal  dose  continuing  for  three  or  four  hours.  Applied  externally, 
it  paralyzes  the  sensory  nerves  of  the  part,  producing  its  characteristic 
numbness  and  tingling. 

Antagonists. 

Caffeine ,  Atropine,  Morphine ,  Ether ,  Ammonia  and  Amyl  Nitrite  antagonize  its 
effects  on  the  heart  and  respiration.  Digitalis  counteracts  its  heart  action  and  the  relaxa¬ 
tion  of  cardiac  inhibition.  In  Aconite  poisoning,  the  stomach  should  be  evacuated, 
warmth  applied  to  the  extremities,  stimulants  administered,  artificial  respiration  if  neces¬ 
sary,  and  the  recumbent  posture  strictly  maintained.  Caffeine  maybe  administered  hypo¬ 
dermically  and  per  orem. 

Therapeutics. 

Aconite  antagonizes  the  fever  process,  and  rightly  used  is  therefore  one 
of  the  most  valuable  drugs  we  possess.  It  has  well  been  called  the 
“  therapeutic  lancet,”  and  is  certainly  responsible  to  a  great  extent  for  the 
disuse  of  venesection.  Its  power  over  the  circulation,  respiration  and 
transpiration  renders  it  of  the  greatest  value  in  all  affections  characterized 
by  high  resisting  pulse,  dry  hot  skin,  and  elevated  body-temperature.  It 
is  especially  useful  in  acute  throat  affections,  the  early  stage  of  acute 


78 


ADEPS - ETHER. 


inflammations  of  the  respiratory  organs,  catarrhal  croup,  acute  pleuritis 
and  peritonitis  before  the  stage  of  effusion,  simple  and  eruptive  fevers, 
puerperal  and  surgical  fevers,  facial  erysipelas,  acute  rheumatism,  cardiac 
affections  with  overaction  or  hypertrophy  and  without  valvular  lesion, 
diarrhoea  and  dysentery  from  cold  or  exposure,  menstrual  suppression 
from  chill,  and  neuralgia  of  the  5th  (externally  and  internally),  it  having 
a  very  positive  and  selective  influence  on  that  nerve.  It  is  also  highly 
recommended  in  otitis,  nervous  palpitations,  restlessness,  and  sick  head¬ 
ache,  as  also  in  the  acute  stage  of  gonorrhoea. 

Aconite  is  best  administered  in  small  doses  frequently  repeated  ;  from 
half  a  drop  to  a  drop  of  the  tincture  every  fifteen  minutes  in  a  teaspoon¬ 
ful  of  water  as  a  rule  give  better  results  than  do  proportionately  larger 
doses  at  longer  intervals. 

Aconitine  has  been  remarkably  efficient  in  trigeminal  neuralgia ; — so 
also  has  Napelline  been  in  the  same  affection,  and  as  an  hypnotic  it  is 
well  mentioned  by  several  observers  of  authority. 

ADEPS,  Lard  , — is  the  prepared  internal  fat  of  the  abdomen  of 
Sits  scrofa  (Pig),  purified  by  washing,  melting  and  straining.  A  soft, 
white,  unctuous  solid,  of  bland  taste  and  neutral  reaction,  entirely  soluble 
in  ether,  benzin,  and  bisulphide  of  carbon ;  composed  of  38  per  cent  of 
stearin  and  margarin,  and  62  per  cent,  of  olein.  Lard  forms  70  per 
cent,  of  Ceratum,  and  80  per  cent,  of  Unguentum,  and  enters  into  the 
composition  of  several  of  the  official  cerates. 

Preparations. 

Adeps  Benzoinatus,  Benzoinated  Lard, — has  2  per  cent,  of  Benzoin  in  powder  incor¬ 
porated  by  stirring. 

Oleum  Adipis,  Lard  Oil, — is  a  fixed  oil  expressed  from  lard  at  a  low  temperature. 

The  actions  of  the  Oils  and  Fats  will  be  described  under  Morrhu/E 
Oleum  (which  see). 

Lard  is  only  used  as  an  ingredient  of  ointments  and  cerates.  Lard 
Oil  is  used  in  making  the  Unguentum  Hydrargyri  Nitratis,  but  has  been 
proposed  as  an  inferior  substitute  for  Cod-liver  oil  in  cases  where  the 
taste  of  the  latter  is  particularly  offensive. 

./ETHER,  Ether,  Ethyl  Oxide  (C,H5)20, — in  its  absolute  form  is 
not  official,  the  strongest  preparation  containing  6  per  cent,  of  alcohol 
and  some  water.  Considered  as  a  generic  term,  an  ether  is  analogous  to 
a  salt,  as  an  alcohol  is  to  a  metallic  hydrate.  The  particular  ether 
officially  so  named  is  Ethyl  Oxide,  prepared  from  Ethyl  Hydrate  (Ethylic 
Alcohol)  by  a  dehydrating  agent  with  the  aid  of  heat,  and  then  purified 
by  various  processes.  The  agent  used  is  Sulphuric  Acid,  hence  this  ether 
is  improperly  called  “Sulphuric  Ether,”  but  the  acid  simply  dehydrates 


/ETHER. 


79 


the  alcohol  and  remains  in  the  retort,  becoming  constantly  more  diluted 
by  the  abstraction  of  water  from  the  alcohol.  Consequently  H20  is  the 
difference  between  Alcohol  and  Ether.  (C2H60)2—  H20  =  (C2H5)20. 
The  official  ethers  are  the  three  following,  viz. — 

/Ether,  Ether, — is  a  liquid  composed  of  about  74  per  cent,  of  Ethyl 
Oxide,  and  about  26  per  cent,  of  Alcohol  containing  a  little  water;  an 
inflammable,  thin,  very  diffuse,  clear  and  colorless  liquid,  having  a 
burning,  sweetish  taste,  and  a  neutral  reaction,  of  sp.  gr.  about  0.750  at 
590  F.  Its  vapor  is  heavier  than  air  and  forms  therewith  a  highly  explo¬ 
sive  mixture.  Ether  is  freely  soluble  in  alcohol,  chloroform,  benzol,  oils, 
and  in  8  volumes  of  water  at  590  F.  It  boils  at  the  temperature  of  the 
body  (98.6°),  and  is  a  solvent  of  oils,  fats,  resins,  caoutchouc,  gutta¬ 
percha,  and  many  other  substances.  It  has  chiefly  a  pharmaceutical  value. 

/Ether  Fortior,  Stronger  Ether, — is  a  liquid  composed  of  about  94 
per  cent,  of  Ethyl  Oxide,  and  about  6  per  cent,  of  Alcohol  containing  a 
little  water.  Sp.  gr.  not  above  0.725  at  590  F.  It  is  the  preparation 
employed  for  anaesthetic  use,  and  is  generally  though  improperly  called 
“  Sulphuric  Ether,”  a  term  which  belongs  to  Ethyl  Sulphate  (C4H10SO4). 
The  dose  of  /Ether  Fortior  for  internal  administration  is  npx-5j,  in  syrup. 

/Ether  Aceticus,  Acetic  Ether,  Acetate  of  Ethyl,  C2H5C2H30, — is  an 
inflammable  liquid,  transparent  and  colorless,  of  ethereal  and  acetous 
odor,  soluble  in  alcohol,  ether,  chloroform,  and  17  of  water.  Sp.  gr. 
0.889  t0  0*897*  Is  a  constituent  of  Sp.  Odoratus  and  Tr.  Ferri  Acetatis. 
Dose,  rrp  x-3j. 

Hydrobromic  Ether,  Ethyl  Bromide,  C2H5Br  (Unofficial), — is  not 
inflammable.  Dose,  internally  and  hypodermically,  rtp  x-5j* 

Hydriodic  Ether,  Ethyl  Iodide,  C2H3I  (Unofficial), — is  a  colorless 
liquid,  non-inflammable,  and  insoluble  in  water.  Dose,  inhaled,  up  xv. 

[For  the  Chlorinated  Ethers  see  under  Chloroform.] 

Preparations . 

Oleum  ASthereum,  Ethereal  Oil, — is  a  volatile  liquid,  consisting  of  equal  volumes  of 
heavy  Oil  of  Wine  and  Stronger  Ether.  Used  to  prepare  the  Spt.  Etheris  Comp.,  and 
as  it  occurs  in  commerce  is  usually  a  worthless  preparation. 

Spirilus  sEtheris,  Spirit  of  Ether, — has  of  Stronger  Ether  30  parts,  Alcohol  70. 
Dose,  np  x-3j. 

Spiritus  AEtheris  Compositus ,  Hoffman’s  Anodyne, — contains  Stronger  Ether  30,  Alco¬ 
hol,  67,  Ethereal  Oil  3  parts.  Dose,  Tipv-^j. 

Spiritus  AEtheris  Nitrosi,  Spirit  of  Nitrous  Ether,  Sweet  Spirit  of  Nitre, — is  an  alco¬ 
holic  solution  of  Ethyl  Nitrite,  C2H5N02,  containing  5  per  cent,  of  the  crude  ether.  It 
turns  acid  with  age,  and  should  not  be  kept  long.  It  is  a  constituent  of  Mist.  Glycyrrhizae 
Co.  (3  per  cent.),  Dose,  ^ss-^ss.  Its  incompatibles  are  Potassic  Iodide,  Ferric  Sul¬ 
phate,  Tr.  Guaiaci,  Tannic  and  Gallic  Acids,  and  Antipyrine. 

Ancesthetic  Mixtures. 

Nussbaum' s  has — Ether  3  parts,  Chloroform  1,  Alcohol  1. 

Vienna  General  Hospital  uses — Ether  9,  Chloroform  30,  Alcohol  9. 

The  “  Vienna  Mixture ,” — Ether  3,  Chloroform  1. 

Medico-  Chirurgical  Society  of  London  (1864)  proposed — Ether  3,  Chloroform  2,  Alco¬ 
hol  I. 


8o 


TiTHER. 


Physiological  Action  of  Ether. 

Ether  is  anodyne,  antispasmodic,  diaphoretic  and  anthelmintic ;  a 
cardiac  and  cerebral  stimulant,  an  anaesthetic,  and  a  narcotic  poison. 
Given  internally,  it  is  one  of  the  most  powerful  stimulants  of  the  secre¬ 
tions,  acting  especially  on  the  secretions  of  the  stomach,  salivary  glands 
and  pancreas.  On  the  cerebrum  and  the  motor  and  sensory  nerves  its 
action  is  similar  to  that  of  alcohol,  but  more  prompt  and  less  protracted. 
It  is  eliminated  rapidly,  chiefly  by  the  lungs.  Externally  it  is  a  powerful 
refrigerant  and  local  anaesthetic ;  also  rubefacient  when  rubbed  into  the 
skin. 

Inhaled  Ether  produces  at  first  faucial  irritation,  a  sense  of  strangula¬ 
tion  and  cough ;  then  a  stage  of  excitement  (cerebral  intoxication),  in 
which  the  face  is  flushed  and  the  respiration  and  pulse  are  accelerated.  A 
tetanic  convulsive  stage  generally  follows,  the  face  being  cyanosed,  the 
muscles  rigid,  and  the  respiration  stertorous.  This  soon  subsides,  and 
complete  insensibility  is  established,  the  muscles  being  then  relaxed,  the 
reflexes  abolished,  and  the  cerebral  functions  suspended,  the  lower  centres 
in  the  medulla  carrying  on  the  processes  of  respiration  and  circulation. 
If  the  inhalation  be  continued,  these  also  become  paralyzed,  death  usually 
resulting  from  slow  paralysis  of  respiration,  the  heart  pulsating  long  after 
breathing  has  ceased.  [Chloroform  usually  paralyzes  the  heart.]  If  the 
inhalation  be  discontinued  before  the  lower  centres  are  affected,  the 
patient  gradually  emerges  from  the  condition  of  insensibility,  and,  as  the 
narcosis  subsides,  vomiting  is  usually  experienced. 

Ether  Compared  with  Chloroform. 

Ether  is  less  irritant  than  Chloroform  to  the  mucous  membranes  when 
swallowed,  but  its  vapor  is  more  irritant  to  the  air-passages.  It  is  more 
of  a  general  stimulant,  and  less  depressant  to  the  heart  and  circulation. 
It  does  not  clot  the  blood.  Its  vapor  is  very  inflammable,  less  pleasant  to 
inhale,  slower  in  action,  has  a  longer  stage  of  excitement,  and  a  less  pro¬ 
found  narcosis,  and  causes  a  greater  degree  of  vomiting.  It  is  much  less 
dangerous  than  Chloroform,  death  from  the  inhalation  of  Ether  occurring 
slowly  and  usually  by  paralysis  of  respiration — from  Chloroform,  it  is 
almost  always  sudden,  and  by  paralysis  of  the  heart.  Ether  has  undoubt¬ 
edly  caused  a  number  of  deaths,  besides  several  which  occurred  some 
hours  after  the  anaesthesia.  The  reported  cases  of  fatal  Chloroform  nar¬ 
cosis  number  about  500,  those  from  Ether  about  20. 

Modes  of  Dying  from  Ancesthetics. 

(I.)  From  sudden  paralysis  of  the  cardiac  ganglia,  early  in  the  inhalation,  by  reflex 
action  proceeding  from  some  peripheral  injury  before  complete  anaesthesia  is  produced. 
Thus,  in  the  extraction  of  teeth,  a  small  quantity  of  Chloroform  having  been  administered, 
the  heart  is  enfeebled,  and  the  action  of  the  cerebral  hemispheres  suspended,  but  not  those 


.ETHER. 


8l 


of  the  basal  or  medullary  ganglia.  If  at  this  stage  the  5th  nerve  be  irritated,  by  the  inti¬ 
mate  relation  of  its  nucleus  with  that  of  the  pneumogastric  reflex  inhibition  may  be  trans¬ 
mitted  over  the  latter,  arresting  the  cardiac  ganglia.  The  stage  of  incomplete  anaesthesia 
is  always  a  dangerous  one  in  which  to  perform  any  operation  around  the  distribution  of  the 
5th  nerve. 

(2.)  In  the  stage  of  rigidity,  from  tetanic  fixation  of  the  respiratory  muscles,  the  blood 
backing  up  on  the  venous  side,  and  the  arresting  of  the  heart’s  action,  respiration  ceasing 
before  the  cardiac  action  is  stopped. 

(3.)  In  the  stage  of  complete  relaxation,  by  paralysis  of  respiration;  or  by  paralysis  of 
the  tongue,  causing  obstructed  respiration. 

(4.)  In  the  same  stage,  by  paralysis  of  the  motor  ganglia  of  the  heart. 

(5.)  From  depression  of  the  functions  by  chloroform  narcosis,  and  from  shock, — and 
may  occur  in  the  anaesthetic  state,  or  afterwards. 


Contraindications  for  Anaesthesia  are — fatty  degeneration  or  dilata¬ 
tion  of  the  heart,  renal  and  pulmonary  disease,  enlarged  tonsils,  cerebral 
tumor,  and  chronic  alcoholism — particularly  the  first  and  last  named. 

Dangerous  Symptoms  should  be  met  by  withdrawing  the  vapor  and 
inverting  the  patient  head  downwards,  drawing  the  tongue  forwards,  and 
applying  a  cold  douche  to  the  face  and  chest.  Atropine  hypodermically 
is  an  agent  of  great  value  in  combating  the  cardiac  failure, — artificial  res¬ 
piration  and  faradization  of  the  respiratory  muscles  if  breathing  ceases. 
Amyl  Nitrite  by  inhalation,  or  Ammonia  hypodermically.  Heat  to  the 
body  and  limbs. 

Notes  on  Other  Ancesthetics. 

A  comparison  of  these  agents  in  respect  to  their  safety  has  been  lately  made  by  Dr. 
Richardson,  who  considers  Methylic  Ether  to  be  the  safest  of  all,  and  the  others  as  follows  : 

Safe  are — Ethyl  Bromide,  Ethyl  Chloride,  Ether,  Ethene  (olefiant  gas),  Ethene  Chlo¬ 
ride,  Methyl  Bromide,  Methyl  Chloride,  Methyl  Ether,  Methene  Chloride,  Methane 
(marsh  gas),  Nitrous  Oxide. 

Of  doubtful  value  are — Amylene,  Amyl  Chloride,  Butyl  Chloride,  Benzene  (benzol), 
Carbon  Disulphide,  Carbon  Dioxide,  Carbon  Tetrachloride,  Methyl  Alcohol,  Methylal, 
Spirits  of  Turpentine. 

Dangerous  are — Amyl  Hydride,  Butyl  Hydride,  Carbon  Monoxide,  Ethyl  Hydride. 
Chloroform  and  Ethene  Dichloride  are  considered  useful,  but  requiring  care. 


Physiological  Action  of  Other  Ethers. 

Hydriodic  Ether  is  an  antispasmodic  and  a  general  stimulant ;  also 
an  anaesthetic  if  inhaled  for  a  sufficiently  long  time.  Its  use  as  a  medicinal 
agent  is  chiefly  to  bring  the  system  rapidly  under  the  influence  of  iodine. 
It  increases  appetite,  stimulates  the  action  of  the  heart,  gives  vivacity  to 
the  general  feelings  and  activity  to  the  intellect. 

Hydrobromic  Ether  has  a  not  unpleasant  odor,  produces  but  little 
irritation  of  the  air-passages,  has  very  brief  stages  of  excitement  and 
rigidity,  and  but  a  short  stage  of  insensibility,  with  prompt  awakening 
and  but  little  of  the  mental  confusion  and  excitement  consequent  on  the 
use  of  the  other  anaesthetics.  It  is  not  inflammable,  acts  quickly,  and  is 
a  good  local  anaesthetic.  Its  actions  in  other  respects  correspond  with 
those  of  Ether. 

6 


82 


.ETHER. 


Nitrous  Ether  is  a  mild  diaphoretic,  a  diffusible  stimulant,  a  carmin¬ 
ative,  and  an  efficient  diuretic.  On  the  blood  it  acts  similarly  to  Amyl 
Nitrite,  diminishing  oxygenation,  relaxing  the  peripheral  vessels,  accel¬ 
erating  the  heart’s  action,  and  thus  lowering  arterial  tension.  Relaxing 
the  renal  and  cutaneous  vessels,  it  is  diuretic  and  diaphoretic. 

Acetic  Ether  has  a  pleasant  odor  and  taste,  forming  agreeable  combi¬ 
nations  with  other  carminatives  as  a  stimulant  and  antispasmodic. 


Therapeutics. 

When  diluted  with  alcohol  Ether  mixes  readily  with  water,  and  may  be 
administered  internally  with  advantage  in  indigestion  of  fats,  and  to  aid 
the  digestion  of  Cod-liver  Oil.  It  is  also  given  in  hysteria  to  relieve  the 
paroxysm  and  flatulence,  and  in  hepatic  colic  from  calculi,  Ether  with 
Turpentine  (Durande’s  solvent  remedy),  which  acts  only  as  an  anodyne 
and  antispasmodic,  is  considered  by  some  as  of  great  value. 

Subcutaneously  Ether  is  used  in  the  algid  stage  of  cholera,  sudden  car¬ 
diac  depression,  neuralgia,  and  in  the  adynamia  of  hemorrhage,  pneu¬ 
monia  and  the  eruptive  fevers.' 

Local  anaesthesia  by  the  Ether-spray  affords  great  relief  in  neuralgia  of 
superficial  nerves,  lumbago,  chorea,  and  spinal  irritation.  In  minor  sur¬ 
gical  operations  it  is  a  valuable  method. 

As  an  Anaesthetic  the  vapor  of  Ether  is  less  prompt  than  that  of 
Chloroform,  but  is  equally  efficient  and  much  safer.  It  should  be  inhaled 
in  as  concentrated  a  form  as  possible,  and  will  then  produce  insensibility 
in  from  5  to  10  minutes.  If  a  light  be  in  the  room  it  should  be  high 
above  the  patient.  A  grate-fire  or  gas-stove  in  the  vicinity  is  very  dan¬ 
gerous.  [Compare  Chloroform.]  Besides  its  surgical  uses  ether-anaesthesia 
is  employed  in  neuralgia,  cancer,  tetanus,  chorea,  colic,  delirium,  puer¬ 
peral  mania  and  convulsions,  infantile  convulsions,  hystero-epilepsy,  epi¬ 
leptic  seizures,  laryngismus  stridulus,  whooping-cough,  and  asthma.  The 
unpleasant  after-effects  may  be  greatly  modified  if  not  entirely  prevented 
by  the  previous  administration  of  Morphine  (gr.  yV- i)  and  Atropine 
(gr.  y|~o)  subcutaneously. 

Hydrobromic  Ether  had  a  short  period  of  popularity  as  an  anaesthetic, 
but  fell  into  disrepute  after  a  few  cases  of  death  under  its  influence,  which 
were  probably  not  due  to  the  agent  used  (Levis’  and  Sims’  cases).  Its 
action  is  less  prolonged  than  that  of  Ether,  but  it  has  many  advantages, 
requiring  only  5j  to  5ij  rapidly  given,  and  being  uninflammable.  Its 
inhalation  has  been  of  especial  value  in  hysteria,  epilepsy,  chorea  and 
other  spasmodic  disorders  ;  and  it  has  been  employed  subcutaneously  in 
place  of  Ether  in  the  treatment  of  such  spasmodic  affections  as  whooping- 
cough,  chorea,  etc. 


AGARICUS  ALBUS — AGARICUS  CHIRURGORUM. 


83 


The  Compound  Spirit  of  Ether  (Hoffman’s  Anodyne)  is  an  admi¬ 
rable  agent  in  gastralgia,  colic,  flatulence,  syncope,  etc.,  also  in  the  various 
manifestations  of  the  hysterical  paroxysm.  In  combination  with  the 
camphorated  tincture  of  Opium  it  is  often  remarkably  efficient  in  checking 
the  diarrhoea  of  hot  weather. 

Spirit  of  Nitrous  Ether  is  used  as  a  diaphoretic,  a  diuretic  and  a 
carminative ;  also  in  expectorant  mixtures,  as  an  antipyretic  in  febrile 
affections,  and  to  relieve  pain  in  angina  pectoris,  dysmenorrhoea  and 
asthma. 

Hydriodic  Ether  may  be  obtained  in  glass  capsules  containing  five 
minims  each,  and  is  used  by  inhalation  in  chronic  pulmonary  disorders, 
cardiac  dyspnoea,  spasmodic  affections  of  the  bronchi  and  larynx,  asthma, 
and  in  catarrhal  laryngitis  with  dyspnoea.  It  is  not  employed  as  an  anaes¬ 
thetic. 


AGARICUS  ALBUS,  Purging  Agaric  (Unofficial), — is  a  fungus, 
occurring  in  large  white  spongy  pieces,  obtained  from  the  European  larch. 
It  contains  Agaricin ,  a  crystalline  substance,  and  Agaric  Acid ;  also  from 
40  to  70  per  cent,  of  resins. 

The  taste  of  Purging  Agaric  is  first  sweetish,  then  becoming  very  acrid 
and  bitter.  The  powder  inhaled  causes  violent  sneezing,  and  taken  inter¬ 
nally  in  full  doses  it  produces  watery  stools.  Small  doses  check  diarrhoea 
and  dysentery,  and  diminish  the  secretions  of  the  bronchi  and  mammae. 

Agaricus  Albus  was  formerly  employed  as  a  drastic  purgative,  in  doses 
of  gr.  xxx  to  3j.  It  has  lately  been  used,  with  much  success,  in  15-grain 
doses  of  the  powder,  or  3  grains  of  the  alcoholic  extract,  to  check  the 
night-sweats  of  phthisis. 


AGARICUS  CHIRURGORUM,  Surgeon’s  Agaric  (Unoffi¬ 
cial), — is  the  interior  portion  of  the  fungus  Poiyporus  fome?itarius ,  which 
grows  on  the  trunks  of  beeches,  birches,  and  oaks  in  Europe.  It  is  pre¬ 
pared  for  use  by  boiling  in  weak  lye  and  beating  with  mallets,  and  then 
occurs  in  light,  thin,  yellowish-brown  pieces,  soft  and  pliable,  without 
odor  or  taste.  It  is  almost  pure  cellulose.  It  was  formerly  used  as  a 
mechanical  hemostatic,  and  for  the  purpose  of  moxa.  When  soaked  in  a 
strong  solution  of  Potassium  Nitrate  or  Potassium  Chlorate  and  dried,  it. 
is  very  inflammable,  and  is  then  called  Spunk. 


84 


AGARICUS  MUSCARIUS. 


AGARICUS  MUSCARIUS,  Amanita  Muscaria,  Fly-Agaric 

(Unofficial), — is  a  poisonous  mushroom,  of  a  disagreeable  odor  and  a 
burning,  acrid  taste,  used  in  infusion  with  milk  for  poisoning  flies,  and 
used  by  the  Tartars  as  an  intoxicant.  It  contains  an  actively  toxic  alkaloid, 
Muscarine  C5H13N02,  of  syrupy  consistence,  odorless  and  tasteless, 
soluble  in  water  and  alcohol,  and  readily  dissolved  out  by  water  and 
dilute  acetic  acid,  so  that  a  doubtful  mushroom  may  be  easily  rendered 
innocuous.  It  may  also  be  produced  synthetically,  but  it  is  doubtful 
whether  the  article  so  prepared  is  as  active  as  the  natural  product.  It  has 
been  made  from  Choline  by  Schmiedeberg. 

Preparations. 

Muscarina,  Muscarine  (Unofficial), — Dose,  gr.  T  It  may  be  used  hypodermic¬ 

ally  in  watery  solution. 

Muscarince  Nitras,  Nitrate  of  Muscarine  (Unofficial), — may  be  used  hypodermically, 
in  doses  of  from  gr.  Tb  to  gr.  f. 

Physiological  Action. 

Muscarine  is  a  powerful  respiratory  and  cardiac  depressant,  paralyzing 
the  respiratory  centre  and  arresting  the  heart  in  diastole  by  paralyzing 
its  motor  ganglia  while  stimulating  its  inhibitory  apparatus.  It  lowers  the 
arterial  tension,  produces  profound  salivation,  lachrymation  and  sweating, 
contracts  the  pulmonary  vessels,  causing  intense  dyspnoea,  and  increases 
the  intestinal,  hepatic  and  pancreatic  secretions,  but  markedly  diminishes 
the  renal.  It  disturbs  the  gastro-intestinal  tract,  causing  tetanic  intesti¬ 
nal  contractions,  severe  colic,  vomiting  and  purging.  It  produces  spasm 
of  the  accommodation,  marked  myosis  and  contraction  of  the  pupil  when 
given  internally,  but  dilates  the  pupil  widely  when  locally  applied.  [Gel- 
semium  does  so  also.]  Under  its  action  the  body  temperature  is  decid¬ 
edly  reduced,  and  the  excretion  of  waste-products  is  lessened.  It  is 
eliminated  unchanged  by  the  kidneys. 

Agaricus  acts  as  an  intoxicant  to  the  cerebrum,  producing  more  vertigo 
and  delirium  than  Alcohol,  followed  by  profound  sopor  with  lowered  re¬ 
flexes,  perhaps  coma  and  death. 

Antagonists. 

Atropine  exactly  opposes  Muscarine,  and  vice  versa;  no  example  of  physiological 
antagonism  being  so  complete  in  all  particulars.  When  a  frog’s  heart  is  arrested  by  the 
topical  action  of  a  minute  quantity  of  Muscarine,  the  application  of  a  little  Atropine  will 
immediately  paralyze  the  inhibition  and  restore  the  pulsations.  An  equally  prompt 
antagonism  runs  through  their  entire  spheres  of  action.  Digitaline  is  to  some  extent  an¬ 
tagonistic  ;  so  also  is  Eserine. 

Therapeutics. 

Muscarine  has  been  as  yet  little  used  in  medicine,  but  it  will  probably 
prove  to  be  a  valuable  drug.  It  has  been  long  used,  with  marked  benefit, 
in  the  night-sweats  of  phthisis.  A  tincture  of  Agaricus  has  been  found 
beneficial  in  ataxic  typhus,  chorea,  and  chilblains.  Muscarine  promises 


AILANTHUS - ALCOHOL. 


85 


to  be  of  great  value  in  inflammations  characterized  by  copious  exudation, 
especially  eye-inflammations,  catarrhal  jaundice,  recent  hemorrhoids, 
acute  bronchitis,  pulmonary  hemorrhage,  incipient  pulmonary  congestion, 
diabetes  of  both  forms,  and  in  constipation  due  to  intestinal  torpor  and 
deficient  secretion,  accompanied  by  a  torpid  liver  and  difficult  digestion 
of  fats.  In  the  latter  affection  it  should  be  given  in  small  doses,  gr.  -gh-, 
thrice  daily. 

AILANTHUS,  Tree  of  Heaven  (Unofficial), — is  the  bark  of 
Ailanthus  glandulosa ,  a  well-known  shade  tree,  of  the  nat.  ord.  Simaru- 
bacese,  indigenous  to  China,  but  cultivated  elsewhere.  It  contains  an 
oleo-resin  and  a  volatile  oil,  on  which  its  properties  probably  depend. 
Dose,  gr.  x-3j* 

Preparations. 

Extractum  Ailanthus  Fluidum  (Unofficial), — Dose,  up  x-  3  j . 

Tinctura  Ailanthus  (Unofficial), — Dose,  up  x- 3  ij. 

Physiological  Action  and  Therapeutics. 

Ailanthus  is  a  decided  nauseant,  and  a  drastic  purgative,  causing  also 
vertigo,  weakness,  cold  sweats,  dull  headache,  pains  in  the  back,  numb¬ 
ness  and  tingling  in  the  limbs.  It  paralyzes  the  cerebrum  and  spinal  cord 
of  animals,  impairment  of  motility  beginning  in  their  hind  extremities. 
The  cardiac  action,  at  first  increased,  soon  slows,  the  pulse  becoming 
small  and  weak,  and  the  respiration  depressed,  death  occurring  from 
paralysis  of  respiration.  It  is  a  good  taeniafuge. 

Ailanthus  is  used  against  tapeworm,  a  decoction  of  the  fresh  bark  (5j 
ad  5iv),  or  the  oleo-resin  in  drachm  doses,  being  very  efficient.  It  has 
also  been  well  employed  in  malignant  scarlatina,  with  dark  and  partial 
eruption,  insensibility,  delirium  and  other  cerebral  symptoms. 

♦ 

ALCOHOL  , — is  a  liquid  composed  of  91  per  cent,  by  weight  (94  per 
cent,  by  volume)  of  Ethyl  Alcohol ,  C2H5HO,  and  9  per  cent,  by  weight 
(6  per  cent,  by  volume)  of  water.  Sp.  gr.  0.820  at  6o°  F.,  and  0.812  at 
770  F.  An  inflammable,  transparent,  colorless,  mobile  and  volatile 
liquid,  of  agreeable  odor  and  burning  taste.  Obtained  by  the  distilla- 
'  tion  of  fermented  saccharine  fluids.  Used  in  making  all  the  Tinctures 
and  Spirits;  also  in  some  of  the  Liniments,  Liquors  and  Mixtures. 

Preparations. 

Alcohol  Dilutum,  Diluted  Alcohol, — consists  of  Alcohol  and  Distilled  Water,  equal 
parts  of  each.  Sp.  gr.  0.928  at  6o°  F. 

Spirilus  Frumenti ,  Whiskey, — obtained  from  the  distillation  of  fermented  grain,  rye 
or  corn  (U.  S.),  barley  (Scotch),  and  at  least  two  years  old.  Sp.  gr.  0.917  to  0.930.  Has 
an  alcoholic  strength  of  44  to  50  per  cent,  by  weight ;  also  Ethers  developed  by  the  action 


86 


ALCOHOL. 


of  acetic  and  butyric  acids  on  the  alcohol,  and  traces  of  Amylic  Alcohol  (fusel-oil)  even  in 
the  best. 

Spirilus  Vini  Gallici ,  Brandy, — obtained  from  the  distillation  of  fermented  grapes,  and 
at  least  four  years  old.  Sp.  gr.  0.925  to  0.941.  Has  an  alcoholic  strength  of  39  to  47 
per  cent,  by  weight,  and  (Enanthic  and  other  Ethers  developed  by  age.  Pale  Brandy  is 
colored  by  the  cask,  the  dark  has  caramel  to  color  it.  Is  often  prepared  artificially  by 
adding  to  high  wines  Acetic  or  Nitric  Ether,  Caramel,  and  Logwood  or  Catechu  for 
astringency. 

Spiritus  Odoratus .  Perfumed  Spirit,  Cologne-water, — prepared  by  adding  to  800  parts 
of  Alcohol,  Water  158,  Acetic  Ether  2,  Oil  of  Bergamot  16,  Oil  of  Lemon  8,  Oil  of  Rose¬ 
mary  8,  Oil  of  Lavender  Flowers  4,  and  Oil  of  Orange  Flowers  4  parts.  A  perfume  or 
ingredient  of  lotions. 

Vinum  Album,  White  Wine, — should  contain  from  10  to  12  per  cent,  by  weight  ot 
absolute  alcohol,  and  is  made  by  fermenting  the  unmodified  juice  of  the  grape,  freed  from 
seeds,  stems  and  skins. 

Vinum  Albtim  Fortius ,  Stronger  White  Wine, — should  contain  20  to  25  per  cent,  by 
weight  of  absolute  alcohol,  and  is  made  by  adding  1  part  of  Alcohol  to  7  of  Vinum  Album. 
Is  simply  a  formal  recognition  of  the  fact  that  the  stronger  sherries  are  artificially  made. 
Used  to  prepare  the  official  Vina  (Wines). 

Vinum  Rubrum ,  Red  Wine, — should  contain  from  10  to  12  per  cent,  by  weight  of 
absolute  alcohol,  and  is  made  by  fermenting  the  juice  of  colored  grapes  in  presence  ot 
their  skins. 

Vinum  Aromaticum ,  Aromatic  Wine, — consists  of  Stronger  White  Wine  94  per  cent., 
with  Lavender,  Origanum,  Peppermint,  Rosemary,  Sage  and  Wormwood,  of  each  I  per 
cent. 

Unofficial  Alcoholic  Preparations. 

Rectified  Spirit ,  sp.  gr.  0.835, — has  85  per  cent,  by  weight  of  absolute  alcohol,  and  no 
fusel  oil.  Is  often  spoken  of  as  “  56  over  proof,”  meaning  that  to  reduce  100  volumes  of 
it  to  the  strength  of  proof  spirit,  requires  56  volumes  of  water. 

Proof  Spirit ,  sp.  gr.  0.920, — contains  49  per  cent,  by  weight  of  absolute  alcohol,  with  a 
peculiar  oil  and  other  foreign  matters. 

Rum , — is  obtained  from  the  distillation  of  fermented  molasses,  and  has  about  42  per 
cent,  by  weight  of  alcohol. 

Gin, — has  about  the  same  alcoholic  strength  as  rum,  and  approaches  very  nearly  to  the 
official  Spiritus  Juniperi  Compositus.  It  is  usually  distilled  from  rye  or  barley,  and  flavored, 
in  Holland,  with  juniper  berries  and  hops,  in  England,  often  with  oil  of  turpentine,  various 
cheap  aromatics,  acetate  of  lead,  sulphate  of  zinc,  cayenne  pepper,  etc.  Pure  gin  is  slightly 
diuretic,  from  the  oil  of  juniper  contained  in  it. 

Vinum  Portense,  Port  Wine, — is  not  a  natural  wine,  spirit  being  added  during  the  pro¬ 
cess  of  manufacture,  and  the  alcoholic  strength  raised  to  30  or  40  per  cent. 

Vinum  Xericum,  Sherry  Wine, — a  dry,  spirituous  white  wine,  generally  made  to  order 
by  the  dealers,  and  having  from  20  to  35  per  cent,  of  alcohol. 

Sparkling  Wines,  as  Champagne,  Hock,  Catawba, — are  more  or  less  sweet,  and  charged 
with  carbonic  acid,  being  bottled  before  fermentation  is  completed  and  the  grape  sugar  all 
converted  into  alcohol.  They  contain  8  to  10  per  cent,  of  absolute  alcohol. 

Sweet  Wines,  as  Burgundy,  Tokay,  Muscatel,  Malaga,  Angelica,  Madeira,  etc., — are  of 
low  alcoholic  strength,  6  to  7  per  cent.,  unless  fortified. 

Light  Red  Wines,  as  Claret,  Red  Rhine,  Concord, — have  5  to  7  per  cent,  alcohol,  tan¬ 
nic  acid,  grape  coloring  matter,  etc. 

Dry  Acid  Wines,  as  Rhine  and  Moselle  wines,  California  Hock,  Ohio,  and  Kelley- 
Island  Catawba, — in  these  fermentation  is  complete,  and  the  alcoholic  strength  from  5  to 
7  per  cent. 

Beer ,  Ale  and  Porter , — are  fermented  liquors,  made  from  malted  grain,  with  hops  and 
other  bitters  added.  Beer  is  made  by  slow  fermentation,  the  yeast  sinking ;  Ale  by  rapid 
fermentation,  the  yeast  floating.  Their  alcoholic  strength  is  from  2  to  3  per  cent,  in  beer, 
to  4  to  6  per  cent,  in  ale  and  porter, — and  they  also  contain  malt  extract,  carbonic  acid, 
lactic  acid,  various  aromatics,  potassium  and  sodium  salts,  etc. 

Koumiss, — is  obtained  by  the  fermentation  of  milk,  that  of  the  mare  being  used  in 
Tartary,  where  it  is  largely  employed  as  a  food.  It  contains  from  I  to  3  per  cent,  of  alco¬ 
hol,  sugar,  lactic  acid,  casein,  fat,  salts,  carbonic  acid  and  ethers.  (See  page  262.) 


ALCOHOL. 


87 


Principal  Alcohols. 

Ethylic  Alcohol,  Ethyl  Hydrate,  C2H60, — Grain-spirit. 

Methylic  Alcohol,  Methyl  Hydrate,  CH40, — Wood-spirit. 

Amylic  Alcohol,  Amyl  Hydrate,  C5Hr20, — Potato-spirit,  Fusel  Oil. 
Occurs  also  in  the  excessive  distillation  of  fermented  grain,  after  the 
ethylic  alcohol  has  distilled  over. 

Phenylic  Alcohol,  Phenol,  Carbolic  Acid,  C6H60, — from  coal-tar 
(see  page  60). 

Composition ,  etc.,  of  Alcohols. 

An  Alcohol  is  a  volatile  organic  compound,  which  contains  no  N,  has  a  great  affinity 
for  water,  and  reacts  with  acids,  forming  H20  and  ethers.  Alcohols  are  therefore  analo¬ 
gous  to  the  metallic  hydrates,  and  Ethers  to  salts.  They  are  obtained  by  distillation  from 
the  fermented  product  of  grape-sugar,  or  some  substance  (as  starch)  easily  converted  into 
grape-sugar,  which,  in  the  presence  of  certain  low  vegetable  organisms  (as  the  yeast- 
plant),  splits  up  into  Alcohol  and  C02;  and  may  be  made  synthetically  by  shaking  Ole¬ 
fiant  gas  (C2H4)  with  strong  Sulphuric  Acid),  then  diluting  and  distilling.  C2H4  -f- 
H20  =  C2H60,  Ethylic  Alcohol.  Absolute  Ethylic  Alcohol,  which  is  only  used  for 
chemical  testing,  is  made  by  shaking  Rectified  Spirit  with  Potassium  Carbonate,  decant¬ 
ing,  and  distilling  with  slaked  lime. 

Alcohol  very  slowly  oxidized  forms  Aldehyde  (C2H40),  if  less  slowly,  Acetic  acid 
(C2H402),  if  quickly  as  in  burning,  C02  and  H20,  which  are  in  all  cases  the  ultimate 
products  of  its  continued  oxidation. 

Physiological  Action. 

Alcohol  is  a  cerebral  excitant  and  depressant  and  a  narcotic  poison.  It 
is  anaesthetic,  antiseptic,  and  antiparasitic,  a  mild  counter-irritant,  and  it 
coagulates  albumen  by  abstracting  its  water.  It  is  very  diffusible,  and  is 
partly  oxidized  by  the  organism,  part  being  excreted  unchanged. 

In  small  doses,  Alcohol  relaxes  the  vessels,  stimulates  the  gastric  glands, 
promotes  appetite  and  digestion,  lessens  the  elimination  of  waste-products 
(urea  and  C02),  causes  a  subjective  sensation  of  heat,  and  slightly  raises 
the  body  temperature.  It  briefly  stimulates  the  heart,  prolonging  its  sys¬ 
tole  and  reducing  the  length  of  the  diastole,  and  increases  the  functional 
activity  of  all  the  organs.  A  portion  is  oxidized  by  the  organism  (about 
Sjss  in  twenty-four  hours),  yielding  force  which  is  utilized  as  nervous, 
muscular  and  glandular  power. 

The  continued  use  of  small  or  moderate  doses  congests  the  stomach 
and  liver,  over-stimulating  the  gastric  glands  and  the  hepatic  cells  to  the 
production  of  pathological  secretions,  causing  gastric  catarrh  and  morn¬ 
ing-vomiting  of  mucus,  and  impairing  digestion.  By  irritation  it  sets  up 
hyperplasia  of  the  submucous  connective  tissue  (sclerosis),  especially  in 
the  stomach,  brain,  kidneys  and  liver  (cirrhosis)  ;  produces  fatty  degen¬ 
eration  (steatosis)  of  the  blood,  the  arterial  walls,  and  the  various  organs, 
and  depresses  the  heart  and  the  arterial  tension.  Epilepsy,  paraplegia, 
amaurosis  and  insanity  may  result  from  the  long-continued  use  of  spirits, 
alcohol  having  an  especial  affinity  for  the  nervous  system.  The  malt 
liquors  (beer,  ale,  etc.)  are  less  prone  than  the  spirituous  to  affect  the 


88 


ALCOHOL. 


brain,  but  are  even  more  apt  to  set  up  fatty  degeneration  of  the  liver  and 
heart. 

In  large  doses  Alcohol  precipitates  pepsin  and  destroys  its  activity  as  a 
ferment,  arrests  digestion,  produces  exhilaration,  intoxication,  hallucina¬ 
tions,  delirium,  muscular  incoordination,  depression  of  the  heart,  lowered 
arterial  tension  and  body  temperature,  abolished  reflexes  and  coma. 

A  toxic  dose,  after  a  very  brief  period  of  excitement,  produces  insensi¬ 
bility,  stertorous  breathing,  dilated  or  contracted  pupils,  complete  mus¬ 
cular  resolution,  and  death  by  paralysis  of  the  heart  and  respiration. 

Acute  Alcoholism  may  be  confounded  with  apoplexy,  opium  narcosis, 
concussion  of  the  brain,  and  even  acute  pneumonia, — the  differential 
diagnosis  being  impossible  to  make  in  the  stage  of  deep  coma.  The 
pupils  are  not  a  trustworthy  indication,  as  in  alcoholism  they  may  be 
either  dilated  or  contracted. 

Alcohol  is  a  food  within  narrow  limits,  Sjss  per  diem  being  the  prob¬ 
able  quantity  which  the  adult  organism  can  oxidize,  more  than  this  being 
probably  poisonous,  as  it  sets  up  structural  changes  in  the  various  organs, 
and  lowers  the  power  of  resistance  to  morbific  influences.  It  has  frequently 
caused  an  intractable  form  of  phthisis.  The  very  young  and  the  very  old 
stand  more  alcohol  relatively  than  the  adult.  It  has  been  proven  to  exist 
normally  in  the  human  organism. 

Treatment  of  Acute  Alcoholism. 

The  stomach  should  be  evacuated,  Ammonia  by  inhalation  cautiously,  warmth  applied 
to  the  extremities,  cold  affusion  to  the  head,  faradism  of  the  muscles  of  respiration.  Milk, 
mucilaginous  drinks,  black  coffee,  are  useful  afterwards.  Lupuline  as  a  substitute  stimu¬ 
lant,  Chloral  (cautiously)  to  secure  sleep,  but  is  dangerous  in  old  topers.  Capsicum  is 
excellent  for  the  same  purpose  in  20  to  30-grain  doses.  Nutritious,  digestible  diet  in  fluid 
form  and  small  quantity  frequently  repeated.  The  Chloride  of  Ammonium,  about  g  ss 
in  half  a  pint  of  water  at  one  draught,  has  a  marvellous  effect  in  generally  straightening 
up  the  victim,  antagonizing  stupor,  and  restoring  faculties. 

Therapeutics. 

Though  Alcohol  is  decidedly  injurious  in  health,  in  disease  it  is  a  most 
useful  agent.  It  is  invaluable  in  diphtheria,  poisoning  by  cardiac  depres¬ 
sants  and  snake-venom,  adynamic  fevers  and  cardiac  failure  from  any 
cause.  It  is  an  excellent  dressing  to  wounds  and  bed-sores,  may  prevent 
colds  from  exposure  by  relaxing  the  peripheral  vessels  and  restoring  the 
balance  of  the  circulation,  and  in  phthisis  it  does  good  if  it  promotes 
digestion  and  assimilation.  In  atonic  indigestion  of  nervous  and  depressed 
subjects,  cholera  infantum,  diarrhoea,  etc.,  brandy  is  universally  found  to 
be  beneficial.  In  the  vomiting  of  yellow  fever  or  of  sea-sickness  iced 
champagne  is  very  efficient.  In  anaemia  and  chlorosis  good  red  wines 
are  almost  indispensable,  as  also  in  convalescence  from  acute  diseases, 
sudden  and  profuse  hemorrhage,  and  in  many  other  morbid  conditions. 

Koumiss  is  an  excellent  food  and  stimulant  in  feeble  digestion,  phthisis, 
chronic  bronchitis,  and  in  all  adynamic  states  in  which  the  effects  of 


ALLIUM - ALNUS - ALOE. 


89 


alcohol  and  nutrients  are  indicated.  The  stomach  is  very  tolerant  of  kou¬ 
miss  even  when  it  will  bear  nothing  else,  and  as  it  increases  the  body 
nutrition  remarkably  it  is  of  great  value  in  the  treatment  of  all  the 
cachexise.  Each  quart  is  estimated  to  contain  4  ounces  of  solid  food,  be¬ 
sides  1  to  3  per  cent,  of  alcohol.  (See  also  under  Kumyss,  page  262.) 

ALLIUM,  Garlic  , — is  the  bulb  of  Allium  sativum ,  a  plant  of  the 
nat.  ord.  Liliacese,  indigenous  to  Asia,  but  cultivated  in  Europe  and 
America.  It  is  sub-globular  and  compound,  consisting  of  eight  bulblets, 
covered  by  dry,  membranous  scales.  Its  odor  is  pungent  and  disagreeable 
and  its  taste  is  warm  and  acrid.  It  contains  a  Volatile  Oil,  which  consists 
mainly  of  the  Sulphide  of  Allyl  (C3H5)2S,  on  which  its  qualities  depend. 
Allied  species  are  Allium  Cepa,  the  Onion,  and  Allium  Porrum,  the 
Leek. 

Syrnpiis  Allii ,  Syrup  of  Garlic, — contains  15  per  cent,  of  Garlic,  Sugar  60,  Dilute 
Acetic  Acid  40  parts.  Dose,  gj-iv,  according  to  age. 

Physiological  Action  and  Therapeutics. 

Garlic,  Leeks  and  Onions  are  stimulant  to  the  digestion  and  to  the 
nervous  system,  and  are  supposed  to  have  a  special  influence  upon  the 
bronchial  secretion.  Garlic  is  also  thought  to  be  emmenagogue  and  an¬ 
thelmintic.  It  promotes  diaphoresis  and  diuresis,  and  acts  as  a  tonic  and 
carminative.  Many  persons  use  it  as  a  condiment.  Large  doses  will  often 
produce  gastric  irritation,  flatulence,  hemorrhoids,  headache  and  fever. 
In  domestic  practice  it  is  frequently  employed  as  an  external  application 
in  the  cutaneous  eruptions  of  children,  and  as  a  poultice  or  liniment  in 
infantile  disorders  of  many  kinds.  Internally  it  is  of  real  benefit  in  feeble 
digestion  and  flatulence,  chronic  catarrhal  affections  of  children,  in  ner¬ 
vous  and  spasmodic  coughs  and  in  nervous  vomiting. 

ALNUS,  Alder-Bark  (Unofficial),  is  the  bark  of  Alnus  serrulata, . 
the  common  American  Alder,  a  small  tree  of  the  nat.  ord.  Betulaceae. 
It  has  similar  properties  to  those  of  A.  glutinosa,  the  European  Alder,  and 
A.  urcana,  the  Tag  Alder,  and  contains  a  tannic  acid,  an  oil  and  a  resin. 
The  bark  and  leaves  are  astringent  and  bitter,  and  are  chiefly  used  as 
gargles  for  the  throat,  as  local  applications  to  wounds  and  ulcers,  and  to 
restrain  the  secretion  of  milk.  Dose  of  the  powdered  bark  gr.  x,  in 
decoction  or  infusion,  several  times  a  day.  The  Tag  Alder  is  highly 
recommended  as  a  hemostatic. 

ALOE,  Aloes, — is  the  inspissated  juice  of  the  leaves  of  Aloe  soco- 
trina,  a  plant  of  the  nat.  ord.  Liliaceae,  inhabitating  the  island  of  Socotra 
and  the  eastern  coast  of  Africa  near  the  southern  shore  of  the  Red  Sea. 
It  has  orange-colored  flowers  and  resembles  in  appearance  the  American 


90 


ALOE. 


aloe  or  century-plant  (. Agave  cunericana).  It  occurs  in  soft  masses,  hard 
exteriorly,  of  a  yellowish-brown  color,  fragrant  odor  and  bitter  taste,  solu¬ 
ble  in  alcohol  and  in  boiling  water,  and  containing  a  peculiar  volatile 
oil,  a  resin  and  Soa/oin,  C15H1607,  a  variety  of  the  principle  Aloin ,  which 
is  common  to  all  varieties  of  aloes, — also  Aloetic  and  Chrysammic  Acids. 
Dose,  gr.  j-v. 

Other  varieties  are  Aloe  Barbadensis,  Barbadoes  Aloes,  from  Aloe 
vulgaris ;  and  Aloe  Capensis,  Cape  Aloes,  from  Aloe  ferox ,  the  first  of 
which  is  official  in  the  Br.  Phar. 

Preparations. 

Aloe  Purificata ,  Purified  Aloes, — prepared  by  heating  with  alcohol,  straining  and 
evaporating.  Is  almost  entirely  soluble  in  alcohol.  Dose,  gr.  j-v. 

•  Extraction  Aloes  Aquosum ,  Watery  Extract  of  Aloes, — prepared  by  mixing  I  with  io 
parts  of  Boiling  Distilled  Water,  standing  12  hours,  decanting,  straining  and  evaporating. 
Dose,  gr.  ss-v. 

Tinctura  Aloes,  Tincture  of  Aloes, — has  of  Aloes  10,  extract  of  Glycyrrhiza  10,  Di¬ 
luted  Alcohol  to  100  parts.  Dose,  3  ss-ij. 

Tinctura  Aloes  et  Myrrhce ,  Tincture  of  Aloes  and  Myrrh, — Aloes  10,  Myrrh  10, 
Alcohol  to  100  parts.  Dose,  3  ss-ij. 

Vinum  Aloes,  Wine  of  Aloes, — has  of  Aloes  6,  Cardamom  1,  Ginger  1,  Stronger  White 
Wine  to  100  parts.  Dose,  ^j-iv. 

Pilulce  Aloes,  Pills  of  Aloes, — each  has  of  Aloes  gr.  ij  with  the  same  quantity  of  Soap. 

Pilulce  Aloes  et  Asafetidce ,  Pills  of  Aloes  and  Asafetida, — each  contains  gr.  iy£  of  each 
ingredient. 

Pilulce  Aloes  et  Ferri,  Pills  of  Aloes  and  Iron, — each  pill  contains  gr.  j  each  of  Aloes, 
Sulphate  of  Iron  and  Aromatic  Powder,  with  Confection  of  Rose. 

Pilulce  Aloes  et  Mastiches,  Pills  of  Aloes  and  Mastic,  Lady  Webster’s  Pill, — each  has 
of  Aloes  gr.  ij,  Mastic  gr.  ss,  Red  Rose  gr.  ss. 

Pilulce  Aloes  et  Myrrhce,  Pills  of  Aloes  and  Myrrh, — each  contains  of  Aloes  gr.  ij, 
Myrrh  gr.  j,  Aromatic  Powder  gr.  ss,  mixed  with  Syrup. 

Pulvis  Aloes  et  Canellce,  Powder  of  Aloes  and  Canella  (Unofficial), — contains  the  pow¬ 
dered  bark  of  Canella  alba.  Dose,  gr.  v-xx. 

Aloes  is  also  a  constituent  of  Pilulae  Rhei  Compositae  and  Tinctura  Benzoini  Composita — 
(which  see,  pages  336  and  129  respectively). 


Physiological  Action. 

Aloes  is  a  tonic -astringent  and  resin-bearing  purgative,  an  emmena- 
•gogue  and  an  anthelmintic  against  the  thread-worm.  As  a  cathartic  it  acts 
chiefly  on  the  lower  half  of  the  large  intestine,  in  doses  of  gr.  j-iv  producing 
in  about  10  hours  copious  soft  evacuations  with  some  griping  pain.  This 
effect  is  produced  whether  the  drug  be  taken  internally  or  absorbed  from 
an  exposed  surface,  so  that  it  probably  diffuses  into  the  blood  and  is 
eliminated  by  the  mucous  membrane  of  the  colon.  It  is  a  stomachic  tonic 
in  small  doses,  a  stimulant  of  the  hepatic  functions,  and  an  excitant  of 
the  pelvic  circulation.  It  may  cause  abortion  in  the  female  and  priapism 
in  the  male,  and  is  said  to  have  frequently  produced  hemorrhoids,  which 
if  existing  it  will  certainly  aggravate.  Given  to  nursing  mothers  it  im¬ 
parts  a  purgative  quality  to  their  milk. 

Therapeutics. 

Aloes  is  chiefly  used  in  combination  with  Iron,  Myrrh,  Nux-vomica, 
etc.,  for  amenorrhoea  and  chronic  constipation  with  atonic  dyspepsia  and 


ALTHAEA - ALUMEN. 


91 


hypochondriasis.  It  is  curative  in  certain  forms  of  hemorrhoids,  especially 
those  occurring  after  delivery  and  where  the  condition  is  not  one  of 
active  pelvic  congestion.  It  is  also  used  internally  and  as  an  injection 
in  gonorrhoea,  and  for  simple  atonic  jaundice.  It  must  be  avoided  in 
irritable  rectum,  hemorrhoids  of  active  form,  menorrhagia  and  pregnancy, 
unless  given  in  small  doses  and  with  care.  The  Pil.  Aloes  et  Ferri  is 
perhaps  the  most  generally  useful  agent  in  anaemia,  amenorrhoea  and  con¬ 
stipation  of  girls  at  the  period  of  puberty. 

ALTHAEA,  Marsh-Mallow,  — is  the  peeled  root  of  Althcea  offici¬ 
nalis ,  a  European  plant  of  the  nat.  ord.  Malvaceae,  occurring  in  dry 
cylindrical  pieces,  of  white  color,  without  pith,  of  faintly  aromatic  odor 
and  sweetish  mucilaginous  taste.  It  contains  about  35  per  cent,  each  of 
vegetable  mucus  and  starch,  with  2  per  cent,  of  Asparagin,  also  pectous 
matter,  sugar,  fixed  oil,  but  no  tannin.  It  is  a  constituent  of  Massa 
Hydrargyri  and  Pilulae  Phosphori,  and  is  much  used  as  an  excipient  in 
extemporaneous  pharmacy.  Dose,  indefinite. 

Syrupus  Alihcra,  Syrup  of  Althcea, — has  of  Althcea  4  per  cent.,  and  should  be  freshly 
made.  Dose,  indefinite. 

Physiological  Action  and  Therapeutics. 

Althaea  is  one  of  the  best  mucilaginous  drugs,  but  has  no  active  medi¬ 
cinal  properties.  It  is  used  in  Europe  to  make  pectoral  teas  and  syrups, 
and  is  extensively  employed  as  a  mucilaginous  demulcent.  The  powdered 
root  makes  a  good  emollient  poultice.  In  the  German  Pharmacopoeia  a 
Compound  Althaea  Tea  is  official,  which  under  the  common  name,  “  Ger¬ 
man  Breast  Tea,”  is  a  popular  demulcent  drink  in  bronchial  affections, 
coughs,  colds,  etc. 

Asparagin  is  an  organic  principle,  occurring  in  large  rhombic  crystals, 
and  found  in  many  other  plants,  as  in  the  shoots  of  asparagus,  vetches, 
potatoes,  liquorice,  the  sweet  almond,  the  root  of  the  locust,  etc.  It  is 
considered  a  derivative  of  Succinic  Acid ,  and  has  diuretic  properties, 
besides  being  sedative  to  the  circulation.  It  may  be  used  in  ascites,  espe¬ 
cially  in  children,  in  the  anasarca  of  Bright’s  disease,  and  in  gout.  Dose, 
gr.  ij-iij,  in  water. 

ALUMEN,  ALUM,  Potassa-alum,  — is  the  Sulphate  of  Potassium 
and  Aluminium,  K2A1.2(S04)4. 24H20,  which,  when  the  24  molecules  of  water 
are  driven  off,  becomes  Alumen  Exsiccatum ,  Dried  Alum ,  K2A12(S04)4. 
Alum  occurs  in  large,  octahedral  crystals,  or  cubebs,  of  sweetish  astringent 
taste  and  acid  reaction.  It  is  soluble  in  10 y2  parts  of  water  at  590  F. , 
and  in  0.3  part  of  boiling  water,  but  is  insoluble  in  alcohol.  The 
Ammonia-alum  (Aluminii  et  Ammonii  Sulphas)  was  formerly  official, 
and  is  still  sold  and  dispensed  as  “Alum.”  Dose,  gr.  x-xx, — as  an 
metic  3j  for  a  child. 


92 


ALUMINIUM. 


Preparation. 

Alumen  Exsiccatum ,  Dried  Alum, — is  a  white,  granular  powder,  slowly  soluble  in  20 
parts  of  water  at  590  F.,  and  quickly  soluble  in  0.7  of  boiling  water.  Dose,  gr.  x-xx. 

> 

Physiological  Action. 

Alum  is  an  astringent,  coagulating  albumen  and  stimulating  muscular 
contraction.  At  first  it  excites  the  flow  of  saliva  and  then  markedly 
diminishes  it.  It  coagulates  pepsin  and  arrests  digestion,  stops  peristalsis, 
and  usually  causes  constipation,  though  sometimes  inducing  diarrhoea. 
Although  coagulating  albumen,  even  in  weak  solution,  it  enters  the  blood, 
constricts  the  capillaries,  arrests  secretions,  especially  those  of  mucous 
surfaces,  and  stops  capillary  hemorrhage. 

In  teaspoonful  doses  Alum  is  an  efficient  and  non-depressant  emetic. 
In  large  doses  it  is  a  gastro-intestinal  irritant,  gj $/%  of  dried  Alum  having 
caused  the  death  of  an  adult  in  8  hours. 

Therapeutics. 

Alum  is  used  locally  as  an  astringent  in  chronic  catarrhs,  leucorrhoea, 
gonorrhoea,  hemorrhoids,  bed-sores,  ulcers,  relaxed  throat,  colliquative 
sweats,  catarrhal  ophthalmia  and  granular  lids.  The  dried  powder  is 
escharotic,  destroying  granulations  and  warty  growths,  and  is  used  by 
insufflation  in  chronic  nasal  catarrh. 

Internally  it  is  beneficial  in  gastric  catarrh,  gastralgia,  enteralgia,  pas¬ 
sive  hemorrhages,  lead  colic  and  constipation.  As  an  emetic  it  is  em¬ 
ployed  in  croup,  and  it  is  a  good  antidote  in  lead-poisoning. 

Alum  is  best  administered  alone,  as  it  forms  precipitates  with  a  large 
number  of  drugs. 


ALUMINIUM. — This  metal  is  not  official,  though  of  its  salts  two 
are,  besides  Alum.  They  are — 

Aluminii  Hydras ,  Hydrate  of  Aluminium,  Hydrated  Alumina,  A12H06, — is  a  white, 
light,  amorphous,  tasteless  powder,  insoluble  in  water  or  alcohol,  but  soluble  in  strong 
alkaline  or  acid  solutions.  Dose,  gr.  iij-xx  in  powder  or  mixture. 

Aluminii  Sulphas ,  Sulphate  of  Aluminium,  A12(S04)3.  t8H20, —  is  a  white  crystalline 
powder,  soluble  in  1.2  of  water  at  59 0  F.,  almost  insoluble  in  alcohol.  Used  locally. 

Physiological  Action  and  Therapeutics. 

The  Hydrate  is  a  feebly  astringent  and  desiccant  powder,  occasionally 
used  in  inflammatory  skin  affections  as  a  local  application,  and  internally 
in  diarrhoea. 

The  Sulphate  is  antiseptic  and  astringent.  It  has  been  used  internally 
in  diarrhoeas,  but  is  chiefly  employed  in  a  5  per  cent,  solution  locally  to 
ulcers,  or  in  stronger  solution  (5iij  ad  5vj)  in  foul  discharges  from  mucous 
surfaces.  A  saturated  solution  is  a  mild  caustic,  and  may  be  used  daily 
as  a  local  application  to  the  enlarged  tonsils,  nasal  polypi,  ulceration  of 


AMMONIACUM - AMMONIUM.  93 

os  uteri,  and  various  chronic  enlargements.  The  Benzoinated  Solution 
of  Alumina  is  an  unofficial  preparation  used  for  the  same  purposes. 

AMMONIACUM,  Ammoniac, — is  a  gum-resin,  obtained  from 
Dorema  Ammoniacum ,  a  Persian  plant  of  the  nat.  ord.  Umbelliferae, 
occurring  in  yellowish-brown  tears  of  peculiar  odor,  and  bitter,  acrid  and 
nauseous  taste.  When  triturated  with  water  it  readily  yields  a  milk-white 
emulsion,  and  contains  a  Volatile  Oil ,  which  differs  from  that  of  Asafoetida 
in  that  it  is  neither  sulphuretted  nor  phosphoretted.  It  also  contains 
resin,  gum,  gluten,  etc.  Dose,  gr.  x-xxx. 

Mistura  Ammoniaci,  Ammoniac  Mixture, — is  an  emulsion  with  water  of  4  per  cent, 
strength,  the  resin  being  suspended  by  the  contained  gum.  Dose,  ^ss-j. 

Emplastrum  Ammoniaci,  Ammoniac  Plaster. — Ammoniac  100  parts,  digested  with  140 
of  Dilute  Acetic  Acid  until  emulsionized,  then  strained  and  evaporated. 

Emplastrum  Ammoniaci  cum  Hydrargyro,  Ammoniac  Plaster  with  Mercury. — Am¬ 
moniac  72,  Mercury  18  per  cent.,  and  contains  also  Lead-plaster,  Sulphur,  Olive  Oil,  and 
Dilute  Acetic  Acid. 

Ammoniac  is  a  stimulating  expectorant  and  a  laxative,  and  has  a  mildly 
irritant  action  on  the  skin.  Its  actions  are  similar  to  those  of  Asafoetida, 
but  much  less  powerful.  It  is  not  much  used,  but  may  be  employed  with 
benefit  in  chronic  bronchial  affections,  especially  of  the  aged,  the  mix¬ 
ture  with  the  Chloride  or  Carbonate  of  Ammonium  facilitating  expectora¬ 
tion  and  lessening  wheezing.  It  is  also  recommended  in  asthma,  and  in 
glandular  enlargements  and  indolent  swellings  the  plasters  are  employed 
as  stimulating  alteratives  and  resolvents. 

AMMONIUM,  NH4,  — is  a  hypothetical  compound  radical,  which 
does  not  exist  in  the  free  state,  but  which  in  combination  with  acids  forms 
salts  which  closely  resemble  those  of  the  elements  Potassium  and  Sodium. 
Many  of  its  salts  are  official,  as  well  as  the  aqueous  solutions  of  the  gas 
Ammonia,  NH3,  which  is  produced  during  the  putrefaction  of  all  organisms 
and  of  many  organic  nitrogenous  compounds  existing  in  the  air  and  in  the 
soil  in  the  free  state.  The  chief  commercial  source  of  Ammonium  salts 
is  the  ammoniacal  liquor  from  gas-works  and  bones. 

Preparations  of  Ammonia. 

Aqua  Ammonice,  Water  of  Ammonia, — is  an  aqueous  solution  of  Ammonia,  contain¬ 
ing  y<jtfi  by  weight  of  the  gas.  It  is  a  colorless  liquid  of  pungent  odor,  acrid  taste  and 
strongly  alkaline  reaction.  Sp.  gr.  0.959  at  59°  F.  Dose,  rtpv-gss,  well-diluted. 

Aqua  Ai7imonice  Fortior ,  Stronger  Water  of  Ammonia, — contains  28  per  cent,  by 
weight  of  the  gas.  Sp.  gr.  0.900  at  590  F. 

Spiritus  Ammonice ,  Spirit  of  Ammonia  — is  a  10  per  cent,  solution  of  the  gas  in  alco¬ 
hol.  Sp.  gr.  about  0.810.  Dose,  rr^x-^j,  diluted. 

Spiritus  Ammonice  Aromaticus,  Aromatic  Spirit  of  Ammonia, — contains  Ammonium 
Carbonate,  Aqua  Ammonite,  Oils  of  Lemon,  Lavender,  and  Pimenta,  Alcohol  and 
Water.  Used  in  the  Tinct.  Guaiaci  Ammoniata  and  the  Tinct.  Valeriante  Ammoniata. 
Dose,  ^ss-ij. 

Linimentum  Ammonice,  Ammonia  Liniment, — has  of  Aqua  Ammonite  30  parts,  Cotton-  . 

seed  Oil  70. 


94 


AMMONIUM. 


'  Ammonium  Salts  and  their  Preparations . 

Liquor  Ammonii  Acetatis,  Solution  of  the  Acetate  of  Ammonium,  Spirit  of  Mindere- 
rus, — is  prepared  by  neutralizing  Dilute  Acetic  Acid  with  Carbonate  of  Ammonium,  and 
contains  about  7 y2  per  cent,  of  the  Acetate.  It  should  be  freshly  made.  Used  in  Mis- 
tura  Ferri  et  Ammonii  Acetatis.  Dose,  j. 

Ammonii  Benzoas,  Benzoate  of  Ammonium,  NH4C7II502, — in  minute  four-sided 
laminar  crystals,  soluble  in  5  of  water  and  28  of  alcohol  at  590  F.  Dose,  gr.  v-xv. 

Ammonii  Bromidum ,  Bromide  of  Ammonium,  NH4Br, — in  prismatic  crystals  or  as  a 
granular  salt,  soluble  in  I x/2  of  water  and  150  of  alcohol  at  590  F.  Dose,  gr.  x-^ss, 
well  diluted. 

Ammonii  Carbonas,  Carbonate  of  Ammonium,  NH4HC03.NH4NH2C02, — occurs 
in  white  masses  consisting  of  both  the  bicarbonate  and  carbonate,  which  on  exposure  to 
air  becomes  a  white  powder  (acid  carbonate).  Soluble  in  4  parts  of  water  at  590  F. 
Dose,  gr.  v-x. 

Ammonii  Chloridum,  Chloride  of  Ammonium,  Sal-ammoniac,  HN4C1, — a  white, 
crystalline  powder,  of  saline  taste,  and  slightly  acid  reaction  ;  soluble  in  3  of  water  and 
very  sparingly  in  alcohol.  Dose,  gr.  j-xx. 

Trochisci  Ammonii  Chloridi ,  Troches  of  Chloride  of  Ammonium, — each  contains  2 
grains  of  the  chloride. 

Ammonii  Iodidum ,  Iodide  of  Ammonium,  NH4I, — a  deliquescent,  granular,  white 
salt,  soluble  in  I  of  water  and  9  of  alcohol  at  590  F.  Dose,  gr.  ij-x. 

Ammonii  Nitras,  Nitrate  of  Ammonium,  NH4N03. — in  colorless  crystals  or  fused 
masses,  soluble  in  0.5  of  water  and  20  of  alcohol  at  590  F.  Only  used  to  prepare  Nitrous 
Oxide  Gas  by  heating  to  365°  F.,  for  anaesthesia. 

Ammonii  Phosphas ,  Phosphate  of  Ammonium  (NH4)2HP04, — in  colorless  prisms, 
soluble  in  4  of  water,  insoluble  in  alcohol.  Dose,  gr.  v-xx. 

Ammonii  Sulphas ,  Sulphate  of  Ammonium  (NH4)2S04, — is  only  used  for  the  prepara¬ 
tion  of  other  ammonium  salts. 

Ammonii  Valerianas,  Valerianate  of  Ammonium  NH4C5H902, — in  white,  quadrangu¬ 
lar  plates,  deliquescent ;  very  soluble  in  water  and  alcohol.  Dose,  gr.  j-v. 

RaspaiPs  “  Eau  Sedative  ”  (Unofficial), — consists  of  Aqua  Ammonke  3  ij,  Sodii  Chlori¬ 
dum  ^ij,  Spiritus  Vini  Camphorat.  ^iij,  Aqua  ^xxxij.  For  local  use. 


Physiological  Action. 

The  gas  Ammonia  is  intensely  alkaline  and  irritant  to  mucous  mem¬ 
branes  ;  inhaled  producing  spasmodic  cough  and  a  sense  of  suffocation. 
Its  prolonged  inhalation  will  induce  violent  inflammation  of  the  air- 
passages  and  oedema  of  the  glottis.  It  stimulates  the  nasal  branch  of  the 
fifth  nerve,  exciting  the  vaso-motor  centre  by  reflex  action,  and  thus  rais¬ 
ing  the  arterial  tension.  Applied  to  the  skin  and  allowed  to  evaporate, 
it  has  a  slight  rubefacient  effect,  but  if  evaporation  be  prevented  it  pene¬ 
trates  the  epidermis  and  has  a  powerfully  vesicant  action.  The  Aqua, 
swallowed  undiluted,  may  cause  death  quickly  by  suffocation  from  the 
action  of  its  vapor  upon  the  air  passages ;  if  not,  it  may  excite  gastro¬ 
enteritis  accompanied  by  coma,  differing  in  the  latter  respect  from 
potassium  or  sodium  poisoning.  After  absorption  it  stimulates  both  the 
respiration  and  the  circulation  by  direct  action  on  their  respective  nerve- 
centres.  Ammonia  exists  normally  in  the  circulation,  where  it  keeps  the 
fibrin  in  solution  and  thus  maintains  the  fluidity  of  the  blood.  It  in¬ 
creases  the  glycogenic  function  of  the  liver,  and  is  converted  finally  into 
urea.  It  is  a  powerful  irritant  to  muscular  tissue,  causing  tetanic  contrac¬ 
tion  and  subsequent  rigor  mortis  when  directly  applied. 

Ammonium  Salts  all  stimulate  and  finally  paralyze  the  spinal  cord. 


AMMONIUM.  ' 


95 


motor  nerves  and  muscles,  in  animals,  but  the  order  and  readiness  of  the 
action  vary  with  the  salts  employed,  some  having  a  predominating  influence 
on  the  cord,  others  on  the  motor  nerves.  In  general  they  may  be  said  to 
form  a  series,  of  which  the  members  at  one  end  stimulate  the  cord,  and 
those  at  the  other  paralyze  both  the  cord  and  the  motor  nerves.  At  the 
stimulant  end  are  Ammonia  and  the  Chloride  ;  at  the  paralyzant  end  the 
Iodide;  the  Bromide,  Phosphate  and  Sulphate  lying  between  (Brunton). 
In  medicinal  doses  they  act  on  man  as  stimulating  expectorants,  in  large 
quantity  they  injure  the  structure  of  the  red  blood-corpuscles,  and  if  long- 
continued  they  produce  rapid  emaciation  by  impairing  digestion  and 
increasing-tissue-waste. 

The  Chloride  has  decided  cholagogue  powers,  increases  the  excretion 
of  urea,  in  20-grain  doses  is  purgative,  and  is  considered  to  have  a  select¬ 
ive  action  upon  the  gastric  mucous  membrane.  The  Carbonate  is  a 
powerful  and  very  diffusible  stimulant ;  when  administered  internally  in 
moderate  doses,  it  is  probably  decomposed  by  the  HC1  of  the  gastric 
juice,  nascent  ammonia  being  set  free  and  absorbed.  It  stimulates  the 
respiratory  centre,  acts  as  a  stimulating  expectorant,  and  in  very  small 
doses  stimulates  the  secretion  of  the  gastric  juice.  It  is  also  emetic,  and 
has  been  supposed  to  prevent  iodism  when  administered  conjointly  with 
Iodide  of  Potassium.  The  Solution  of  the  Acetate  is  an  active  dia¬ 
phoretic  if  the  body  be  warm,  or  a  diuretic  if  it  be  cool.  In  wineglassful 
doses  it  will  counteract  many  of  the  immediate  effects  of  alcohol.  The 
Phosphate  is  diuretic,  and  is  believed  to  decompose  the  insoluble  Urate 
of  Sodium  in  the  blood,  converting  it  into  the  soluble  salts  Urate  of  Am¬ 
monium  and  Phosphate  of  Sodium,  and  thus  promoting  its  elimination. 
The  Benzoate  is  also  diuretic,  and  like  Benzoic  Acid  passes  out  of  the 
system  in  the  urine  as  Hippuric  Acid.  It  acidifies  the  urine  where  there 
is  phosphatic  tendency  of  the  same.  The  Nitrate  and  Sulphate  are 
only  used  for  the  preparation  of  other  salts,  while  the  Iodide,  Bromide 
and  Valerianate  correspond  in  action  to  that  of  their  titular  bases,  and 
are  described  under  their  respective  titles,  Iodum,Bromium  and  Valeriana. 

Antagonists  to  Ammonia. 

When  inhaled,  give  HC1  vapors  by  inhalation  to  form  the  chloride;  if  taken  in  solu¬ 
tion,  give  Vegetable  Acids ,  and  demulcents  to  protect  the  mucous  surfaces.  Its  physio¬ 
logical  antagonists  are  the  cardiac  sedatives,  Aconite,  Digitalis,  Veratrum,  etc. 

Therapeutics. 

The  strong  solution  of  Ammonia  may  be  used  as  a  rubefacient  and 
vesicant,  and  its  vapor,  by  cautious  inhalation,  in  syncope  and  the  results 
of  shock.  Locally,  it  is  a  good  application  to  bites  of  the  less  venom¬ 
ous  reptiles  and  to  the  stings  of  insects.  The  Carbonate  is  used  inter¬ 
nally  in  the  eruptive  fevers,  delirium  tremens,  continued  fevers,  pneu¬ 
monia,  etc.,  where  much  depression  exists ;  as  a  stimulating  expectorant 


96 


AMMONIUM. 


in  chronic  bronchitis,  in  the  broncho-pneumonia  of  children,  and  in 
cardiac  asthma.  It  is  highly  recommended  in  scarlet  fever  in  doses  of  3 
to  5  grains  every  one,  two  or  three  hours,  all  acid  drinks  or  fruits  being 
prohibited  while  it  is  being  administered.  With  ten-minim  doses  of  tinc¬ 
ture  of  capsicum  in  an  ounce  of  some  bitter  infusion  it  is  exceedingly 
efficient,  in  5-10-grain  doses,  for  the  sinking  sensations  and  craving  for 
stimulants  experienced  by  subjects  of  alcoholism.  It  may  be  used  as  an 
emetic  in  bronchitis,  when  the  tubes  are  choked  with  mucus  and  the  cir¬ 
culation  of  the  patient  is  weak.  It  may  also  be  employed  by  inhalation, 
and  administered  internally,  for  similar  purposes  as  Liquor  Ammoniae. 

The  Chloride  has  a  high  repute  in  catarrh  of  the  stomach,  with  anorexia, 
bad  taste  in  the  mouth,  flatulence,  coated  tongue,  etc.,  in  short,  the 
symptoms  of  so-called  “  biliousness  also,  in  chronic  congestion  of  the 
liver,  jaundice  from  catarrh  of  the  bile-ducts,  nervous  and  sick  headaches, 
myalgia,  amenorrhoea,  muscular  rheumatism  and  neuralgia.  In  the  latter 
affection  it  should  be  given  in  30-grain  doses  several  times  a  day.  It 
is  also  efficient  in  bronchial  catarrh  without  fever,  and  in  chronic  bron¬ 
chitis  when  the  secretion  is  scanty  and  tough.  It  is  remarkably  efficient 
in  straightening  up  a  victim  of  acute  alcoholism ;  to  one  almost  on  the 
verge  of  delirium  tremens,  a  T/2  drachm  in  half  a  pint  of  water,  swallowed  at 
one  draught,  will  restore  the  patient’s  faculties  so  quickly  as  to  astonish 
one  who  has  never  seen  it  so  employed.  Locally,  in  solution,  it  has 
been  well  employed  in  inflammatory  swellings,  as  sprains,  inflamed  joints, 
orchitis,  etc.,  as  a  lotion  ;  also,  to  allay  itching  in  prurigo,  to  remove 
ecchymoses  and  glandular  enlargements.  Edit  Sedative  is  often  a  good 
local  application  in  headaches. 

The  Solution  of  the  Acetate  is  especially  beneficial  in  the  exanthe¬ 
mata,  influenza,  coryza,  anomalous  febrile  conditions  of  children,  acidity 
and  vomiting ;  also,  in  erysipelas  when  there  is  feeble  circulation,  cyan¬ 
osis  and  delirium.  It  is  frequently  combined  with  Spirit  of  Nitrous  Ether, 
as  a  diuretic  and  diaphoretic  in  febrile  affections.  The  Phosphate  is 
particularly  applicable  to  gout  and  lithaemia,  and  is  a  very  efficient  chola- 
gogue.  The  Benzoate  is  useful  in  cystitis  with  alkaline  urine  and  phos- 
phatic  deposits,  as  it  acidulates  the  urine,  at  the  same  time  stimulating 
and  disinfecting  the  mucous  coat  of  the  bladder. 

Aqua  Ammonite  has  been  administered  by  intra-venous  injection,  with 
efficacy  and  safety,  in  sudden  or  threatened  thrombosis,  cardiac  paralysis 
from  Chloroform,  and  in  poisoning  by  Hydrocyanic  Acid  and  other  car¬ 
diac  depressants.  In  the  same  manner,  it  has  been  employed,  but  unsuc¬ 
cessfully,  in  poisoning  by  the  bite  of  venomous  reptiles.  Ten  drops  of  the 
strong  Liquor  are  diluted  with  three  parts  of  water,  and  carefully  injected 
into  a  vein,  all  air  being  rigorously  excluded  from  entrance  thereinto. 

The  therapeutics  of  the  Iodide,  Bromide  and  Valerianate  are  enume¬ 
rated  under  the  titles  Iodum,  Bromum  and  Valeriana  respectively. 


AMYGDALA. 


97 


AMYGDALA,  Almond, — the  seeds  of  two  varieties  of  Amygdalus 
communis  (nat.  ord.  Rosaceae),  namely  Amygdala  amara  and  Amygdala 
dulcis,  are  official,  together  with  several  preparations,  some  prepared  from 
one  variety,  some  from  another,  while  one  is  from  either  and  one  from 
both.  An  important  point  is  the  reaction  between  Amygdalin  and 
Emulsin  in  the  presence  of  water  producing  Hydrocyanic  Acid  (see  ante , 
page  67).  Amygdalin,  C2oH27NOn,  is  a  crystalline  glucoside,  existing  in 
Amygdala  amara  but  not  in  Amygdala  dulcis  ;  while  the  ferment  Emulsin 
is  common  to  both  varieties. 

Amygdala  Amara,  Bitter  Almond, — is  the  seed  of  Amygdalus  commu¬ 
nis,  var.  amara,  a  tree  of  the  nat.  ord.  Rosaceae,  indigenous  to  Western 
Asia,  but  cultivated  in  many  other  parts  of  the  world.  The  seed  is  lanceo¬ 
late  in  shape,  brownish  in  color,  about  an  inch  long,  having  a  white,  oily 
embryo  of  bitter  taste,  which,  when  triturated  with  water,  emits  an  odor  of 
Hydrocyanic  Acid.  Cultivated  chiefly  in  Spain  and  the  Balearic  Islands. 

Amygdala  Dulcis,  Sweet  Almond, — is  the  seed  of  Amygdalus  commu¬ 
nis,  var.  dulcis,  a  tree  of  the  nat.  ord.  Rosaceae.  The  bitter  and  sweet 
almond  trees  are  identical  botanically,  and  the  fruits  and  seeds  of  the  two 
varieties  resemble  each  other  closely,  only  differing  in  taste  and  the  pres¬ 
ence  of  Amygdalin  (see  above).  The  sweet  almond  is  largely  cultivated 
about  Malaga  and  in  California. 

Preparations. 

Aqua  Amygdalce  Amarce ,  Bitter  Almond  Water, — is  a  weak  solution  of  the  Oil  of 
Bitter  Almond  in  Distilled  Water  (1  to  1000).  Is  only  a  flavored  water.  Dose,  indefinite. 

Oleum  Amygdalce  Amarce,  Oil  of  Bitter  Amond, — is  a  volatile  oil,  of  peculiar  and 
aromatic  odor,  bitter,  burning  taste,  and  neutral  reaction  ;  soluble  in  300  of  water,  but 
freely  in  alcohol  and  ether.  Dose  rrp^-j,  in  mixture. 

This  essential  oil,  one  of  the  products  of  the  reaction  between  Amygdalin  and  Emulsin 
(see  ante,  p.  67),  contains  a  varying  quantity  of  Hydrocyanic  Acid  (3  to  14  per  cent.), 
which  may  be  removed  by  distillation  with  caustic  potash.  Nitrobenzol,  or  “  Oil  of  Mir- 
bane,”  closely  resembles  the  oil  of  bitter  almond,  and  like  it  is  used  for  flavoring.  It  con¬ 
tains  no  Hydrocyanic  Acid,  but  is  a  dangerous  poison,  producing  toxic  effects  when 
inhaled,  even  in  small  doses. 

Syrupus  Amygdalce,  Syrup  of  Almond, — has  of  Bitter  Almond  3  per  cent.,  of  Sweet 
Almond  10.  Dose  indefinite. 

Mistura  Amygdalce,  Mixture  of  Amygdala,  —  made  of  Sweet  Almond  6  per  cent., 
with  Acacia,  Sugar  and  Water.  A  demulcent  drink,  used  as  a  vehicle  for  cough  mix¬ 
tures.  Dose,  3  ij-  3  ss. 

Oleum  AmygdaUe  Expression,  Expressed  Oil  of  Almond, — is  the  fixed  oil  which  is 
expressed  from  either  Bitter  or  Sweet  Almond.  Used  in  Unguentum  Aquae  Rosae,  and 
as  a  bland  local  application  in  skin  affections. 

Physiological  Action  and  Therapeutics. 

The  bitter  and  sweet  varieties  of  the  species  Amygdalus  communis  differ 
in  action  only  through  the  agency  of  the  principle  Amygdalin  contained 
in  the  former.  The  Sweet  Almond  is  demulcent  and  nutritive,  while  the 
fixed  oil  expressed  from  either  variety  is  a  bland  application,  having  the 
same  action  as  Olive  Oil.  The  action  of  the  Bitter  Almond  and  its  oil  is 
due  to  the  Hydrocyanic  Acid  contained  in  them  (see  ante,  p.  67). 

7 


98 


AMYL  NITRIS. 


The  Expressed  Oil  of  Almond  is  demulcent,  and  in  doses  of  3  j-ij  a 
mild  laxative.  It  is  used  externally  for  excoriations,  chapped  hands,  and 
inflammatory  skin  affections,  and  is  applied  to  the  ear  in  earache.  The 
cake  remaining  after  the  expression  of  the  fixed  oil  from  the  sweet  almond 
is  ground  into  flour,  and  used  in  the  form  of  biscuits  for  diabetics  as  a 
substitute  for  bread,  as  it  contains  no  starch. 

The  Oil  of  Bitter  Almond  is  used  as  a  flavoring  agent,  and  may  be 
employed  locally  or  internally  in  lieu  of  Hydrocyanic  Acid.  The  Syrup 
is  somewhat  sedative,  but  is  generally  used  as  a  demulcent  or  for  flavoring 
purposes.  The  Mixture  is  used  in  catarrhal  affections  and  as  a  vehicle  for 
cough-mixtures.  The  poisonous  character  of  the  Bitter  Almond  and  its 
essential  oil  (Oleum  Amygdalae  Amarae)  should  be  kept  in  mind. 


AMYL  NITRIS,  Nitrite  of  Amyl,  C5HnN02, — is  a  clear,  yellow¬ 
ish  liquid,  of  ethereal  and  fruity  odor,  aromatic  taste,  and  neutral  or 
slightly  acid  reaction,  extremely  volatile,  insoluble  in  water  but  freely 
soluble  in  alcohol,  ether,  chloroform  and  benzin.  It  is  produced  by 
the  action  of  Nitric  or  Nitrous  Acid  upon  Amylic  Alcohol,  and  when 
impure  may  have  Nitric  or  Hydrocyanic  Acid  in  it.  Dose  internally 
up dissolved  in  alcohol, — by  inhalation  upij-v;  but  larger  doses  are 
probably  safe. 

Unofficial  Analogue. 

Nitroglycerinum, — Nitroglycerin,  Glonoin,  Trinitrin,  Trinitrate  of  Glyceryl,  C3H5- 
(N03)3, — is  a  clear,  oily  liquid,  insoluble  in  water,  but  soluble  in  alcohol,  ether,  oils, 
etc.,  produced  by  the  action  of  nitric  and  sulphuric  acids  upon  glycerin.  Is  a  dangerous 
explosive,  and  should  not  be  kept  in  stronger  solution  than  i  per  cent.  Dose,  n\Ho  to  off 
or  more,  according  to  susceptibility. 

Unofficial  Preparations  of  Nitroglycerin. 

Tindura  Nitroglycerini,  Tincture  of  Nitroglycerin, — a  I  per  cent,  solution  in  alcohol. 
Dose,  rrp^-x.  The  strong  tincture  sold  by  the  homoeopathic  pharmaceutists  and  official 
in  their  American  Pharmacopoeia  is  a  io  per  cent,  solution,  or  ten  times  the  strength  of 
the  above.  It  is  an  extremely  dangerous  preparation,  both  as  an  explosive  and  as  a 
medicine.  (See  American  Homoeopathic  Pharmacopoeia ,  2d  ed.,  Boericke  &  Tafel,  18S3, 
page  235.) 

Tabellce  Nitroglycerini ,  B.  P., — Tabellae  Trinitrini, — are  tablets  of  chocolate,  each  con¬ 
taining  gr.  of  pure  Nitroglycerin.  Dose,  j-ij. 

Other  Nitrites. 

Sodii  Nitris,  Nitrite  of  Sodium,  and  Potassii  Nitris,  Nitrite  of  Potassium  (both  unoffi¬ 
cial),  are  used  as  substitutes  for  Amyl  Nitrite  and  Nitroglycerin.  The  former  is  a  white, 
granular  powder,  deliquescent,  with  a  cool,  saline  taste,  very  soluble  in  water,  is  made  by 
heating  Sodium  Nitrate,  and  has  the  formula  NaN02.  Dose,  gr.  }4-v,  according  to  indi¬ 
vidual  susceptibility. 

Ethyl  Nitrite ,  C2H5N02, — constitutes  5  per  cent,  of  Spiritus  Albheris  Nitrosi.  (See 
ante ,  page  79.) 

Physiological  Action. 

Nitrite  of  Amyl  and  the  other  Nitrites  agree  closely  in  their  general 
action,  producing  great  vascular  dilatation  by  paralyzing  either  the  sym¬ 
pathetic  system,  the  vaso-motor  centre  or  the  muscular  coat  of  the  arteri- 


AMYL  NITRIS. 


99 


oles, — which,  is  yet  undecided.  They  cause  tumultuous  action  of  the  heart 
by  relaxing  its  inhibition; — lowered  respiration,  from  paralysis  of  the  re¬ 
spiratory  muscles  and  impairment  of  the  ozonizing  function  of  the  blood; 
— diminution  of  sensation,  motility  and  reflexes  ; — a  sense  of  heat,  but 
lowered  body-temperature ;  also  throbbing  pain  in  the  head,  beating 
carotids,  quickened  pulse,  flushed  face  and  vertigo. 

The  effect  of  an  ordinary  inhalation  of  Amyl  Nitrite  on  man  is  very 
transitory,  excepting  the  headache,  which  may  last  several  hours.  Of  the 
nitrites  it  is  the  most  prompt  but  least  enduring  in  action,  and  is  best 
administered  by  inhalation.  It  causes  sugar  to  appear  in  the  urine  and 
increases  the  quantity  voided.  Mixed  with  blood  it  forms  methgemoglobin, 
which  is  not  so  readily  deoxidized  as  haemoglobin,  and  under  its  influence 
the  blood  in  the  body  becomes  of  a  dark  chocolate  color  both  in  the 
arteries  and  in  the  veins. 

Nitroglycerin  acts  similarly,  but  less  promptly,  and  its  action  is  more 
enduring.  Its  headache  is  of  intensely  frontal  character,  and  persists  for 
hours  after  the  other  effects  have  passed  off.  It  is  more  suitable  for  internal 
administration. 

Nitrite  of  Sodium  is  also  slower  in  action  than  Amyl  Nitrite,  and  does 
not  cause  so  much  throbbing  headache  as  Nitroglycerin.  It  may  be 
given  in  solution  with  water. 

The  action  of  all  these  agents  is  probably  due  to  the  Nitrous  Acid  con¬ 
tained  in  them. 

Antagonists. 

Ergot,  Belladonna,  Strychnine,  Brucine,  Digitalis,  Picrotoxin,  and  all  other  agents 
which  increase  the  functional  activity  of  the  spinal  cord  and  sympathetic  are  antagonistic, 
though  by  reason  of  their  slower  rate  of  diffusion  the  antagonism  may  not  be  always  avail¬ 
able.  Stimulants,  artificial  respiration,  the  alternate  cold  and  hot  douche,  with  cold  to  the 
head,  and  Ergotin  or  Atropine  subcutaneously,  are  the  best  means  to  be  used  in  cases  of 
poisoning  by  the  Nitrites. 

Therapeutics. 

The  inhalation  of  Amyl  Nitrite  is  a  useful  palliative  in  angina  pectoris, 
epilepsy,  tetanus,  and  many  of  the  respiratory  neuroses,  as  spasmodic 
asthma,  whooping-cough,  laryngismus  stridulus,  etc.  It  is  also  indicated 
in  migraine  of  the  pale-face  form,  and  in  the  cold  stage  of  intermittents 
and  pernicious  remittents,  to  prevent  internal  congestion, — also  in  convul¬ 
sions  of  various  kinds,  including  the  puerperal.  It  has  been  sometimes 
used  in  threatened  death  from  chloroform  anaesthesia,  and  in  poisoning 
by  strychnine. 

Nitroglycerin  has  been  used  with  benefit  in  neuralgic  dysmenorrhoea, 
sea-sickness,  and  in  chronic  interstitial  nephritis,  by  redistributing' to  the 
kidneys  their  blood-supply  cut  off  by  degeneration  of  the  renal  ganglionic 
centres.  It  promptly  relieves  hiccough,  migraine  of  spasmodic  character, 
and  has  afforded  immediate  relief  in  neuralgia  of  the  fifth.  Its  administra¬ 
tion  in  angina  pectoris,  though  not  producing  such  prompt  results  as  that 


IOO 


AMYLUM — ANISUM. 


of  Amyl  Nitrite,  gives  excellent  and  much  more  lasting  effects.  It  is 
useful  in  the  weak  heart  of  the  aged,  or  that  from  fatty  degeneration,  or 
when,  as  in  Bright’s  disease,  the  arterial  tension  is  above  normal ;  also  in 
irritable  and  overacting  heart,  which  it  relieves  by  lowering  arterial 
tension. 

Nitrite  of  Sodium  has  been  successfully  employed  in  angina  pectoris, 
hemicrania,  and  in  asthma  of  purely  bronchial  and  neurotic  origin.  It 
has  also  proved  decidedly  beneficial  in  the  abnormally  high  arterial  ten¬ 
sion  of  chronic  desquamative  nephritis,  especially  when  complicated  with 
a  weakened  and  dilated  heart. 


AMYLUM,  Starch,  C6H10O5, — is  the  fecula  of  the  seed  of  Triticum 
vulgare ,  common  wheat,  a  plant  of  the  nat.  ord.  Graminaceae.  Though 
wheat-starch  is  the  official  kind,  any  other  might  be  properly  used,  as  the 
starch  occurring  in  barley,  oats,  arrow-root,  sago  and  tapioca,  all  of  which 
foods  were  official  in  the  U.  S.  P.  of  1870.  The  last  three  are  entirely  com¬ 
posed  of  starch  ;  wheat  contains  about  70  per  cent.,  and  rice  90  per  cent. 

Starch  is  a  carbo-hydrate,  and  occurs  in  distinct  grains,  forming  irregular,  angular  masses, 
white,  inodorous  and  tasteless,  easily  pulverized,  of  neutral  reaction,  and  insoluble  in 
alcohol,  ether  or  cold  water.  Under  the  microscope  the  granules  are  seen  to  be  lenticular 
in  form  and  concentrically  striated.  When  boiled  with  water  it  yields  a  whitish  jelly  of 
bluish  tinge,  which  when  cool  gives  a  deep  blue  color  with  test-solution  of  iodine,  the 
color  disappearing  on  warming  and  returning  on  cooling. 

By  boiling  with  dilute  mineral  acids  starch  is  converted  into  glucose, 
dextrin  being  formed  as  an  intermediate  product.  Hot  concentrated  nitric 
acid  converts  it  into  oxalic  acid,  but  cold  fuming  nitric  acid  dissolves  it, 
forming  an  explosive  compound.  Diastase,  ptyalin  and  pancreatin  con¬ 
vert  it  into  glucose.  [For  Glycogen,  Dextrin,  Cellulose  and  other  allied 
substances  see  the  article  Saccharum  in  the  following  pages.] 

Amylum  Iodatum ,  Iodized  Starch, — has  of  Starch  95  parts,  Iodine  5,  triturated  with 
distilled  water  and  dried.  Used  as  a  method  of  giving  Iodine  (see  Iodum).  Dose, 

3j_5ss> 

Glyceritum  Amyli ,  Glycerite  of  Starch, — has  of  Starch  10  parts,  Glycerin  90,  tritu¬ 
rated  and  heated  to  a  transparent  jelly.  Used  as  a  vehicle  for  external  applications. 

Starch,  though  a  nutritive  of  the  first  order,  may  be  regarded  as  inert 
medicinally.  It  serves  as  a  protective  and  absorbent  if  dusted  over  the 
skin,  as  a  vehicle  for  enemata,  and  as  an  antidote  in  iodine-poisoning. 
Mixed  with  glue  it  makes  an  excellent  stiff  bandage  for  surgical  purposes. 


ANISUM,  Anise  , — is  the  fruit  of  Pimpinella  Anisutn ,  a  European 
plant  of  the  nat.  ord.  Umbelliferae.  It  occurs  in  ovate  bodies,  ^5  inch 
long,  hairy,  of  grayish  color,  aromatic  odor,  and  sweet,  spicy  taste, 
resembling  conium  fruit  in  appearance.  Dose,  gr.  x-xx. 


ANTHEMIS. 


IOI 


Preparations. 

Oletim  Anisi,  Oil  of  Anise, — is  a  volatile  oil  distilled  from  Anise  or  from  Illicium 
anisatum  (the  star-anise),  and  represents  the  medicinal  qualities  of  the  plant.  That  from 
Anise  congeals  at  50°  to  590  F.,  and  is  soluble  in  an  equal  part  of  alcohol.  That  from 
Illicium  congeals  at  about  2>SlA°  F.  The  oil  is  an  ingredient  of  Tinctura  Opii  Cam- 
phorata,  Trochisci  Glycyrrhizee  et  Opii,  and  of  the  two  following  preparations.  Dose, 

"lj-v-  .  .  ...... 

Aqua  Anisi, — has  in  500  parts  1  of  Oil  of  Anise  mixed  with  distilled  water  by  the  aid 
of  cotton.  Dose,  indefinite. 

Spiritus  Anisi, — is  a  10  per  cent,  solution  of  the  oil  in  alcohol.  Dose,  £j-ij. 

The  Volatile  Oil  is  the  active  constituent  of  Anise.  It  has  a  slightly 
stimulant  action  on  the  heart  and  the  digestive  organs,  and  liquefies  the 
bronchial  secretion,  being  probably  in  part  excreted  by  the  bronchial 
mucous  membrane.  It  is  a  favorite  flavoring  ingredient  of  cough-mix¬ 
tures,  and  relieves  slight  intestinal  colic  and  flatulence  in  children.  In 
full  doses  it  has  a  weak  narcotic  power. 

ANTHEMIS,  Chamomile, — the  flower-heads  of  Anthemis  nobilis, 
a  European  perennial  of  the  nat.  ord.  Compositae,  collected  from  culti¬ 
vated  plants.  Chamomile-flowers  are  sub-globular,  about  ^  inch  broads 
having  numerous  white,  three-toothed  florets  on  a  conical,  solid  receptacle, 
a  strong  but  agreeable  odor,  and  an  aromatic,  bitter  taste ;  and  contain  a 
volatile  oil,  a  camphor  and  a  bitter  principle  but  no  alkaloid.  There  are 
no  official  preparations.  An  infusion  (5iv  to  Oj)  may  be  given  in  doses 
of  gj-ij. 

Oleum  Anthemidis,  Chamomile  Oil  (Unofficial), — the  volatile  oil  is  of  a  dark  blue  or 
green  color,  and  is  composed  of  various  ethers,  the  Angelates  and  Valerianates  of  Butyl 
predominating.  Dose,  rtpij-x,  on  sugar. 

Physiological  Action  and  Therapeutics. 

Chamomile  is  a  stomachic  tonic.  It  improves  the  appetite  and  aids 
digestion  by  increasing  the  vascularity  of  the  gastric  mucous  membrane. 
In  large  doses  the  warm  infusion  is  emetic,  and  perhaps  diaphoretic, 
though  the  latter  action  is  chiefly  due  to  the  hot  water.  The  oil  is  re¬ 
markably  efficient  in  reducing  reflex  excitability  in  frogs,  even  after  its 
excitation  by  Strychnine  or  Brucine. 

Chamomile  is  popular  in  domestic  practice.  An  infusion  is  used  by 
nurses  for  many  infantile  complaints,  and  externally  as  a  fomentation  to 
relieve  pain,  as  in  colic,  etc.  The  oil  is  very  efficient  in  reflex  cough, 
pulmonary  catarrh,  acute  dyspepsia,  diarrhoea  of  children,  spasmodic 
asthma,  whooping-cough,  colic,  and  the  spasmodic  and  pseudo-neuralgic 
affections  of  hysterical  women.  It  should  prove  extremely  useful  in  poi¬ 
soning  by  Strychnine,  from  its  power  over  reflex  excitability. 

The  Chamomile  of  the  homoeopaths  is  the  Matricaria  Chamomilla ,  or 
German  Chamomile,  official  in  the  U.  S.  Pharmacopoeia  as  “Matri¬ 
caria,”  which  see. 


102 


ANTIM0N1UM. 


ANTI  MON  IUM,  Antimony,  Sb. — Metallic  Antimony  is  not 
official,  nor  is  it  used  in  medicine.  It  is  represented,  however,  by  the 
following  official  salts  and  preparations,  viz.  : 

Compounds  of  Antimony  and  their  Preparations. 

Antimonii  et  Potassii  Tartras,  Tartrate  of  Antimony  and  Potasssium,  Tartar  Emetic, 
2KSb0C4H406.H20, — small  white  crystals  or  a  granular  powder  of  sweet,  disagreeable 
metallic  taste,  soluble  in  17  of  water  at  590  F.,  and  in  3  of  boiling  water,  insoluble  in 
alcohol.  Dose,  gr.  yL-i,  but  after  tolerance  is  established  as  high  as  gr.  ij  may  be  given. 
Is  an  ingredient  of  the  two  following,  viz.  : 

Vinum  Antimonii ,  Wine  of  Antimony, — has  of  Tartar  Emetic  4,  Boiling  Distilled 
Water  60,  Stronger  White  Wine  to  1000  parts.  Contains  about  2  grains  of  Tartar 
Emetic  to  the  £  ,  and  is  an  ingredient  of  Mistura  Glycyrrhizse  Composita.  Dose,  as  a 
febrifuge  and  expectorant,  rrpv-xv. 

Syrupus  Scillce  Compositus,  Cox’s  Hive  Mixture,  Hive  Syrup  (see  under  Scilla ), — con¬ 
tains  about  y  grain  of  Tartar  Emetic  to  the  3  ,  or  more  accurately  3  parts  in  2000,  with 
Squill,  Senega,  etc.  Dose,  cautiously  in  children. 

Antimonii  Oxidum ,  Oxide  of  Antimony,  Sb203, — a  heavy,  gray  powder,  insoluble  in 
water  of  alcohol,  but  readily  and  wholly  soluble  in  Hydrochloric  or  Tartaric  Acids. 
Dose,  gr.j-iij.  It  constitutes  Jjd  of — 

Pulvis  Antimonialis ,  Antimonial  or  James’  Powder, —  consists  of  the  Oxide  of  Anti¬ 
mony  33  parts,  with  67  of  Calcium  Phosphate.  Dose,  gr.  iij-viij,  every  3  hours  as  a  dia¬ 
phoretic,  larger  doses  for  emetic  and  cathartic  effects. 

Antimonii  Sulphidum ,  Sulphide  of  Antimony,  Sb2S3, — is  the  native  sulphide,  purified 
by  fusion,  and  as  nearly  free  from  Arsenic  as  possible, — steel  gray  masses,  or  a  black, 
lustreless  powder,  insoluble  in  water  or  alcohol.  Dose,  gr.  X~j. 

Antimonii  Sulphidum  Purification,  Sb2S3, — is  purified  by  maceration  in  Aq.  Ammo¬ 
nia,  washing  and  drying.  Dose,  gr.  %-]. 

Antimonium  Sulphuratum ,  Sulphurated  Antimony, — is  chiefly  Sb2S3,  with  a  very 
small  amount  of  Sb203.  A  reddish-brown,  odorless  and  tasteless  powder,  insoluble  in 
water  or  alcohol.  Is  a  constituent  of  Pil.  Antimonii  Compositae.  Dose,  gr.  j-v. 

Pilules  Antimonii  Composites,  Plummer’s  Pills, — each  pill  containing  gr.  y2  each  of 
Calomel  and  Sulphurated  Antimony. 

Physiological  Action. 

Tartar  Emetic  in  its  action  represents  the  other  official  antimonial 
preparations,  being  a  cardiac,  arterial  and  general  depressant,  a  proto¬ 
plasmic  poison,  a  systemic  and  local  emetic,  a  specific  gastro-intestinal 
irritant,  an  expectorant  and  a  diaphoretic.  Like  Aconite,  Arsenic,  Hy¬ 
drocyanic  Acid  and  Potassium,  it  is  destructive  to  protoplasm,  destroying 
function  in  all  nitrogenous  tissue,  and  paralyzing  the  spinal  cord,  the  motor 
nerves,  the  muscles  and  the  sensory  nerve  terminations.  It  is  especially 
depressant  to  the  heart-muscle  and  the  cardiac  motor  ganglia ;  it  combines 
with  the  red  blood-corpuscles,  lessening  their  oxidizing  power,  lowering 
the  blood-pressure  and  reducing  the  body-temperature.  Its  taste  is  styp¬ 
tic  and  one  of  its  earliest  effects  is  the  production  of  constriction  of  the 
fauces.  It  promotes  waste  and  rapid  excretion  of  waste-products,  carbonic 
acid  and  urea  being  especially  increased.  Being  eliminated  by  all  the 
excretory  organs,  including  the  skin,  it  excites  follicular  inflammation  at 
the  points  of  elimination  ;  resulting  in  an  eruption  which  is  papular  at 
first,  then  becomes  vesicular,  and  finally  pustular,  the  pustules  being  um- 
bilicated,  like  those  of  variola.  This  same  eruption  is  also  produced  by 
the  application  of  the  drug  to  the  skin  with  friction.  Aphthous  ulcerations, 


ANTIMONIUM.  IO3 

extending  from  the  mouth  to  the  stomach,  with  salivation  and  painful 
deglutition,  may  also  result  from  its  continued  use. 

In  small  doses  Tartar  Emetic  stimulates  secretion  in  the  bronchial  and 
salivary  glands,  the  stomach,  intestinal  canal,  liver  and  pancreas.  In 
larger  doses  it  excites  nausea,  vomiting  and  purging,  with  evacuations 
like  the  “  rice-water  discharges”  of  cholera,  and  great  prostration  of  the 
vital  powers.  Toxic  doses  produce  similar  symptoms,  besides  epigastric 
pain,  cyanosis,  delirium,  cramps,  motor  and  sensory  paralysis,  suppression 
of  urine  and  collapse, — much  the  same  phenomena  as  observed  in  Asiatic 
cholera. 

The  Sulphide  occurs  native,  and  is  the  source  from  which  the  other 
compounds  are  prepared.  It  seems  to  be  inert  medicinally.  Sulphurated 
Antimony  owes  its  efficacy  to  the  small  quantity  of  the  Oxide  contained 
in  it,  and  as  this  is  variable,  the  action  of  the  preparation  is  uncertain. 
The  Oxide  has  a  similar  action  to  that  of  Tartar  Emetic,  but  being  in¬ 
soluble  in  water,  it  is  of  much  less  certain  activity. 

Antidotes  ana  Antagonists. 

Tannic  Acid ,  or  any  substance  containing  it,  is  the  antidote,  forming  the  insoluble  tan- 
nate.  Opium,  Alcohol,  Ether,  and  other  antispasmodics  are  physiological  antagonists. 
Demulcent  drinks  should  be  freely  administered  to  protect  the  mucous  membranes.  Al¬ 
kalies  and  Salts  of  Lead  decompose  Tartar  Emetic. 

t 

Therapeutics. 

Tartar  Emetic  was  formerly  much  employed  as  an  antiphlogistic  on 
account  of  its  power  to  cut  short  acute  inflammations  of  sthenic  type,  and 
its  use  was  very  much  abused,  so  that  it  has  now  gone  out  of  fashion  as  a 
remedy.  The  contra-stimulant  treatment  of  pneumonia  and  other  inflam¬ 
matory  diseases  by  large  doses  of  this  salt  after  tolerance  was  established, 
is  only  worthy  of  reference  as  an  historical  fact.  The  same  may  be  said 
of  its  external  use  as  a  counter-irritant  as  well  as  of  its  employment  as  an 
emetic,  in  both  of  which  capacities  it  is  too  severe,  while  its  emesis  is  too 
tardy  in  action  to  be  of  any  value  in  poisoning.  It  is,  however,  a  very 
efficient  agent  in  many  grave  affections,  if  used  in  small  doses  (gr.  eV-^)  ; 
being  highly  recommended  in  acute  inflammatory  affections  of  the  respi¬ 
ratory  tract,  especially  pneumonia,  broncho-pneumonia,  acute  oedema  of 
the  lungs,  feverish  and  catarrhal  colds,  bronchitis,  laryngitis  and  tonsil¬ 
litis.  In  many  respects  it  acts  like  Aconite  in  these  and  kindred  affections, 
producing  copious  diaphoresis,  slowing  the  pulse  and  allaying  restlessness. 
It  is  considered  a  good  remedy  in  puerperal  peritonitis,  mammitis  and 
orchitis,  in  lumbago  and  other  muscular  rheumatisms,  also  in  photophobia 
and  in  gastric  indigestion  after  beer-drinking.  In  still  smaller  doses 
(gr.  hourly)  it  is  particularly  efficient  in  catarrhal  inflammations  of 
the  respiratory  mucous  membrane  in  children,  accompanied  by  rattling 
breathing  and  much  mucus,  which  is  expelled  with  difficulty.  Such  cases 


104 


ANTIPYRINA. 


often  simulate  asthma,  the  attacks  being  marked  by  cough,  wheezing,  and 
difficult  respiration,  also  sibilant  rales  in  the  chest,  and  usually  follow  on 
severe  colds  or  on  measles.  The  Compound  Syrup  of  Squill  is  commonly 
used  as  an  expectorant  and  nauseant  in  the  treatment  of  bronchitis  and 
croup.  The  quantity  of  Tartar  Emetic  in  it  (gr.  ^  to  the  5)  should  be 
remembered  in  administering  it  to  children.  (See  Scilla.) 

The  Oxide  is  chiefly  employed  in  the  form  of  James’  Powder  (Pulvis 
Antimonialis)  for  its  mild  diaphoretic  qualities.  The  Sulphide  is  not 
used  in  medicine.  Sulphurated  Antimony  is  very  uncertain  in  action 
and  is  but  little  used.  The  Compound  Pill  of  Antimony  (Plummer’s 
Pill)  was  devised  to  obtain  mercurial  results  without  writing  Hydrargyrum 
on  a  prescription. 


ANTIPYRINA,  Antipyrine,  Dimethyl  -  oxy  -  chinicine, — 

C20H18N4O2  (Unofficial), — is  an  alkaloidal  product  of  the  destructive  dis¬ 
tillation  of  Coal-tar  (compare  Chinolina),  and  prepared  by  a  patented 
and  complicated  process.  It  may  also  be  obtained  synthetically  by  heat¬ 
ing  Methyl-oxy-chinicine  with  Phenyl-hydracine,  and  collecting  the 
powder.  It  is  a  grayish  or  reddish-white  crystalline  powder,  which  com¬ 
bines  with  acids  to  form  salts,  is  somewhat  bitter,  and  soluble  in  one-half 
its  weight  of  hot  water,  and  in  its  own  weight  of  cold  water;  but  is  still 
more  so  if  the  water  is  acidulated  with  dilute  nitro-hydrochloric  acid.  It 
is  less  soluble  in  alcohol,  chloroform  or  ether,  gives  an  intensely  red  color 
with  Ferric  Chloride,  and  a  beautiful  green  with  Nitric  Acid.  It  is  not 
irritant  to  either  the  stomach  or  the  tissues,  and  may  be  administered 
hypodermically. 

The  full  antipyretic  dose  for  an  adult  was  at  first  stated  at  30  grains  hourly  for  three 
hours,  or  90  grains  for  the  antipyretic  effect.  For  children,  gr.  j  for  each  year  of  age  as 
a  dose,  to  be  repeated  twice,  or  thrice,  with  the  same  intervals  between  each  dose.  That 
such  dosage  was  far  too  great,  soon  became  evident  from  the  many  reports  of  alarming 
symptoms  of  collapse  resulting  in  numerous  instances;  and  the  tendency  has  lately  been 
towards  a  decreased  size  of  dose  at  shorter  intervals,  which  should  be  lengthened  as  soon 
as  the  drug-effects  begin  to  be  manifested.  An  average  adult  dose  is  now  placed  at  10 
grains,  for  children  %  grain  per  year  of  age  between  2  and  5,  ]/2  grain  per  year  from  5  to 
10;  not  exceeding  5  grains  at  a  dose  for  any  child  under  15  years  of  age. 

Antipyrine  has  but  little  flavor,  is  not  unpleasant,  and  is  therefore  readily  taken  by  chil¬ 
dren,  in  which  respect  it  is  greatly  superior  to  Quinine.  It  may  be  administered  in  com¬ 
pressed  tablets,  each  having  from  I  to  5  grains; — or  in  Elixir  Aurantii,—  say  gr.  lxxx 
in  5  iv,  of  which  solution  each  3  contains  gr.  ijss.  If  vomiting  result,  the  same  dose  may 
be  dissolved  in  half  its  weight  of  hot  water,  and  injected  hypodermically  while  warm. 

Antipyrine  may  be  decomposed  when  brought  into  contact  with  Nitrous  compounds,  a 
new  and  poisonous  substance  being  supposed  to  be  formed,  of  uncertain  composition,  but 
resembling  the  Anilin  greens.  The  mixture  of  this  drug  with  Spiritus  Etheris  Nitrosi  is, 
therefore,  highly  dangerous,  if  this  supposed  reaction  is  at  all  likely  to  occur. 


Physiological  Action. 

Antipyrine  is  a  powerful  antipyretic,  a  local  anaesthetic,  and  a  general 
analgesic, — and  also  possesses  diaphoretic,  mydriatic,  antiseptic,  disinfec- 


ANTIPYRINA. 


105 

tant,  hemostatic  and  slightly  hypnotic  powers.  After  the  ingestion  of  a 
full  medicinal  dose,  (gr.  xxx),  there  is  a  stimulant  stage  of  short  duration, 
in  which  the  heart’s  action  is  increased,  and  a  subjective  sense  of  heat  is 
experienced,  with  flushing  of  the  face.  This  is  soon  followed  by  profuse 
sweating,  coldness  of  the  surface,  slowed  pulse,  considerable  depression, 
and  if  fever  be  present  by  lowered  temperature ;  the  latter  coming  on 
within  half  an  hour  after  taking  the  drug  and  its  degree  being  in  direct 
ratio  to  the  quantity  administered,  as  also  its  continuance, — the  former 
being  usually  from  3  to  5  degrees,  and  the  latter  from  1  to  10  hours,  a  fair 
average  being  about  2  hours.  In  one  case  a  fall  of  120  F.  was  observed. 

When  given  with  Kairine,  the  mixture  of  the  two  drugs  has  been  found  to  produce  a 
much  greater  fall  of  temperature,  with  longer  continuance  down,  than  that  produced  by 
an  equal  quantity  of  either  drug  given  alone. 

After  the  antipyretic  effect  of  the  dose  has  passed  off,  the  temperature 
(in  fever)  commences  to  rise  again, — the  onset  being  usually  preceded  by 
a  chill,  which  is  of  slight  degree  when  compared  with  the  severe  rigors 
and  dangerous  depression  occurring  under  the  action  of  Kairine,  Chino- 
line,  and  other  members  of  the  group. 

In  health  its  administration  gives  rise  to  slight  nausea,  singing  in  the 
ears,  and  a  reduction  of  the  body  temperature  of  scarcely  any  extent, 
about  F.  It  slightly  raises  the  arterial  tension  and  blood-pressure  ; — 
sometimes  (but  seldom)  induces  vomiting,  also  a  peculiar  eruption  on  the 
skin; — and  (very  rarely)  such  a  degree  of  depression  as  to  amount  to 
collapse.  It  has  no  effect  upon  the  respiration,  but  acts  as  a  sedative 
upon  the  cerebrum,  leaving  behind  a  somewhat  depressant  influence  on 
the  brain.  It  dilates  the  pupils  and  is  eliminated  by  the  kidneys,  appear¬ 
ing  in  the  urine  some  three  hours  after  its  ingestion.  The  profuse  sweat¬ 
ing  which  it  causes  may  be  prevented  by  giving  in  advance  a  small  dose 
of  Atropine  or  Agaricine. 

In  toxic  dose  its  principal  influence  is  exerted  upon  the  blood,  altering 
the  shape  of  the  red  corpuscles,  separating  the  hematin,  and  causing 
decomposition  of  that  fluid. 

As  an  Antipyretic ,  Antipyrine,  like  Alcohol,  acts  by  a  double  mode  of 
operation, — (1),  by  diminishing  oxidation,  and  (2)  by  promoting  heat- 
loss.  The  latter  is  attained  by  dilating  the  cutaneous  vessels,  allowing 
free  radiation  from  the  surface,  and  by  the  refrigerant  action  of  the  evapo¬ 
ration  of  the  sweat. 

As  an  Analgesic ,  Antipyrine  has  a  very  considerable  degree  of  power, 
in  common  with  all  the  Chinoline  derivatives;  but  its  property  in  this 
respect  is  found  to  act  almost  entirely  upon  pain  due  to  manifestations 
of  the  rheumatic  diathesis.  In  general  anodyne  action,  it  is  not  to  be 
compared  with  the  derivatives  of  Opium.  Its  hemostatic  power  is 
claimed  to  be  superior  to  that  of  Ergotine. 


io6 


APIOL. 


Therapeutics. 

By  far  the  most  popular  of  the  modern  antipyretics,  Antipyrine  deserves 
its  rank  in  professional  esteem,  being  the  most  certain,  the  most  powerful 
and  the  least  dangerous ; — but  devoid  of  any  other  influence  upon  the  course 
of  any  febrile  disorder.  Its  principal  applications  are  as  follows,  viz.  :  — 

In  hyperpyrexia  from  any  cause,  it  is  efficient.  In  acute  rheumatism, 
it  has  held  the  first  place  as  a  remedy,  for  some  time  ;  a  claim  which  is 
now  disputed  in  favor  of  Salol.  In  typhoid  fever  and  other  febrile  con¬ 
ditions,  wherein  hyperpyrexia  occurs,  as  phthisis,  erysipelas,  pleuritis, 
pneumonia,  surgical  fever,  etc.  In  neuralgias,  neuritis,  and  other  painful 
affections,  especially  when  of  rheumatic  origin, — as  lumbago,  sciatica, 
hemicrania,  supra-orbital  neuralgia,  etc.,  in  which  io-grain  doses  are  gen¬ 
erally  sufficient,  and  may  be  given  hypodermically.  In  painful  affections 
of  hysterical  persons ; — pain  from  cerebral  tumors  and  from  cardiac  dis¬ 
eases, — also  painful  menstruation  ; — all  of  which  are  often  relieved  by  it. 
In  acute  paroxysms  of  gout,  a  dose  of  io  grains  every  two  hours,  preceded 
by  a  commencing  dose  of  25  grains,  promptly  relieved  the  pain  and  short¬ 
ened  the  duration  of  the  attack  in  one  very  thoroughly  observed  and 
carefully  reported  case.  In  chronic  gout,  very  remarkable  results  are 
reported  from  the  use  of  this  agent,  indicating  a  specific  action  thereon 
of  curative  character. 

It  has  seemed  to  render  efficient  service  in  dysmenorrhoea,  carbuncle, 
and  cerebro-spinal  meningitis ;  and  affords  valuable  aid  in  the  pyrexia  of 
intermittents,  in  which  stage  the  slow  action  of  Quinine  prevents  its 
availability  for  immediate  relief. 

APIOL  (Unofficial), — is  a  non-volatile,  oily  liquid,  of  acid  reaction 
and  pungent  taste,  soluble  in  alcohol,  ether,  chloroform,  and  in  glacial 
acetic  acid.  It  is  extracted  from  the  fruit  of  Petroseli?ium  sativum  (Pars¬ 
ley),  a  biennial  plant  of  the  nat  ord.  Umbelliferae,  which  also  contains  a 
gelatinous  substance  named  Apiin,  and  a  Volatile  Oil  which  is  by  some 
considered  to  be  the  true  emmenagogue  principle  of  the  plant.  Apiol  is 
probably  a  mixture  of  several  substances,  and  as  found  in  commerce  is 
often  an  impure  oleoresin.  Dose,  rr^ iij— x  in  capsule  two  or  three  times  a 
day  ;  as  an  emmenagogue,  rrpxv  in  one  daily  dose. 

Physiological  Action  and  Therapeutics. 

In  small  doses  (npiij-v)  Apiol  is  carminative,  diuretic,  diaphoretic,  ex¬ 
pectorant  and  stimulant  to  the  circulation.  In  full  doses  (rrpxv)  it  is 
decidedly  emmenagogue  and  feebly  antiperiodic,’  producing  headache, 
tinnitus  aurium,  intoxication,  giddiness,  etc.,  its  action  generally  resem¬ 
bling  that  of  Quinine.  Large  doses  (npxxx-5j)  are  decidedly  narcotic. 

It  has  had  some  reputation  in  intermittents  and  in  malarial  neuralgiae, 
but  is  most  frequently  employed  in  amenorrhcea  and  dysmenorrhoea, 


APOCYNUM — APOMORPHINA. 


107 


being  of  especial  advantage  in  the  amenorrhoea  of  anaemia,  also  when 
the  menstrual  discharge  is  fetid.  It  is  becoming  fashionable  as  a  supposed 
abortifacient,  but  is  useless  for  this  purpose,  and  if  freely  used  may  produce 
decided  narcotism,  especially  if  the  preparation  employed  should  happen 
to  be  an  active  one.  The  capsules  of  Apiol  put  up  in  France  and  sold  in 
this  country  over  the  counters  of  drug-stores  to  any  applicant  are  gen¬ 
erally  inert;  hence  cases  of  poisoning  by  this  drug  are  seldom  observed. 
They  are,  however,  an  important  source  of  revenue  to  the  retailers,  as, 
being  “imported”  preparations,  they  command  a  high  price,  which  is 
readily  paid  by  gullible  women  who  wish  to  “bring  around  their  courses.” 

APOCYNUM,  Canadian  Hemp  , — is  the  root  of  Apocynum  can- 
nabinum ,  an  indigenous  perennial  plant  of  the  nat.  ord.  Apocynaceae, 
and  inodorous  but  of  bitter,  disagreeable  taste.  It  contains  a  peculiar 
active  principle,  Apocynin ,  also  tannic  and  gallic  acids,  resin,  wax,  ca¬ 
outchouc,  etc.  Dose  of  the  powdered  root,  gr.  v-xxx.  A  decoction 
(Sss  to  the  pint)  may  be  given  in  doses  of  3j-ij  thrice  daily. 

Physiological  Action  and  Therapeutics. 

Apocynum  is  powerfully  emetic  and  cathartic  in  full  doses,  also  diapho¬ 
retic,  expectorant  and  sometimes  actively  diuretic.  It  lowers  the  pulse- 
rate,  produces  much  nausea,  and  induces  drowsiness.  It  should  not  be 
confounded  with  Indian  or  American  Hemp  (Cannabis  sativa),  which 
have  entirely  different  qualities. 

The  only  condition  in  which  Apocynum  has  proven  of  much  value  is 
dropsy,  especially  the  anasarca  of  Bright’s  disease  and  ascites,  in  which 
15-grain  doses  are  indicated.  The  active  principle,  Apocynin,  is  a  good 
expectorant,  in  doses  of  gr.  to  gr. 

APOMORPHINA,  Apomorphine,  — is  an  artificial  alkaloid,  pre¬ 
pared  from  Morphine  or  Codeine  by  the  action  of  strong  acids  or  zinc 
chloride.  The  Hydrochlorate  (C17H17N02HC1)  is  official,  and  occurs  in 
minute,  colorless  crystals,  odorless,  of  bitter  taste,  and  neutral  or  faintly 
acid  reaction  ;  soluble  in  7  of  water  and  50  of  alcohol  at  590,  F.,  almost 
insoluble  in  ether  or  chloroform;  decomposed  by  boiling  water  or  boil¬ 
ing  alcohol. 

Dose,gr.  to  ^  hypodermically,  gr.  TL-  to  £  by  the  mouth.  For  young  children,  gr. 

to  jL  should  not  be  exceeded.  Solutions  should  be  fresh  when  used,  and  as  they  alter 
rapidly  by  keeping,  should  have  a  few  drops  of  hydrochloric  acid  added  to  them,  to  pre¬ 
vent  decomposition. 

Physiological  Action  and  Therapeutics. 

Apomorphine  is  a  systemic  emetic,  acting  directly  on  the  vomiting 
centre,  and  is  the  quickest,  most  certain  and  least  irritating  of  all  emetics, 
acting  in  from  five  to  twenty  minutes  with  but  moderate  nausea.  In  large 
dose  it  is  very  depressant  to  the  heart  (gr.  T*y  having  caused  death  in  a 


io8 


AQUA. 


weak  adult  by  cardiac  failure),  and  produces  paralysis  of  the  motor  and 
sensory  nerves,  delirium,  convulsions,  and  depression  of  respiratory 
power.  Small  doses  (gr.  are  expectorant. 

The  Hydrochlorate  is  the  preparation  usually  employed,  and  the  only 
official  one.  It  is  the  best  emetic  to  use  in  many  cases  of  poisoning,  par¬ 
ticularly  when  swallowing  is  difficult,  but  is  useless  in  narcotic  poisoning 
after  narcosis  has  blunted  the  vagus  centre.  It  is  a  very  desirable  agent 
in  any  case  where  time  is  of  great  importance. 

As  an  expectorant  it  is  highly  recommended  but  has  not  yet  been  much 
used.  In  catarrhs  the  ^  of  a  grain  every  3  hours  will  prove  of  great 
advantage,  but  it  must  be  used  with  caution  especially  in  young  children, 
who  bear  this  remedy  very  badly. 

In  hacking  coughs  without  expectoration  it  has  proven  a  very  efficient 
agent,  given  in  minute  doses,  gr.  N  to  in  the  24  hours. 


AQUA,  Water,  H20, — is  natural  water,  in  its  purest  attainable  state, 
a  colorless,  limpid  liquid,  devoid  of  odor  or  taste,  of  neutral  reaction,  and 
containing  not  more  than  1  part  of  fixed  impurities  in  10,000  parts. 
Besides  entering  into  the  composition  of  most  of  the  official  extracts,  fluid 
extracts,  and  many  other  pharmaceutical  preparations,  from  it  are  pre¬ 
pared  the  13  official  Waters  (Aquae),  and  also  the  official — 

Aqua  Destillata,  Distilled  Water,  H20, — 1000  parts  of  water  are  distilled,  the  first 
50  parts  obtained  being  thrown  away,  800  parts  are  preserved.  It  is  as  near  chemically 
pure  water  as  can  be  obtained. 

Aqua  Carbonata,  Carbonated  Water,  Soda-water,  is  water  highly  charged  with  car¬ 
bonic  acid  gas,  C02,  the  excess  of  gas  being  dissolved  in  the  water  by  pressure,  and 
escaping  in  bubbles  when  the  pressure  is  taken  off.  It  was  official  in  the  U.  S.  P.,  1870, 
under  the  title  Aqua  Acidi  Carbonici,  the  formula  requiring  that  the  water  be  charged 
with  five  times  its  volume  of  gas,  for  which  a  pressure  of  five  atmospheres  is  required. 
The  materials  usually  employed  by  soda-water  manufacturers  for  producing  the  gas,  are 
either  Sodium  Bicarbonate  or  Marble-dust,  and  Sulphuric  Acid. 


Nomenclature 


Aqua  Fluvialis,  River-water. 

Aqua  Pluvialis,  Rain-water. 

Aqua  Fontana,  Spring  or  Well-water. 
Aqua  Marina,  Sea-water. 

Aqua  Carbonata,  Carbonated  Water,  Soda 
Water. 


of  Water. 

Aqua  Destillata,  Distilled  Water. 
Aqua  Bulliens,  Boiling  Water. 
Aqua  Fervens,  Hot  Water. 

Aqua  Communis,  Common  Water. 
Balneum  Maris,  Warm-water  Bath. 
Balneum  Vaporis,  Vapor  Bath. 


Mineral  Waters. 

Natural  Water  differs  from  Distilled  in  containing  saline  and  other  con¬ 
stituents  in  varying  proportions, — from  common  water  (Aq.  Communis), 
in  which  they  are  so  small  in  quantity  as  not  to  alter  the  taste,  color,  etc., 
up  to  the  Sea-water,  having  3)^  per  cent.,  and  that  of  the  Dead  Sea  with 
2^/2  per  cent.  Spring  waters,  impregnated  with  foreign  substances  so  as 
to  have  a  decided  taste  and  a  marked  action  on  the  human  system,  are 
called  Mineral  Walers,  which  may  be  subdivided  into  various  groups, 
according  to  their  prevailing  constituents,  as  Carbonated ,  Alkaline ,  Saline , 
Sulphuretted ,  Silicious,  etc.  Full  analyses  of  all  the  principal  mineral 


AQUA. 


IO9 


waters  of  Europe  and  America  are  given  in  the  United  States  Dispensa¬ 
tory ,  1 6th  edition,  but  a  few  of  the  most  prominent  will  be  mentioned 
here. 

Carbonated  Mineral  Waters. 

Selters,  Nassau,  Germany, . 30  cubic  inches 

Apollinaris,  Nuenahr,  Prussia, . 47  “  of  C02 

Old  Sweet  Spring,  West  Virginia, . II  “  |  to  the  pint. 

Sweet  Chalybeate  Spring,  Virginia, . 13  “ 

These  waters  are  cold,  contain  generally  Carbonates  of  Calcium,  Magnesium  and 
Sodium  (in  some,  Iron),  which  are  held  in  solution  by  the  excess  of  Carbonic  Acid,  also 
Chlorides  of  Sodium  and  Potassium,  Sulphates,  Phosphates,  etc. 


Alkaline  Alineral  Waters. 


Ems,  Germany. 
Salzbrunn,  Germany. 
Gleickenberg,  Austria. 
Vichy,  France. 

Vais,  France. 

Bladon  Spring,  Ala. 
Congress  Spring,  Cal. 
Seltzer  Spring,  Cal. 


Perry  Spring,  Ills. 

St.  Louis  Spring,  Mich. 
Buffalo  Lithia  Spring,  Va. 
Plot  Spring,  Va. 

Warm  Spring,  Va. 
Berkeley  Spring,  Va. 
Bethesda  Spring,  Wis. 
Gettysburg  Spring,  Pa. 


These  waters  are  generally  cold,  those  of  Vichy  and  Ems  being  warm.  They  contain 
a  considerable  amount  of  Sodium  Carbonate,  also  Sodium  Chloride  and  Sulphate,  and 
various  other  Chlorides,  Carbonates  and  Sulphates,  with  Carbonic  Acid  gas  in  varying 
quantity.  Vichy  and  Vais  waters  depend  for  their  efficacy  almost  wholly  on  the  quantity 
of  Sodium  Carbonate  contained  in  them,  which  is  for  Vichy  from  26  to  50  grains  and  for 
Vais  about  60  grains  to  the  pint. 


Saline  Mineral  Waters. 


Friedrichshall,  Germany. 

Hunyadi  Janos,  Hungary. 
Baden-Baden,  Germany. 
Wiesbaden,  Germany. 

Carlsbad,  Bohemia. 

Pullna,  Bohemia. 

Seidlitz,  Bohemia. 

Marienbad,  Bohemia. 

St.  Catherine’s, 


Cheltenham,  England. 
Kissengen,  Bavaria. 
Reichenhall,  Bavaria. 
Adelheidsquelle,  Bavaria. 
Kreutznach,  Prussia. 
Saratoga  Springs,  N.  Y. 
Ballston,  N.  Y. 

Hot  Springs,  Arkansas, 
io,  Canada. 


These  waters  are  of  more  complex  composition,  the  various  waters  of  Saratoga  contain¬ 
ing  more  than  thirty  constituent  salts.  Those  usually  present  are  the  Sulphates  and  Car¬ 
bonates  of  Sodium,  Calcium,  Magnesium,  etc.  ( Magnesian  waters);  Chlorides  of  Sodium, 
Potassium  and  Lithium  ( Chlorinated  waters);  Ferrous  salts  ( Chalybeate  waters ),  with 
Iodine,  Bromine,  Manganese  salts,  and  Phosphates  in  some  few.  Carbonic  Acid  gas  is 
present  in  all.  Most  of  them  are  purgative,  some  are  considered  alterative,  and  many  are 
warm  (ioo°-i6o°). 

The  most  powerful  member  of  the  saline  group  is  Hunyadi  Janos,  which  contains  about 
150  grains  each  of  Magnesium  and  Sodium  Sulphates  to  the  pint,  and  is,  therefore,  effec¬ 
tively  purgative.  Nearly  as  strong  is  Pullna  water,  with  124  grains  of  Sodium  Sulphate 
and  93  grains  of  Magnesium  Sulphate  to  the  pint.  Friedrichshall  is  less  powerful,  but 
perhaps  a  better  aperient  water  in  doses  of  6  to  10  fluid  ounces.  Marienbad  contains 
no  Magnesium  Sulphate,  but  has  36  grains  of  Sodium  Sulphate,  9  of  Sodium  Carbonate, 
II  of  Sodium  Chloride,  and  a  small  quantity  of  Ferrous  Carbonate  to  the  pint;  in  trans¬ 
portation,  however,  it  loses  its  Carbonic  Acid  and  deposits  the  Iron.  It  is  not  aperient  in 
ordinary  doses.  Carlsbad  water  contains  20  grains  of  Sodium  Sulphate  and  9  each  of 
Sodium  Carbonate  and  Chloride  to  the  pint.  The  so-called  “Carlsbad  Salt  ”  is  simply 
Sodium  Sulphate  with  a  trace  of  the  Carbonate.  Hartnack  gives  the  following  formula 
for  its  artificial  preparation  :  Sodium  Sulphate  loo  parts,  Sodium  Bicarb.  80,  Sodium  Chlo¬ 
ride  40;  a  dessertspoonful  in  water  as  a  mild  saline  purgative.  These  waters  are  imported 
into  the  United  States  in  large  quantities,  and  may  be  ordered  through  any  druggist. 


I  IO 


AQUA. 


Sulphurous  Mineral  Waters. 

Aix-la-Chapelle,  Prussia.  Blue  Lick  Spring,  Ky. 

Bareges,  S.  France.  Sharon  Spring,  N.  Y. 

Eux-Bonnes,  S.  France.  Yellow  Sulphur  Spring,  Va. 

Llandrindod,  Wales.  White  Sulphur  Spring,  W.  Va. 

Harrowgate,  England.  Salt  Lake  Warm  Springs,  Utah. 


These  waters  all  contain  Sulphuretted  Hydrogen  gas,  also  Carbonic  Acid  gas  and  Car¬ 
bonates,  Chlorides  and  Sulphates  of  Sodium,  Potassium,  Magnesium  and  Calcium  ;  some¬ 
times  Carbonate  and  Oxide  of  Iron,  Iodide  and  Bromide  of  Sodium. 


Silicious  Mineral  Waters. 

Hot  Springs,  Iceland.  Geysers  of  Yellowstone  Park. 

The  constituents  of  these  waters  are  chiefly  alkaline  Silicates. 


Physiological  Action  of  Water. 

Water  is  an  essential  constituent  of  all  the  tissues  of  the  body,  form¬ 
ing  from  0.2  per  cent,  of  the  enamel  of  the  teeth  to  77  per  cent,  of  the 
ligaments.  In  the  liquids  of  the  organism  it  is  contained  in  the  propor¬ 
tions  of  78  per  cent,  of  the  blood  to  93  per  cent,  of  the  urine,  and  99 
per  cent,  of  the  tears.  In  moderate  quantity  it  is  necessary  to  digestion, 
but  in  large  amount  it  weakens  digestion  by  diluting  the  gastric  juice. 
Ice-cold  water,  if  freely  used,  suspends  the  action  of  the  pepsin,  depresses 
the  nerves  of  the  stomach,  and  lowers  its  blood  supply.  The  free  use  of 
water  internally  produces  increased  cutaneous  and  renal  excretion,  and 
promotes  the  elimination  of  some  of  the  products  of  tissue-change,  as 
urea,  phosphoric  acid,  etc.  In  some  subjects  it  favors  the  deposition  of 
fat. 

Cold  Water  applied  externally,  as  by  a  bath  (4o°-6o°  F.),  abstracts 
a  portion  of  the  body-heat,  lowering  the  surface  temperature  and  depress¬ 
ing  the  cutaneous  nerves,  producing  spasmodic  breathing  and  a  quick¬ 
ened  pulse.  If  the  temperature  of  the  water  is  not  too  low  and  the 
bodily  vigor  is  good,  reaction  soon  occurs,  and  the  general  effect  is  tonic 
to  the  muscular  power,  circulation  and  respiration.  If  this  does  not  take 
place  a  secondary  chill  occurs,  and  serious  depression  may  result. 

Warm  Water  (95°-ioo°  F.)  applied  to  the  surface  of  the  body,  as  by 
baths  of  water  or  steam,  packing,  etc.,  acts  in  the  opposite  manner  at 
first,  increasing  the  circulation  in  the  skin,  the  rapidity  of  the  pulse  and 
respiration  and  the  body  temperature.  Rapid  tissue-change  occurs,  the 
waste  products  being  eliminated  chiefly  by  the  skin  and  the  pulmonary 
mucous  membrane.  If  long-continued,  precordial  oppression,  giddiness 
and  muscular  debility  are  experienced. 

Hot  Water  (iio°-ii2°  F.)  at  first  dilates  the  vessels  of  the  part  to 
which  it  is  applied,  and  soon  afterwards  contracts  them.  It  is  a  valuable 
means  of  relieving  congestion  and  inflammation,  and  is  a  most  effective 
hemostatic  when  the  bleeding  is  from  small  vessels  or  of  capillary  charac- 


AQUA. 


I  I  I 


ter.  Whether  generally  or  locally  applied  it  is  one  of  the  most  reliable 
means  of  relieving  spasm. 

Hot  Vapor  applied  to  the  surface  accelerates  the  circulation  and  pro¬ 
duces  profuse  sweating.  Its  general  action  is  similar  to  that  of  warm  water. 

Mineral  Waters  taken  internally  act  chiefly  by  virtue  of  the  water, 
partly  in  accordance  with  the  effects  of  their  various  constituents.  As 
baths,  their  action  is  doubtless  entirely  due  to  their  temperature. 

Therapeutics  of  Water. 

Cold  Water  or  Ice  has  many  external  applications  of  value  in  the 
treatment  of  disease.  As  a  wet  pack  it  is  used  in  tonsillitis,  diphtheria 
and  croup.  Cold  baths  are  the  most  effective  antipyretic  in  the  high  tem¬ 
perature  of  fevers,  and  the  cold  wet  pack  is  used  for  the  same  purpose. 
Ice  or  cold  water  is  applied  to  the  head  in  acute  cerebral  congestion,  and 
to  the  spine  in  chorea,  etc. ;  also  locally  in  hemorrhoids,  bubo,  orchitis, 
and  to  the  uterus  in  post-partum  hemorrhage.  Cold  affusion  to  the  body 
is  employed  as  a  preventive  of  spasmodic  croup,  as  well  as  to  lessen  the 
tendency  to  taking  cold. 

Hot  Water  externally  as  fomentations,  hot  wet  pack,  baths,  etc.,  is 
most  effective  in  reducing  local  congestion  and  setting  up  resolution  of 
local  inflammation.  Hot  fomentations  to  the  renal  region  are  useful  in 
functional  inactivity  of  the  kidneys.  The  hot  spinal  douche  is  used  in 
affections  of  the  spinal  cord  and  meninges,  and  in  the  backache  of  women. 
The  hot  wet  pack  is  highly  esteemed  in  inflammations  of  the  chest  organs, 
and  hot  injections  for  chronic  inflammation  of  the  uterus.  Hot  water 
dressings  for  wounds  are  strongly  recommended  by  many  high  surgical 
authorities.  Vapor  and  Turkish  baths  are  used  as  diaphoretics  in  advanced 
kidney  disease,  in  acute  and  chronic  rheumatism,  mineral  poisoning,  and 
syphilis.  Warm  baths,  with  cold  applications  to  the  head,  are  esteemed 
as  of  value  in  infantile  convulsions  and  chorea. 

Internally,  water  is  chiefly  of  value  as  a  diuretic,  and  if  hot  as  a  dia¬ 
phoretic.  A  glass  of  cold  water  before  breakfast  daily  is  often  an  effective 
means  of  overcoming  constipation,  while  the  drinking  of  hot  water  an 
hour  before  each  meal  has  been  of  great  value  to  many  dyspeptics.  The 
value  of  the  popular  teas  in  chronic  diseases  is  almost  entirely  due  to  the 
diluent,  diuretic  and  diaphoretic  actions  of  the  hot  water  used. 

Carbonated  Water,  or  “  Soda-water,”  as  it  is  popularly  called,  is 
employed  as  a  grateful  beverage  in  hot  weather,  being  flavored  with  various 
syrups.  It  is  also  an  agent  of  great  value  for  febrile  cases,  as  it  allays  thirst, 
lessens  nausea,  and  promotes  the  secretion  of  urine.  It  forms  an  excellent 
vehicle  for  the  administration  of  the  saline  cathartics,  especially  Magne¬ 
sium  Sulphate,  and  of  the  various  carbonates.  It  is  one  of  the  numerous 
agents  which  have  been  found  efficacious  in  the  vomiting  of  pregnancy. 


I  12 


ARGENTUM. 


Therapeutics  of  the  Mineral  Waters. 

An  undue  value  is  placed  by  the  laity  and  interested  proprietors  on  the 
medicinal  value  of  mineral  waters,  causing  the  various  localities  of  the 
best  advertised  springs  to  become  resorts  for  invalids  and  idlers  from  every 
civilized  country.  The  benefit  derived  is  in  most  instances  due  to  the 
change  of  climate  and  scene,  freedom  from  home  cares  and  business  worry, 
regularity  of  life  and  diet,  drinking  of  water  in  quantity,  and  in  many 
cases  the  substitution  of  water  for  alcoholic  beverages.  In  order  to  get 
the  worth  of  their  money,  people  will  gladly  submit  to  rigid  hygienic  and 
dietetic  restrictions  at  a  watering-place  which  they  would  totally  ignore 
at  home.  The  same  may  be  said  of  the  treatment  at  the  so-called 
“  hydropathic”  or  “  water-cure  ”  establishments.  As  a  rule,  those  springs 
will  prove  of  most  value  which  are  furthest  removed  from  the  patient’s 
residence,  for  “  distance  lends  enchantment  ”  in  these  matters  as  well  as 
in  many  others.  Invalids  whose  homes  are  in  the  vicinity  of  some 
wonder-working  spring  will  not  usually  derive  much  benefit  from  its  water, 
but  will  by  that  of  another  spring,  similar  in  constituents,  but  located 
several  hundred  miles  away. 

The  principal  affections  in  which  mineral  waters  are  esteemed  most 
highly  are  the  following :  dyspepsia,  cirrhosis  of  the  liver,  gout,  rheu¬ 
matism,  lithiasis,  diabetes  of  hepatic  origin,  constipation,  strumous 
disorders,  obesity,  plethora  of  the  pelvic  organs,  hypochondriasis,  skin 
diseases,  especially  those  dependent  on  gastric  derangement,  phthisis, 
constitutional  syphilis,  metallic  poisoning,  etc.,  in  all  of  which  the  influ¬ 
ences  above  mentioned  are  especially  efficacious,  and  are  no  doubt  the 
chief  factors  in  producing  any  benefit  which  maybe  attainable.  Aperient 
and  purgative  waters  are  useful  in  many  cases  where  a  prejudice  exists 
against  purgative  medicine,  but  none  against  the  same  agents  in  a  natural 
water.  The  strong  saline-aperient  waters,  as  Carlsbad,  Hunyadi,  Fried- 
richshall,  etc.,  have  considerable  repute  in  the  treatment  of  the  uric-acid 
diathesis  and  calculous  affections,  and  the  waters  of  St.  Catherine’s  Wells 
are  credited  with  decided  influence  upon  local  and  chronic  rheumatism. 

The  special  therapeutics  of  mineral  waters  are  to  be  found  in  this  volume  under  the 
heads  of  their  principal  constituents,  as  Sodium  Chloride,  Sodium  Sulphate,  Magnesium 
Sulphate,  etc.,  also  in  the  therapeutical  part  of  the  work. 


ARGENTUM,  Silver,  Ag, — is  represented  by  the  following  four 
official  salts,  viz. :  — 


Compounds  of  Silver  and  their  Preparations. 

Argenti  Nitras ,  Nitrate  of  Silver,  AgN03, — occurs  in  colorless  rhombic  crystals,  of 
bitter  caustic  taste  and  neutral  reaction,  soluble  in  0.8  of  water  and  25  of  alcohol  at  590  F. 
Is  best  given  in  pill  or  distilled  water ;  never  with  tannin  or  a  vegetable  extract,  lest  an 
explosive  compound  result.  Dose,  gr.  Ye-fz, — if  watched,  up  to  gr.  j  may  be  given. 
When  melted  with  4  per  cent,  of  Hydrochloric  Acid,  it  makes — 

Argenti  Nitras  Pusus,  Moulded  Nitrate  of  Silver,  Lunar  Caustic, — for  local  use  as  a 


ARGENTUM. 


I  13 


mild  caustic  and  an  astringent.  Argenti  Nitras  Dilutus,  Diluted  Nitrate  of  Silver,  Miti¬ 
gated  Stick, — is  the  same  melted  with  an  equal  weight  of  Potassium  Nitrate.  Is  used 
locally  by  ophthalmologists. 

Argenti  Cyanidum ,  Cyanide  of  Silver,  AgCN, — has  no  medicinal  use  except  for  the 
extemporaneous  preparation  of  Hydrocyanic  Acid.  (See  ante ,  page  67.) 

Argenti  Iodidum,  Iodide  of  Silver,  Agl, — a  greenish  yellow  powder  insoluble  in  water 
or  alcohol.  Is  used  instead  of  the  nitrate  internally,  as  it  is  supposed  not  to  discolor  the 
skin.  Dose,  gr.  %-)  in  pill. 

Argenti  Oxidum ,  Oxide  of  Silver,  Ag20, — a  brownish  black  powder,  nearly  insoluble 
in  water  and  insoluble  in  alcohol.  It  should  not  be  triturated  with  readily  oxidizable  or 
combustible  substances,  and  should  not  be  brought  into  contact  with  ammonia.  Dose,  gr. 
yz- ij  in  pill.  Is  not  dangerous. 

All  the  silver  salts  should  be  protected  from  light  in  dark  amber-colored  vials. 

Physiological  Action. 

Nitrate  of  Silver  is  a  powerful  astringent  and  a  limited  escharotic. 
Applied  to  the  skin  or  mucous  membrane  it  combines  with  the  albumen 
of  the  tissue,  excites  superficial  inflammation,  which  is  soon  followed  by 
an  altered  condition  of  the  part,  and  stains  the  same  black  under  the 
influence  of  light.  The  stains  may  be  removed  by  washing  with  a  strong 
solution  of  Potassium  Cyanide.  Given  internally  in  small  doses  it 
increases  secretion,  stimulates  the  heart,  promotes  nutrition,  and  acts  as 
a  nerve  tonic.  Its  continued  use  produces  symptoms  which  are  collec¬ 
tively  termed  Argyria,  and  are  as  follows :  gastro-intestinal  catarrh, 
tissue  waste,  uraemia,  albuminuria,  fatty  degeneration  of  the  heart,  liver 
and  kidneys,  hemorrhages,  fluidity  of  the  blood,  a  slate-colored  line 
along  the  margin  of  the  gums,  and  a  similar  discoloration  of  the  skin 
and  mucous  membranes,  with  centric  impairment  of  the  nervous  system 
producing  paralysis  on  a  large  scale,  loss  of  coordination  power,  convul¬ 
sions,  and  finally  death  by  paralysis  of  respiration.  Large  doses  produce 
violent  gastro-enteritis,  also  ulcer  of  the  stomach  from  thrombosis  of  its 
veins,  and  destruction  of  the  gastro-intestinal  mucous  membrane. 

The  Iodide  and  Oxide  are  sometimes  used  to  produce  the  same  con¬ 
stitutional  effects,  they  being  supposed  not  to  discolor  the  skin,  but  this 
has  been  found  to  be  fallacious.  The  oxide  is  much  the  least  irritant  of 
the  silver  salts. 

Antagonists  and  Incompatibles. 

Common  Salt  freely  used  is  the  antidote,  precipitating  the  insoluble  chloride  of  silver 
and  acting  as  an  emetic.  The  nitrate  is  exceedingly  sensitive  to  organic  material  and 
light,  which  decompose  it  readily.  Incompatibles  are  all  the  soluble  chlorides  (hence  it 
should  be  used  in  distilled  water),  most  of  the  mineral  acids  and  their  salts,  alkalies  and 
their  carbonates,  lime  water  and  astringeut  infusions. 

A  course  of  silver  medication  should  be  regulated  by  suspending  the  remedy  after  5 
or  6  weeks’  use,  and  then  promoting  elimination  by  purgatives,  diuretics  and  baths.  To 
prevent  the  general  discoloration  Potassium  Iodide  should  be  given  conjointly  with  the 
silver,  and  baths  of  Sodium  Hyposulphite  used  frequently. 

Therapeutics. 

Locally  the  Nitrate  is  much  used  as  a  stimulant  application,  an  astrin¬ 
gent,  a  caustic,  an  alterative  and  an  antiphlogistic.  To  ulcers  and  in 
throat  affections  the  solid  stick  may  be  used,  but  solutions  of  various 
8 


ARNICA. 


I  14 

strengths  from  gr.  j  to  gr.  xl  to  the  3  are  much  better.  The  mildest 
solutions  are  employed  in  conjunctivitis  (never  over  the  cornea),  the 
stronger  in  throat  and  mouth  affections,  and  the  strongest  in  lupus,  ery¬ 
sipelas  and  other  skin  diseases.  A  solution  in  Nitrous  Ether  (gr.  xl  to 
the  3)  is  said  to  abort  superficial  inflammations  if  applied  early  to  the 
neighboring  integument,  and  in  erysipelas  a  solution  of  gr.  xx  to  the  3 
is  often  used  over  the  inflamed  surface  and  beyond,  after  careful  washing 
and  drying,  in  the  hope  of  preventing  the  extension  of  the  disease,  which 
it  will  not  do.  The  mucous  membranes  of  the  conjunctiva,  fauces, 
larnyx,  urethra,  bladder,  uterus,  vagina  and  rectum,  have  all  been  sub¬ 
jected  to  the  local  action  of  this  salt. 

Internally  the  silver  salts  are  used  in  dyspepsia  with  vomiting  of  yeasty 
fluid,  chronic  gastritis  and  gastric  ulcer,  dysentery  of  chronic  type,  espe¬ 
cially  if  rectal  ulcer  (the  Nitrate  internally  and  by  enema),  the  diarrhoea 
of  phthisis  and  typhoid  fever  (Nitrate  with  Opium),  chronic  spinal  in¬ 
flammations  causing  locomotor  ataxia  or  paraplegia,  and  epilepsy,  in  the 
latter  affection  the  Nitrate  having  occasionally  given  good  results. 

The  Oxide  has  been  used  internally  for  gastric  neuralgia,  irritative 
dyspepsia,  pyrosis,  gastric  and  pulmonary  hemorrhages,  and  menorrhagia. 
The  Iodide  is  used  to  obtain  the  constitutional  effects  of  silver,  but  has 
no  advantage  over  the  other  preparations. 


ARNICA  , — is  the  plant  Arnica  monta?ia  or  Leopard’s  Bane,  a  peren¬ 
nial  of  the  nat.  ord.  Compositse,  indigenous  to  the  mountains  of  Northern 
Europe  and  Siberia,  and  said  to  have  been  also  found  in  the  mountains 
about  the  headwaters  of  the  Missouri  and  Columbia  rivers.  It  has  large 
orange-yellow  flowers,  and  a  small,  curved  rhizome  with  several  rootlets. 
Both  the  flowers  and  the  root  are  official.  Its  most  important  constituent 
is  Trimethyl  amine,  C3HyN,  an  ammoniacal  alkaloidal  principle  which  is 
probably  the  active  ingredient.  It  also  contains  Arnicin,  Inulin ,  Capro- 
nic  and  Capiylic  Acids,  tannin,  mucilage,  resins,  and  two  essential  oils, 
one  of  which  exists  in  the  flowers,  the  other  in  the  root. 

Arnic^e  Flores,  Arnica  Flowers, — the  flower-heads  of  Arnica  i?iontana, 
large,  yellow,  having  14  to  16  strap-shaped  florets  in  the  ray,  twice  as 
long  as  the  disk,  which  consists  of  numerous  tubular  florets.  The  odor  is 
feebly  aromatic,  the  taste  bitter  and  acrid.  Used  in  Tincture  and  Infusion. 

Arnioe  Radix,  Arnica  Root, — the  rhizome  and  rootlets  of  Arnica 
montana ,  is  about  2  inches  long  and  to  inch  thick,  externally  brown 
and  rough  from  leaf-scars,  internally  whitish,  with  a  thick  bark  contain¬ 
ing  a  circle  of  resin-cells  and  a  large,  spongy  pith.  Odor  somewhat  aro¬ 
matic,  taste  pungent,  aromatic  and  bitter.  Resembles  Valerian,  which  is 
distinguished  by  its  smell;  Serpeniaria,  which  has  many  contorted  root¬ 
lets  ;  and  Veratrum  Viride,  which  has  thicker  rootlets.  Dose,  gr.  v-xx. 


ARNICA. 


I  15 


Preparations  of  the  Floivers. 

Tinctura  Arnicce  Florum, — 20  per  cent.  Dose,  rrpv-xxx. 

Infusion  Arnicce  (Unofficial), — Arnica  flowers  20  in  100  parts  of  water,  is  thought  by 
many  observers  to  be  the  best  form  for  local  use,  as  it  does  not  excite  dermatitis,  probably 
from  containing  none  of  the  Volatile  Oil,  or  the  insoluble  principle  Arnicin. 

Preparations  of  the  Root. 

Extractum  Arnicce  Radicis, — Dose,  gr.  j-iij. 

Extractum  Arnicce  Radicis  Fluidum , — Dose,  ir^v-xx. 

Tinctura  Arnicce  Radicis , — 10  per  cent.  Dose,  TT^v-xxx. 

Emplaslrum  Arnicce ,  —  contains  Extract  of  Arnica  Root  50  parts  to  100  of  Lead 
Plaster. 

Derivative. 

Trimethy lamina,  Trimethylamine,  C3H9N  (Unofficial), — is  a  thin,  colorless,  strongly 
alkaline  liquid,  boiling  at  50°  F.,  and  at  ordinary  temperatures  is  a  colorless,  inflammable 
gas.  The  Hydrochlorate  is  the  most  stable  salt,  crystallizing  in  white  or  colorless  prisms, 
nearly  odorless,  of  pungent  taste,  very  deliquescent,  and  freely  soluble  in  water  and  in 
alcohol.  Dose,  gr.  ij-iij  in  syrup  every  2  hours. 

Trimethylamine  has  been  obtained  from  Arnica  flowers  and  those  of  several  other 
plants,  from  Ergot,  Hops,  Codeine,  Cod-liver  Oil,  and  decomposing  albuminous  sub¬ 
stances,  such  as  human  urine,  herring-pickle,  and  the  residue  left  in  making  sugar  from 
beets.  It  is  sometimes  incorrectly  named  Propylamine,  a  term  also  applied  to  an  impure 
trimethylamine,  but  in  reality  an  allied  and  isomeric  compound. 

Physiological  Action. 

Arnica  is  irritant,  stimulant,  depressant,  antipyretic,  diuretic  and  vul¬ 
nerary.  It  irritates  the  gastro-intestinal  tract,  and  in  some  persons  the 
local  use  of  an  alcoholic  preparation  of  the  flowers  will  excite  erysipela¬ 
tous  inflammation  of  the  skin,  though  those  of  the  root  have  not  been 
observed  to  do  so.  In  small  doses  internally  it  increases  the  action  of  the 
heart,  raises  the  arterial  tension  and  stimulates  the  action  of  the  skin  and 
the  kidneys.  Large  doses  produce  a  transient  excitement,  followed  by 
depression  of  the  circulation,  respiration,  and  nerve-centres;  headache, 
unconsciousness,  and  even  convulsions  being  induced,  the  body-tempera¬ 
ture  lowered,  the  pupils  dilated,  and  muscular  paresis  produced.  A  toxic 
dose  paralyzes  the  nervous  systems  of  animal  and  organic  life,  causing 
collapse  and  death. 

Trimethylamine  is  an  active  escharotic  and  a  gastro-intestinal  irritant. 
It  lowers  the  rate  and  force  of  the  heart,  decreases  the  body-temperature, 
and  diminishes  (though  sometimes  increases)  the  excretion  of  urea.  The 
Hydrochlorate  is  a  powerful  antipyretic  in  doses  of  gr.  ij  every  3  hours. 

Therapeutics. 

Arnica  is  a  popular  remedy  with  those  who  patronize  the  so-called 
homoeopathic  school  of  practice,  but  like  many  other  agents  which  the 
homceopathists  claim  to  have  given  to  medicine,  it  is  a  remedy  much 
older  than  homoeopathy,  and  was  investigated  originally  by  regular  physi¬ 
cians,  notably  by  Van  der  Kolk  in  the  sphere  of  mental  affections. 

Externally,  the  tincture  in  water  has  a  popular  reputation  in  sprains, 
bruises,  etc.,  though  an  infusion  is  better  for  local  use.  Ecchymoses  are 


ARSENIUM. 


116 

rapidly  dispersed  by  its  administration  internally  as  well  as  externally ; 
and,  in  internal  bruises  from  shocks  or  concussions,  its  internal  use  has 
proven  very  efficacious.  The  aqueous  preparation  locally  promotes  the 
rapid  union  of  cut  surfaces. 

Internally,  besides  its  value  as  noted  above,  Arnica  is  undoubtedly 
effectively  employed  in  typhus  and  typhoid  fevers  as  a  stimulant  and 
antipyretic,  also  in  delirium  tremens,  rheumatism  and  rheumatic  gout, 
hemorrhages,  epistaxis,  haemoptysis,  amaurosis,  concussion  of  the  brain, 
chronic  dysentery,  and  paralysis  of  the  bladder. 

In  idiopathic  mania,  after  the  first  excitement  has  diminished,  Arnica, 
in  aqueous  preparation  internally,  has  given  great  satisfaction.  It  has 
often  checked  an  exhausting  diarrhoea  after  many  other  remedies  have 
failed. 

Trimethylamine  has  been  found  useful  in  acute  rheumatism  and  gout, 
relieving  pain,  reducing  temperature,  and  diminishing  the  frequency  of 
the  pulse.  In  chronic  rheumatism,  as  a  limiment  (i  to  3  of  Glycerin), 
it  is  said  to  give  relief  equal  to  that  produced  by  any  anodyne.  It  has 
also  been  used  with  benefit  in  chorea,  moderating  the  spasmodic  move¬ 
ments  when  not  suspending  them  entirely. 


ARSENIUM,  Arsenic,  As. — The  metal  Arsenic  is  not  used  in 
medicine,  but  is  represented  by  one  of  its  Oxides,  a  salt  of  another  Oxide, 
and  the  Iodide,  which  are  official ;  together  with  four  preparations  of 
these  compounds,  or  of  their  salts,  viz.  : — 

Arsenic  Compounds  and  their  Preparations. 

Acidum  Arseniosum ,  Arsenious  Acid,  Arsenious  Oxide,  White  Arsenic,  As203, — is  a 
heavy,  white  solid,  occurring  as  an  opaque  powder,  or  in  semi  transparent  masses  having 
usually  a  striated  appearance,  soluble  in  30  to  80  of  water  at  590  F.,  the  solubility  varying 
with  its  physical  condition,  also  soluble  in  15  of  boiling  water,  in  alkalies  and  their  carbo¬ 
nates,  hydrochloric  acid  and  in  glycerin.  It  is  volatilized  at  424. 50  F.,  without  melting, 
and  when  thrown  on  ignited  charcoal  it  emits  an  alliaceous  odor.  Arsenious  Acid  is 
obtained  by  roasting  native  arsenides,  and  condensing  the  fumes  in  a  long  horizontal 
chimney.  Dose,  gr.  to  y1^. 

Liquor  Acidi  A rseniosi,  Solution  of  Arsenious  Acid  (Liquor  Arsenici  Hydrochloricus, 
B.  P.),  is  a  1  per  cent,  solution  of  Arsenious  Acid  in  Hydrochloric  Acid  and  Distilled 
Water.  Dose,  rrpij-x. 

Liquor  Potassii  Arsenilis,  Solution  of  Arsenite  of  Potassium,  Fowler’s  Solution, — is 
prepared  by  boiling  together  Arsenious  Acid  1,  Bicarbonate  of  Potassium  I,  and  Distilled 
Water  10 ;  then  adding  Compound  Tincture  of  Lavender  3,  and  Distilled  Water  up  to 
100  parts.  Dose,  rrpij-x. 

Sodii  Arsenias,  Arseniate  of  Sodium,  Na2HAs04.7H20,. — is  a  salt  of  the  second  oxide, 
Arsenic  Acid,  As205.  It  is  in  colorless,  prismatic  crystals,  of  feebly  alkaline  taste  and  a 
faintly  alkaline  reaction,  soluble  in  4  of  water  at  590  F.,  very  soluble  in  boiling  water, 
hardly  soluble  in  alcohol.  Dose,  gr.  yg-| ;  of  the  dried  salt,  gr.  yy-yV 

Liquor  Sodii  Arseniatis,  Solution  of  Arseniate  of  Sodium,  Pearson’s  Solution, — has  of 
the  Arseniate  dried  1  part  in  100  of  Distilled  Water.  Dose,  Tip ij-xv. 

Arsenii  Iodidtim,  Iodide  of  Arsenic,  Asl3, — in  glossy,  orange-red,  crystalline  masses 
or  scales,  gradually  losing  iodine  by  exposure  to  the  air,  soluble  in  3^  of  water  and  in 
10  of  alcohol  at  50°  F.,  is  gradually  decomposed  by  boiling  water  and  by  boiling  alcohol, 
and  is  completely  volatilized  by  heat.  Dose,  gr.  Aj~ s'. 


ARSENIUM. 


ii  7 

Liquor  Arsenii  et  Hydrargyri  lodidi,  Solution  of  Iodide  of  Arsenic  and  Mercury, 
Donovan’s  Solution, — has  of  Iodide  of  Arsenic  I,  Red  Iodide  of  Mercury  i,  in  ioo  parts 
of  Distilled  Water.  Dose,  rr^ij-x. 

Unofficial  Salts  of  Arsenious  Acid. 

Cupri  Arsenis ,  Arsenite  of  Copper, — occurs  in  the  various  cupro-arsenical  pigments, 
Scheele’s  green,  Mineral  green,  Paris  green,  etc.,  used  for  wall-paper  coloring,  and  as 
insect  poison.  It  is  highly  poisonous. 

Arsenii  Bromidum,  Bromide  of  Arsenic.  Liquor  Bromi  Arsenitis,  Solution  of  the 
Arsenite  of  Bromine,  Clemen’s  Solution.  Dose,  rtpj-v,  in  water,  twice  daily  after  meals. 

Physiological  Action. 

Arsenious  Acid,  when  applied  to  the  skin  denuded  of  its  epidermis, 
acts  as  a  painful  escharotic,  producing  violent  inflammation  and  resulting 
in  a  slough  which  forms  a  barrier  to  its  absorption.  If  applied  in  dilute 
solution  over  a  large  surface,  it  will  be  absorbed,  and  may  produce  the 
systemic  effects  to  be  described. 

In  small  doses  it  is  a  stomachic  and  general  tonic,  promoting  the 
appetite  and  digestion,  increasing  the  cardiac  action,  the  respiratory 
power,  and  the  intestinal  secretions, — stimulating  peristalsis,  exalting 
mental  activity  and  the  sexual  appetite,  and  producing  a  fair  skin  and  a 
rotund  form.  When  tolerance  of  the  drug  is  established,  large  doses  are 
used  with  impunity,  as  by  the  arsenic-eaters  of  Styria,  who  can  swallow 
at  once  as  much  as  5  grains  with  safety.  They  are  careful,  however,  not 
to  take  any  water  into  the  stomach  at  the  same  time,  so  that  the  dose  is 
slowly  absorbed,  and  probably  eliminated  rapidly.  Not  all  those  who 
begin  its  use  can  acquire  tolerance  of  it,  but  those  who  do  so  seem  to 
continue  it  without  injury,  and  live  to  an  old  age,  undergoing  great 
exertion  without  exhaustion,  and  being  enabled  to  ascend  steep  moun¬ 
tains  without  difficulty  of  respiration. 

In  full  medicinal  doses ,  continued  for  some  time,  it  causes  itching  and 
oedema  of  the  eyelids,  ptyalism,  nausea  and  vomiting,  diarrhoea  or  dysen¬ 
tery,  epigastric  pain  and  soreness,  feeble  and  irritable  heart,  dyspnoea, 
disordered  sensibility,  herpes  zoster,  urticaria,  eczema  and  other  skin 
eruptions,  jaundice  and  albuminuria. 

In  large  doses ,  it  is  a  powerful  irritant  to  the  gastro-intestinal  and 
bronchial  mucous  membranes.  Toxic  doses  may  produce  either  symptoms 
of  gastro-enteritis,  or  those  of  profoundly  narcotic  character.  In  the 
first  and  most  usual  form  of  acute  arsenical  poisoning,  there  is  burning 
pain  in  the  throat  and  stomach  extending  over  the  abdomen,  vomiting, 
thirst,  bloody  stools,  strangury,  suppressed,  albuminous  or  bloody  urine, 
rapid  and  feeble  heart,  great  anxiety,  cold  breath,  finally  exhaustion  and 
collapse, — a  group  of  symptoms  much  resembling  cholera.  Autopsy  shows 
erosions,  ecchymoses,  and  softening  of  the  gastro-intestinal  mucous  mem¬ 
brane,  congestion  of  the  lungs  and  bronchi,  and  fatty  degeneration  of  the 
liver,  kidneys  and  cardiac  muscle.  The  poison  is  found  in  the  urine, 


1 1 8 


ARSENIUM. 


saliva,  tears,  sweat,  etc.,  and  maybe  detected  even  in  the  parenchymatous 
tissues.  In  the  nervous  form  of  poisoning  by  Arsenic,  profound  coma  and 
insensibility  come  on  suddenly  without  any  gastro-intestinal  symptoms. 

Arsenical  preparations  are  generally  classed  as  alteratives,  but  they  are 
valuable  tonics  and  antiseptics,  and  possess  antiperiodic  powers  second 
only  to  those  of  Quinine. 

Chrotiic  Arsenical  Poisoning  may  occur  from  the  inhalation  of  arsenical 
vapors  or  dust  arising  from  wall-papers  or  other  substances  containing  the 
poison.  The  quantity  necessary  to  produce  symptoms  of  poisoning 
when  inhaled  seems  to  be  very  small.  The  most  prominent  symptoms 
are,  at  first  increased  appetite,  next  colicky  pains,  mucous  or  dysenteric 
stools,  irritation  of  the  eyes,  coryza,  a  short,  dry  cough,  and  a  white  and 
silvery  tongue,  all  accompanied  by  great  bodily  prostration. 

To  avoid  arsenical  poisoning  during  a  course  of  the  drug,  full  doses 
(up  x  of  Fowler’s  Solution)  should  be  used  at  the  commencement,  and 
always  taken  on  a  full  stomach.  The  dose  should  then  be  steadily  re¬ 
duced.  Susceptible  persons  often  tolerate  it  better  if  a  few  drops  of 
Tinctura  Opii  are  administered  with  each  dose. 

•  Antidotes  and  Incompatibles. 

Poisoning  by  Arsenic  is  treated  by  prompt  evacuation  of  the  stomach,  and  washing  it 
by  means  of  the  stomach  pump,  then  Magnesia,  Chalk  and  Lime-water  freely,  or  better 
still,  the  chemical  antidote  to  Arsenic  in  solution,  viz.,  the  Hydrated  Oxide  of  Iron, 
freshly  precipitated  and  in  a  soft  magma,  in  the  proportion  of  gr.  viij  for  each  grain  of  the 
poison  ingested.  (See  Ferri  Oxidum  Hydratum  for  the  preparation  of  this  antidote.) 
Oil  or  mucilaginous  drinks  should  be  given  to  protect  the  mucous  membranes,  and  di¬ 
luents,  alkaline  mineral  waters  or  Iodide  of  Potassium  to  promote  elimination.  Dialyzed 
Iron  has  been  shown  to  be  quite  efficient  as  an  antidote,  and  is  more  easily  obtained 
than  the  hydrated  oxide.  It  has  rendered  good  service  in  many  cases  of  poisoning  from 
inhalation  of  arsenical  fumes. 

Incompatibles  are  salts  of  iron,  magnesia  and  lime,  and  astringents. 

Therapeutics. 

Externally,  Arsenic  has  been  employed  in  the  form  of  paste  as  a  depila¬ 
tory,  and  as  an  escharotic  in  cancers,  but  is  excessively  painful.  Most  of 
the  secret  “  cancer-cures  ”  have  arsenious  acid  for  their  basis.  Internally, 
it  is  used  as  a  tonic  and  astringent  to  the  intestinal  canal,  as  a  tonic  and 
antispasmodic  in  nervous  diseases,  and  for  its  action  on  tissue  change.  It 
is  of  especial  value  in  irritative  dyspepsia,  gastralgia,  pyrosis,  gastric 
ulcer  or  cancer,  regurgitation  of  food  without  nausea,  diarrhoea  coming 
on  immediately  after  taking  food,  vomiting  of  drunkards  and  chronic 
alcoholism.  It  has  proven  of  signal  service  in  the  commencement  of 
phthisis,  and  in  catarrhal  pneumonia,  probably  by  causing  fatty  degen¬ 
eration  of  the  exudation  in  the  alveolar  cavities,  thus  breaking  it  up  and 
quickening  its  absorption.  It  is  often  very  serviceable  in  chronic  bron¬ 
chitis  with  copious  expectoration,  in  acute  catarrh,  hay-fever,  whooping- 
cough,  asthma,  chorea,  epilepsy,  angina  pectoris  and  other  spasmodic 


ASAFCETIDA. 


I  19 

nervous  disorders.  In  many  forms  of  neuralgia,  it  often  gives  prompt 
and  permanent  relief,  especially  in  cases  due  to  malarial  poisoning.  As 
an  antiperiodic,  it  has  high  rank,  being,  however,  of  particular  value  in 
chronic  malarial  poisoning,  and  as  an  adjunct  to  Quinine  in  the  intervals 
between  the  paroxysms  of  intermittents.  Anaemia  and  chlorosis  are  re¬ 
markably  benefited  by  it,  and  in  rheumatic  arthritis  and  chronic  rheuma¬ 
tism  it  is  sometimes  of  great  service.  In  chronic  scaly  and  papular  skin 
diseases  its  value  is  very  great,  but  it  is  not  serviceable  in  acute  forms, 
and  the  more  chronic  the  cutaneous  affection  the  more  likely  is  it  to  be 
amenable  to  Arsenic.  Epithelioma  may  be  retarded  by  small  doses  long 
continued,  and  it  has  certainly  been  useful  in  delaying  the  progress  of 
other  cancers,  particularly  scirrhus  of  the  stomach  and  uterine  carcinoma. 
Hypodermically  its  solutions  have  been  extremely  efficient  in  histrionic 
spasm,  local  chorea  of  the  head  and  neck,  obstinate  cases  of  general 
chorea,  and  in  lymphadenoma. 

The  Bromide  of  Arsenic  is  much  in  favor,  in  the  form  of  Clemen’s 
Solution,  as  a  remedy  for  diabetes  of  hepatic  origin. 


ASAFCETIDA,  Asafetida,  —  a  gum-resin  obtained  by  incision 
from  the  living  root  of  Ferula  Narlhex  and  Ferula  Scorodosma,  peren¬ 
nial  herbs  of  the  nat.  ord.  Umbelliferae,  and  natives  of  Persia  and 
Afghanistan.  It  occurs  in  whitish  tears  embedded  in  a  grayish  sticky 
mass,  of  alliaceous  odor  and  taste,  soluble  in  alcohol  to  at  least  60  per 
cent.,  and  triturated  with  water  it  yields  a  milk-white  emulsion.  Its 
principal  constituent  is  a  Sulphuretted  Volatile  Oil,  consisting  chiefly  of 
Sulphide  of  Allyl,  C6H10S ;  it  also  contains  a  gum  and  a  resin,  with 
ferulaic,  malic,  acetic,  formic  and  valerianic  acids.  Dose,  gr.  v-xx. 

Preparations. 

Tinctura  Asafcetidce , — strength  20  per  cent.  Dose,  3  ss-ij. 

Mistura  Asafcetidce , —  a  watery  emulsion  of  strength  4  per  cent.  Dose,  ^ss- ^  ij. 

Emplastrum  Asafcetidce , — Asafetida  35,  Lead  Plaster  35,  Galbanum  15,  Yellow  Wax 
15,  and  Alcohol  1 20  parts. 

Pilulce  Asafcetidce , — each  has  gr.  iij  with  gr.  j  of  Soap.  Dose.  j-iv. 

Pilulce  Aloes  et  Asafcetidce , — each  has  gr.  iff  of  each  ingredient. 

Pilulce  Galbani  Coinpositce, — each  has  gr.  of  Asafetida,  and  gr.  jss  each  of  Gal¬ 
banum  and  Myrrh,  with  syrup.  Dose,  j-iv  pills. 

Mistura  Magnesia  et  Asafcetidce ,  De wees’  Carminative, — Magnesium  Carbonate  5, 
Tinct.  Asaf.  7,  Tinct.  Opii  1,  Sugar  10,  Aqua  Dest.  q.  s.  ad  100  parts.  Dose,  ^ss-^ss. 

Spiritus  Afnmonice  Fcetidus  (Unofficial), — Asafetida  1 1/2,  Liquor  Ammonise  Fortior  2, 
Spirit  20  parts.  Dose,  gss-j. 


Physiological  Action. 

Asafetida  is  a  powerful  antispasmodic,  a  stimulant  to  the  brain  and 
nervous  system,  a  stimulating  expectorant,  also  tonic,  laxative,  diuretic, 
diaphoretic,  emmenagogue,  aphrodisiac  and  anthelmintic  in  action.  Its 
odor  and  taste  are  extremely  nauseous  and  persistent. 


120 


ASCLEPIAS. 


In  small  doses  continued  it  is  said  to  cause  impaired  digestion,  alliace¬ 
ous  eructations,  acrid  sensation  in  the  fauces,  gastralgia,  flatulent  disten¬ 
tion,  fetid  flatulence,  burning  urination,  diarrhoea  and  tenesmus.  Full 
doses  produce  various  nervous  or  hysterical  phenomena,  with  nausea, 
vomiting  and  purging. 

The  Volatile  Oil  diffuses  into  the  blood  and  tissues,  and  is  excreted  in 
the  urine,  sweat,  breath,  etc.  By  its  action  the  circulation  is  stimulated, 
the  arterial  tension  raised,  the  power  of  the  cardiac  motor  ganglia  is 
increased  and  the  inhibition  relaxed.  Asafetida  also  stimulates  the  brain 
even  to  a  very  pleasant  intoxication,  and  produces  a  subjective  sensation 
of  warmth  without  any  rise  of  body  temperature.  It  stimulates  the 
nervous  system,  the  secretions  and  excretions,  the  menstrual  flow  and  the 
sexual  appetite.  In  Asia  it  is  used  as  a  condiment  with  food,  and  though 
at  first  it  is  extremely  nauseous  to  most  people,  a  taste  for  it  may  be 
readily  acquired. 

Therapeutics. 

The  disgust  which  is  generally  felt  for  this  remedy  makes  its  use  very 
restricted,  though  a  valuable  medicine.  The  Mixture  is  extremely  service¬ 
able  in  the  flatulent  colic  of  infants,  and  as  an  enema  in  infantile  con¬ 
vulsions.  There  is  no  better  remedy  in  hysteria  and  hypochondriasis 
with  indigestion  and  flatulence, — in  constipation  with  amenorrhoea  of 
anaemic  subjects,  due  to  ovarian  and  intestinal  torpor, — in  bronchial 
affections,  cough  of  habit,  chronic  catarrhs,  and  flatulent  indigestion. 


ASCLEPIAS,  Pleurisy  Root, — is  the  root  of  Asclepias  tuberosa , 
a  plant  of  the  nat.  ord,  Asclepiadaceae  and  a  native  of  the  Eastern  and 
Southern  States.  Two  other  species  of  Asclepias  are  used  in  medicine 
and  were  formerly  official.  There  are  no  official  preparations,  but  a  fluid 
extract  is  in  the  market,  the  dose  of  which  is  about  5j  every  four  hours. 
An  infusion  or  decoction  may  be  made  in  the  proportion  of  5j  of  the 
powdered  root  to  a  quart  of  water,  and  given  in  teacupful  doses  every  2 
or  3  hours. 

Physiological  Action  and  Therapeutics. 

Asclepias  contains  two  resins,  a  peculiar  principle,  tannic  and  gallic 
acids,  albumen,  pectin,  gum,  various  salts  and  a  volatile,  odorous,  fatty 
matter.  It  is  emetic  and  cathartic  in  full  doses,  also  diaphoretic  and 
expectorant,  as  well  as  depressant  to  the  action  of  the  heart,  and  prob¬ 
ably  slightly  sedative  and  astringent.  It  is  a  popular  remedy  in  the 
Southern  States  for  pleurisy  (hence  its  common  name),  and  has  been  used 
in  medicine  for  catarrh,  pneumonia,  phthisis,  diarrhoea,  dysentery,  rheu¬ 
matism,  gastralgia,  and  to  promote  the  eruption  in  exanthematous  fevers. 
It  is  undoubtedly  a  powerful  diaphoretic. 


ASPIDIUM - AURANTIUM. 


I  2  I 


ASPIDIUM, — is  the  rhizome  of  Aspidium  Filix-mas  (Male  Fern) 
and  of  Aspidium  marginale  (Marginal  Shield  Fern),  plants  of  the  nat. 
ord.  Filices,  the  former  found  in  most  parts  of  the  world,  the  latter  indi¬ 
genous  to  N.  America.  It  is  3  to  6  inches  long,  thick,  scaly,  having 
fibro-vascular  bundles  within,  arranged  in  an  interrupted  circle ;  odor 
slight  but  disagreeable,  taste  sweetish  and  bitter,  astringent  and  nauseous. 
The  above  principle  is  Filicic  Acid,  CuH1805,  which  is  extracted  in  the 
oleo-resin.  It  also  contains  a  green,  fatty  oil,  a  volatile  oil,  resin,  tannin, 
etc.  Dose,  3ss-5jss  in  a  single  dose  fasting,  or  in  divided  doses  at  short 
intervals,  followed  by  a  purgative. 

Preparation. 

Oleoresina  Aspidii, — is  an  ethereal  extract  and  deposits  Filicic  Acid  on  standing.  It 
should  be  well  shaken  before  being  used.  Dose,  gss-^j,  in  capsules,  repeated  every 
3  hours  for  2  or  3  doses. 


Physiological  Action  and  Therapeutics. 

Aspidium  is  an  efficient  vermicide  against  tape- worm,  particularly  the 
unarmed  variety  (Bothriocephalus  latus).  The  oleoresin  is  the  best  form 
in  which  to  use  it,  the  patient  having  fasted  for  the  previous  day,  or  only 
used  a  milk  diet,  5j  may  then  be  given  in  4  doses  hour  apart.  This 
may  be  repeated  the  next  morning  and  followed  by  three  drops  of  croton 
oil  in  emulsion.  This  is  one  of  many  methods.  Brayera  (Kousso)  may 
be  combined  with  it  advantageously.  A  formula  for  a  mixed  treatment 
by  Aspidium,  Pomegranate  and  Pumpkin-seed  is  given  under  the  title 
Granatum. 


AURANTIUM,  Orange  , — occurs  in  two  official  varieties  of  fruit 
*  and  flowers,  viz.,  those  of  Citrus  vulgaris ,  the  Bitter  Orange,  and  Citrus 
Aurantium ,  the  Sweet  or  Portugal  Orange,  both  trees  of  the  nat.  ord. 
Aurantiaceae,  cultivated  in  almost  all  warm  climates.  Other  varieties  are 
described  under  Limon.  The  official  titles  are — 

Aurantii  Amari  Cortex,  Bitter  Orange  Peel, — the  rind  of  the  fruit 
of  Citrus  Vulgaris ,  characteristics  well  known.  Contains  a  Volatile  Oil 
isomeric  with  Oil  of  Turpentine,  C10H16,  and  a  bitter,  crystalline  principle, 
Hesperidin  or  Aur antiin. 

Aurantii  Dulcis  Cortex,  Sweet  Orange  Peel, — is  the  rind  of  the 
fruit  of  Citrus  Aurantium.  It  contains  a  Volatile  Oil  differing  from  that 
of  the  bitter  orange,  and  less  of  the  bitter  principle. 

Aurantii  Flores,  Orange  Flowers, — the  partly  expanded  fresh  flowers 
of  Citrus  vulgaris  and  Citrus  Aurantium.  They  contain  an  aromatic 
Volatile  Oil  (the  official  Oleum  Aurantii  Florum),  and  a  trace  of  bitter 
principle. 


122 


AURUM. 


Preparations. 

Extraction  Aurantii  Amari  Fluidum , — Bitter  Orange  Peel  ioo,  Alcohol  and  Water. 
Used  as  flavoring.  Dose,  ^ss-j. 

Tinctura  Aurantii  Amari , — Bitter  Orange  Peel  20,  Diluted  Alcohol  q.  s.  ad  ioo.  A 
flavoring  preparation.  Dose,  sjj-ij. 

Tinctura  Aurantii  Dulcis, — Sweet  Orange  Peel  20,  Diluted  Alcohol  q.  s.  ad  ioo.  For 
flavoring.  Dose,  ^j-ij. 

Syrupus  Aurantii , — Sweet  Orange  Peel  5,  Alcohol  5,  Calcii  Phosphas  Praecip.  1,  Sugar 
60,  Water  q.  s.  ad  ioo.  Flavoring. 

Oleum  Aurantii  Corticis , — a  volatile  oil,  extracted  by  mechanical  means  from  fresh 
orange  peel.  Is  soluble  in  2  of  alcohol,  and  is  an  ingredient  of  Bay  Rum  (Sp.  Myrciae). 
Dose,  gtt.  j-v. 

Elixir  Aurantii ,  Simple  Elixir, — Oil  of  Orange  Peel  I,  Sugar  100,  Alcohol  and  Water 
q.  s.  ad  300.  An  excipient  for  extracts  and  tinctures,  designated  to  replace  the  unofficial 
elixirs. 

Spiritus  Aurantii , — Oil  of  Orange  Peel  6,  Alcohol  94  parts.  Dose,  to  be  regulated  by 
the  quantity  of  alcohol  desired. 

Aqua  Aurantii  Florum ,  Recent  Orange  Flowers  40,  Water  200  parts  distilled  to  ioo 
parts.  Dose,  indefinite. 

Oleum  Aurantii  Florum ,  Oil  of  Neroli, — a  volatile  oil,  distilled  from  fresh  orange 
flowers.  Is  the  most  important  constituent  of  Cologne  Water  (Spt.  Odoratus).  Dose, 
gtt.  j-v. 

Syrupus  Aurantii  Florum ,  Orange-flower  Water  35,  Sugar  65.  A  delicate  flavoring 
agent,  but  having  to  some  persons  an  extremely  sickish  taste. 

Physiological  Action  and  Therapeutics. 

Orange  is  aromatic  and  tonic,  also  more  or  less  bitter,  but  has  little 
action  except  a  mild  influence  on  the  nervous  system  due  to  its  volatile 
oil.  Persons  much  exposed  to  its  fumes  are  liable  to  cutaneous  eruptions 
and  various  nervous  disorders.  The  oil  may  produce  violent  colic  and 
convulsions  in  children,  one  case  being  reported  in  which  death  resulted 
from  eating  the  rind.  Its  use  in  medicine  is  confined  to  flavoring  pur¬ 
poses,  though  the  preparations  of  the  Bitter  Orange  may  be  used  as  mild 
tonics  and  stimulants  to  the  digestion,  but  they  are  usually  combined  with 
more  energetic  agents  for  these  purposes. 


AURUM,  Gold,  Au, — is  represented  by  but  one  official  preparation. 
The  Chloride  is  found  in  the  shops,  being  much  used  by  photographers  ; 
and  triturations  of  the  metal  itself  may  be  prepared  according  to  the 
general  formula  therefor. 

Preparations. 

Auri  et  Sodii  Chloridum , — is  a  mixture  composed  of  equal  parts  of  dry  Chloride  of 
Gold  and  Chloride  of  Sodium,  AuC13  4-  NaCl.  An  orange-colored  powder,  soluble  in 
water.  Dose,  gr 

Auri  Chloridum  (Unofficial), — occurs  in  needle-shaped  prisms,  of  an  orange-yellow 
color,  deliquescent,  freely  soluble  in  water.  Dose,  gr.  •sWir-  Is  best  given  in  solution. 

Physiological  Action. 

Locally  used  the  Chloride  of  Gold  is  escharotic  ;  administered  inter¬ 
nally  its  action  closely  resembles  that  of  the  Bichloride  of  Mercury.  In 
small  doses,  it  promotes  appetite  and  digestion,  and  stimulates  the  func¬ 
tions  of  the  brain,  producing  marked  mental  exhilaration  and  a  general 


AZEDARACH. 


123 


sense  of  well-being.  Continued,  it  induces  aphrodisiac  effects  in  both 
sexes,  and  in  women  increases  the  menstrual  discharge.  Full  doses  cause 
nausea  and  vomiting,  glandular  irritation,  salivation  without  loosening  of 
the  teeth  or  sore  gums,  increased  urinary  discharge,  sweat  and  fever  (the 
auric  fever)  ;  nutrition  is  impaired  and  rapid  waste  set  up.  A  toxic  dose 
produces  effects  similar  to  those  from  corrosive  sublimate,  namely,  violent 
gastro-enteritis,  mental  disturbance,  priapism,  tremor,  convulsions  and 
paralysis. 

Antagonists. 

Poisoning  is  treated  by  albumen  (eggs)  or  flour,  and  evacuation  of  the  stomach — just 
as  in  the  case  of  Corrosive  Sublimate. 

Therapeutics. 

Chloride  of  Gold  is  a  useful  remedy  in  irritative  dyspepsia,  gastro¬ 
duodenal  catarrh,  hypochondriasis,  amenorrhoea,  functional  impotence, 
chronic  metritis,  habitual  abortion,  ovarian  dropsy,  vertigo  and  vertigin¬ 
ous  sensations  from  disordered  stomach.  It  is  especially  recommended 
in  chronic  albuminuria,  hepatic  sclerosis,  granular  and  fibroid  kidney,  as 
it  prevents  hyperplasia  of  connective  tissue.  In  syphilis  its  utility  is 
proven  beyond  doubt,  particularly  in  the  tertiary  manifestations  and  syphi¬ 
loma  of  the  bones,  in  which  it  is  fully  as  efficacious  as  the  Bichloride  of 
Mercury,  with  incomparably  less  inconvenience  to  the  patient. 

AVENA  SATIVA, — the  common  Oat,  a  plant  of  the  nat.  ord. 
Graminacese, — was  official  in  the  U.  S.  P.  1870,  as  Avence  Faritia ,  or 
Oat-meal.  A  concentrated  tincture  or  fluid  extract  has  recently  been 
extensively  advertised  by  drug  manufacturers  as  a  nerve  stimulant  and 
tonic,  especially  efficacious  in  the  treatment  of  chorea,  epilepsy,  insomnia, 
nervous  exhaustion,  alcoholism  and  the  Opium-habit.  The  seeds  contain 
starch,  gluten,  gum,  etc., and  form  a  nutritious  food,  the  meal  being  made 
into  a  porridge,  or  gruel.  In  the  latter  form  it  is  a  good  demulcent  for 
coughs.  The  pericarp  contains  an  amorphous  alkaloid,  which  has  doubt¬ 
less  some  stimulant  and  narcotic  power ;  but  the  claims  advanced  for  it, 
as  a  specific  remedy  for  the  cure  of  the  opium-habit,  have  been  strenu¬ 
ously  denied  by  many  competent  observers,  Dose  of  the  concentrated 
tincture  or  fluid  extract,  may  be  stated  at  npx-5ij- 

AZEDARACH,  — is  the  bark  of  the  root  of  Mclia  Azedarach ,  or 
Pride  of  China,  a  handsome  tree  of  the  nat.  ord.  Meliacese,  indigenous 
to  China  and  India,  but  naturalized  in  the  Gulf  States.  It  occurs  in 
curved  pieces  or  quills,  which  are  almost  inodorous  and  have  a  sweetish 
taste,  afterwards  becoming  bitter  and  nauseous.  There  are  no  official 
preparations,  but  a  decoction  of  the  fresh  bark  (5(j  to  Oj  boiled  to  0}4) 
may  be  used  in  tablespoonful  doses. 


124 


BALSAMUM  PERUVIANUM - BALSAMUM  TOLUTANUM. 


Physiological  Action  and  Therapeutics. 

This  drug  is  known  to  produce  symptoms  of  narcotic  poisoning,  as 
giddiness,  dimness  of  sight,  mental  confusion,  stertorous  breathing,  dilated 
pupils  and  stupor.  Large  doses  are  necessary  to  cause  these  effects,  and 
some  authorities  question  their  occurrence.  It  is,  however,  a  gastro¬ 
intestinal  irritant,  producing  vomiting  and  purging,  and  an  anthelmintic 
against  the  round-worm.  Its  active  principle  has  not  been  isolated.  It 
is  only  employed  as  an  althelmintic  against  lumbricoid  worms,  and  as  the 
fresh  bark  is  difficult  to  obtain  in  any  region  where  it  does  not  grow, 
other  agents  will  be  more  generally  used.  It  is  given  to  horses  affected 
with  “  bots.” 

BALSAMUM  PERUVIANUM,  Balsam  of  Peru,— is  a  bal¬ 
sam  obtained  from  Myroxylon  Pereira ,  a  Central  American  tree,  of  the 
nat.  ord.  Leguminosie.  Occurs  as  a  thick,  brown-black  liquid,  its  odor 
reminding  of  benzoin  and  vanilla,  soluble  in  5  of  alcohol,  almost 
insoluble  in  water,  which  only  extracts  from  it  some  Cinnamic  Acid  and 
Cinnamein.  It  is  not  a  true  balsam,  as  it  contains  no  volatile  oil.  Com¬ 
position  is,  —  Cinnaniein  (Benzyl  Cinnamate,  C16H1402)  60  per  cent., 
Cinnamic  Acid  6  per  cent.,  Resins  30  per  cent  ;  also  Benzoic  Acid,  and 
other  bodies.  Dose,  rrpx-xxv,  in  emulsion.  There  are  no  official  pre¬ 
parations. 

Physiological  Action  and  Therapeutics. 

The  actions  of  Balsam  of  Peru  are  those  of  its  several  constituents, 
namely,  antiseptic,  disinfectant,  stimulant  to  the  circulation,  and  sedative 
to  the  nervous  system ;  acting  chiefly  on  the  mucous  membrane,  it  is  tonic 
and  expectorant,  diuretic  and  diaphoretic.  In  large  doses,  it  causes  gas- 
tralgia,  nausea  and  vomiting,  colic  and  diarrhoea.  It  closely  resembles  in 
physiological  action  its  congeners,  Styrax  and  Benzoin. 

Balsam  of  Peru  is  used  locally  in  chronic  skin  diseases  of  inflammatory 
type  and  sore-nipples,  to  relieve  itching,  cleanse  bed-sores,  promote  the 
healing  of  wounds  and  sores,  and  to  kill  the  acarus  scabiei,  being  consid¬ 
ered  by  some  authorities  the  best  of  all  applications  in  itch.  Internally, 
it  is  used  as  a  stimulant  and  disinfectant  expectorant  in  chronic  bronchitis, 
asthma,  etc.,  as  well  as  in  gonorrhoea,  gleet,  leucorrhoea,  and  other  dis¬ 
charges  from  mucous  membranes.  Incorporated  with  Iodoform  it  par¬ 
tially  covers  the  odor  of  that  drug. 

BALSAMUM  TOLUTANUM,  Balsam  of  Tolu,— is  a  balsam 
obtained  from  Myroxylon  toluifera ,  a  tree  of  the  nat.  ord.  Leguminosse, 
native  in  Venezuela  and  New  Granada.  Its  composition  and  properties 
are  similar  to  those  of  Balsamum  Peruvianum,  except  that  it  is  of  lighter 


BAPTISI A - BELLADONNA.  I  2  5 

color,  more  agreeable  odor,  and  contains  a  volatile  oil,  Tolene,  in  the  pro¬ 
portion  of  about  i  per  cent. 

Preparations. 

Tinctura  Tolulana,  Tincture  of  Tolu, — contains  io  per  cent,  of  the  balsam  dissolved 
in  90  of  alcohol.  Dose,  npx-xxx. 

Syrupns  Tolutanus ,  Syrup  of  Tolu, — has  of  the  balsam  4  parts  in  100  of  sugar  and 
water.  Dose,  3  j— ij-  Much  used  in  cough  mixtures.  Covers  the  taste  of  Chloral  well. 

Physiological  Action  and  Therapeutics. 

Balsam  of  Tolu  has  similar  actions  to  those  of  Balsam  of  Peru,  but 
being  more  agreeable  in  flavor  it  is  used  internally  more  than  the  latter. 
It  is  chiefly  employed  as  a  pleasant  excipient  in  cough-mixtures,  and  is  a 
constituent  of  the  compound  Tincture  of  Benzoin. 


BAPTISI  A,  Wild  Indigo  (Unofficial), — is  the  root  bark  of  Baptisia 
tinctoria ,  a  plant  of  the  nat.  ord.  Leguminosse,  native  in  North  America, 
and  contains  an  alkaloid  and  a  resin,  neither  of  which  have  been  examined 
critically.  The  so-called  Baptisin  is  an  impure  resinoid,  obtained  by 
precipitation  from  the  alcoholic  extract  with  water. 

Preparations. 

Extraction  Baptisia ,  Extract  of  Baptisia  (Unofficial).  Dose,  gr.  j-x. 

Extraction  Baptisice  Pluidum,  (Unofficial).  Dose,  rtpij-xx. 

Tinctura  Baptisice ,  (Unofficial).  Dose,  npv-xxx. 

Baptisin  (Unofficial), — the  resinoid.  Dose,  gr.  j-v. 

Physiological  Action  and  Therapeutics. 

Baptisia  has  a  bitter  and  acrid  taste ;  in  small  doses  it  is  laxative,  in 
large  violently  emeto-cathartic,  and  may  excite  severe  gastro-intestinal 
inflammation.  It  is  a  decided  stimulant  of  the  liver,  and  increases  the 
secretions  of  all  the  glandular  appendages  of  the  gastro-intestinal  mucous 
membrane.  It  has  considerable  power  as  an  antiseptic. 

Baptisia  has  been  used  locally  in  decoction  or  cataplasm  to  obstinate 
and  painful  ulcers,  in  threatened  or  exciting  gangrene,  and  gangrenous 
sores.  Internally,  it  is  a  useful  remedy  in  amenorrhoea,  typhoid  and 
typhus  fevers,  variola,  scarlatina,  and  epidemic  dysentery.  In  the  common 
continued-fever,  or  in  the  first  stage  of  typhoid,  it  will  be  found  of  great 
service  in  drop-doses  of  a  fresh  tincture,  repeated  every  hour. 


BELLADONNA,  Deadly  Nightshade  , — is  an  herbaceous,  peren¬ 
nial  plant,  of  the  nat.  ord.  Solanaceae,  having  dark-purple,  bell-shaped 
flowers,  and  glossy,  purplish-black  berries  about  the  size  of  cherries.  It 
is  indigenous  in  the  mountainous  districts  of  Central  and  Southern  Europe 
and  Asia,  and  is  cultivated  in  Europe  and  in  the  United  States.  It  con¬ 
tains  two  alkaloids, — the  official  Atropine  (see  below),  and  Belladonnine , 
the  latter  being  considered  by  many  authorities  as  identical  with  Hyoscy- 


126 


BELLADONNA. 


amine,  Daturine,  and  Duboisine.  These  exist  in  the  plant  in  combination 
with  Malic  Acid.  The  plant  also  contains  the  usual  vegetable  constituents, 
as  albumen,  gums,  etc.,  and  a  coloring  principle  named  Atrosin.  The 
official  titles  are  as  follows  : 

Belladonna  Folia,  Belladonna  Leaves, — ovate  and  tapering,  brownish- 
green  above,  grayish-green  below,  of  slight  odor  and  bitter,  disagreeable 
taste.  Stramonium  leaves  are  more  wrinkled,  Hyoscyamus  leaves  are 
more  hairy.  Dose,  gr.  j,  gradually  increased. 

Belladonna  Radix,  Belladonna  Root, — cylindrical,  tapering,  wrinkled 
pieces,  ^  to  i  inch  thick,  nearly  odorless,  taste  bitter  and  acrid.  Dose, 
gr.  j,  cautiously  increased. 

Preparations  of  the  Leaves. 

Extraction  Belladonnce  Alcoholicum , — Dose,  gr.  xV~K- 

Tinctura  Belladonnce , — 15  per  cent.  Dose,  trpj-xxx. 

Unguentum  Belladonnce , — has  of  the  Alcoholic  Extract  10,  Diluted  Alcohol  6,  Ben- 
zoinated  Lard  84. 

Preparations  of  the  Root. 

Abstraction  Belladonnce, — Dose,  gr.  A-j. 

Extraction  Belladonnce  Fluidum , — Dose,  rtpj-v. 

Emplastrum  Belladonnce, — made  with  Resin  Plaster. 

Linimentum  Belladonnce , — Fluid  Extract  95,  Camphor  5. 


Atropine  and  its  Derivatives. 

Atropina,  Atropine,  C17H23N03, — in  white,  acicular  crystals,  odorless,  of  bitter  taste 
and  alkaline  reaction;  very  soluble  in  alcohol  and  in  chloroform,  also  in  600  of  water  at 
50°  F.  Is  decomposed  by  prolonged  contact  with  caustic  alkalies  and  is  resolvable  into 
Tropin  and  Tropic  Acid. 

Atropime  Sulphas,  Sulphate  of  Atropine  (C17H23N03)2H2S04, — a  white  powder  of 
bitter  taste  and  neutral  reaction,  soluble  in  0.4  of  water  and  in  6.5  of  alcohol  at  50°  F. 
Dose,  gr.  t^Wo- 

Homatropina,  Homatropine,  C16H21N03  (Unofficial), — is  a  derivative  alkaloid 
obtained  by  the  action  of  dilute  HC1  on  Amygdalate  of  Tropin.  The  Hydrobromate  of 
Homatropine  is  used  by  ophthalmologists  as  a  mydriatic,  its  effects  passing  off  much 
sooner  than  those  of  Atropine.  Homatropine  slows  the  heart,  Atropine  quickening  it. 

Tropeius  (Unofficial), — is  a  result  of  the  action  of  a  mineral  acid  on  Tropin. 


Physiological  Action. 

Belladonna  is  an  irritant  narcotic,  a  mydriatic,  an  antispasmodic  and 
an  anodyne  ;  in  small  doses  a  cardiac,  respiratory  and  spinal  stimulant — 
in  large  doses  a  paralyzer  of  the  cardiac  and  respiratory  centres,  the 
spinal  cord,  the  motor  nerves  and  involuntary  muscles.  It  produces  con¬ 
gestion  and  dryness  of  the  mucous  membrane  of  the  throat,  mouth,  nose 
and  larynx,  and  at  first  lessens  the  gastric  and  intestinal  secretions,  but 
soon  reproduces  these  in  large  quantity.  The  heart  rate  is  at  first  slowed, 
but  soon  becomes  very  rapid  and  vigorous,  the  pulse  being  doubled  in 
rapidity ;  the  arterial  tension  being  at  the  same  time  raised,  the  circula¬ 
tion  is  greatly  increased.  This  is  accomplished  by  stimulation  of  the 
cardiac  sympathetic,  and  paralysis  of  the  pneumogastric,  thus  stimulating 
the  accelerator  apparatus  while  lessening  the  inhibitory.  [Digitalis 
increases  both.]  The  vasomotor  ganglia  are  stimulated  all  over  the  body, 


BELLADONNA. 


127 


but  are  afterwards  paralyzed  by  over-stimulation,  the  heart  weakens,  the 
vessels  relax,  and  the  blood-pressure  becomes  greatly  reduced.  Complete 
motor  paralysis  follows,  delirium,  stupor,  and  finally  death,  which  usually 
occurs  by  asphyxia. 

The  pupils  are  dilated  by  the  local  or  systemic  use  of  the  drug,  it  stimu¬ 
lating  the  end-organs  of  the  sympathetic  and  paralyzing  those  of  the 
motor  oculi,  thus  increasing  the  power  of  the  radiating  iris  fibres  and 
lessening  the  action  of  its  circular  ones.  Atropine  locally  also  paralyzes 
accommodation  and  increases  the  intraocular  pressure.  The  least  quantity 
of  Atropine  which  will  affect  the  pupil  is  stated  at  gr.  (Wood)  gr. 

mrW  (Roosa),  gr.  (Ely),  gr.  (Trousseau),  gr.  ^Vinr 

(Loring),  gr.  (Donders). 

The  brain  is  congested  by  Belladonna,  headache,  vertigo,  busy  delirium, 
hallucinations,  etc.,  being  produced,  the  latter  from  a  selective  action  on 
the  cells  of  the  gray  matter.  The  spinal  cord  is  stimulated  from  the  3d 
cervical  to  the  10th  dorsal  vertebra,  resulting  in  complete  motor  paralysis, 
central  and  peripheral,  power  being  lost  first  in  the  lower  extremities. 
Sensation  is  also  impaired  somewhat,  but  the  muscular  irritability  is  not. 
Respiration  is  increased  and  the  body  temperature  elevated.  Metamor¬ 
phosis  is  greatly  promoted  by  the  increased  activity  of  the  circulation. 

A  diffused  eruption  of  scarlet  color,  greatly  resembling  the  eruption  of 
scarlet  fever,  is  often  produced  on  the  skin  and  fauces  by  Belladonna, 
with  dysphagia  and  sore  throat,  and  is  sometimes  followed  by  desquama¬ 
tion  of  the  epidermis.  It  is  due  to  capillary  congestion  caused  by  the 
greatly  increased  circulation. 

Belladonna  is  rapidly  diffused  and  quickly  eliminated,  particularly  by 
the  kidneys.  The  urine  of  an  animal  under  the  action  of  the  drug  will 
dilate  the  pupil  of  another  animal.  Herbivorous  animals  and  birds  are 
scarcely  susceptible  to  it,  and  pigeons  are  not  affected  by  it  at  all. 

Atropine  has  the  same  actions  as  above  described,  being  the  active 
principle  of  the  plant.  Belladonnine  was  long  supposed  to  be  inert, 
but  has  recently  been  shown  to  be  identical  with  Hyoscyamine.  It  is  a 
mydriatic  when  given  internally,  but  not  when  used  locally. 

Antagonists  and  Incompatibles. 

Opium  is  the  physiological  antagonist  to  the  effects  of  Belladonna  on  the  cerebrum, 
pupil,  heart,  respiration,  arterial  tension  and  kidneys.  Physostigmine,  Aconite,  Pilocar¬ 
pine  and  Quinine  are  each  antagonistic  to  some  of  its  effects,  Muscarine  to  most  of  them. 
In  poisoning  by  this  drug,  Tannic  Acid  and  emetics  should  be  used,  then  Morphine, 
Physostigmine  or  Pilocarpine  for  the  nervous  disturbances.  Caustic  alkalies  decompose 
Atropine  and  are  therefore  incompatible  with  the  preparations  of  Belladonna. 

Therapeutics. 

Belladonna  is  one  of  the  most  valuable  drugs  in  the  Materia  Medica, 
ranking  with  Aconite,  Arsenic  and  Opium  in  efficacy  and  wide  range  of 


128 


BENZINUM. 


use.  It  is  especially  useful  in  the  pain  of  inflammation,  particularly  that 
of  rheumatism,  gout,  neuralgia  due  to  peripheral  disturbance,  sciatica, 
cancer  and  pelvic  affections.  In  cerebral  and  spinal  hyperaemia,  conges¬ 
tive  headaches,  encephalitis,  meningitis  and  myelitis  it  proves  one  of  the 
very  best  remedies.  In  erysipelas  of  superficial  and  non-vesicular  charac¬ 
ter  and  when  cerebral,  it  is  really  curative  locally  and  internally  adminis¬ 
tered.  Inflammations  of  the  lungs,  iris,  bladder,  kidneys  and  breasts,  are 
all  amenable  to  it.  In  constipation  from  atony  of  the  bowels  it  is 
remarkably  efficient,  and  in  the  enuresis  of  children  it  is  equally  so  if  used 
freely,  io  to  20  drops  of  the  tincture  thrice  daily.  In  recent  cystitis 
from  chill,  spasm  of  the  urethra,  bladder  and  sphincter  ani,  typhus  and 
typhoid  fevers,  acute  nasal  catarrh,  sore  throat  with  fever,  inflammation, 
and  swollen  tonsils,  many  skin  diseases,  asthma  and  whooping-cough, 
epileptic  and  puerperal  convulsions,  spermatorrhoea  and  seminal  losses, 
Belladonna  is  often  a  highly  useful  agent.  Its  local  application  is  effi¬ 
ciently  used  in  ulcers  of  the  rectum,  anal  fissure,  abscesses,  boils  carbun¬ 
cles,  and  other  superficial  inflammations.  In  scarlet  fever  it  relieves 
many  of  the  symptoms,  and  is  especially  indicated  in  this  disease  when 
the  rash  is  imperfect,  the  pulse  feeble  and  the  condition  one  of  adynamia. 
Its  prophylactic  power  against  scarlet  fever  is  believed  in  by  many  of  our 
best  practitioners,  though  questioned  by  many  others. 

Atropine  is  used  in  poisoning  by  Opium,  Physostigma,  and  Prussic 
Acid  ;  in  ptyalism  from  mercury,  pregnancy,  etc. ;  in  the  sweats  of  phthisis, 
sudden  cardiac  failure,  and  by  eye-surgeons  to  paralyze  accommodation, 
dilate  the  pupil,  contract  the  vessels,  lessen  pain,  and  diminish  (?)  intra¬ 
ocular  tension.  In  opium-poisoning,  it  should  be  given  in  very  small  doses, 
and  repeated  for  effect,  as  most  of  the  unsuccessful  cases  of  its  use  in  this 
connection  were  due  to  overdosing  with  the  antagonist,  superinducing 
belladonna-narcosis  upon  the  opium-narcosis.  In  cases  of  heart-failure 
from  Chloroform  or  Ether  inhalation,  the  hypodermic  injection  of  Atro¬ 
pine  has,  in  the  writer’s  hands,  saved  several  lives  when  all  other  methods 
of  resuscitation  had  failed. 


BENZINUM,  Benzin,  Petroleum  Ether, — is  a  purified  distil¬ 
late  from  American  petroleum,  consisting  of  hydro-carbons,  chiefly  of  the 
marsh-gas  series,  having  a  specific  gravity  from  0.670  to  0.675,  and  boil¬ 
ing  at  1220  to  140°  F.  It  is  a  transparent,  colorless  liquid,  highly  inflam¬ 
mable,  very  diffusive,  insoluble  in  water,  but  soluble  in  alcohol,  ether,  etc. 
It  should  be  distinguished  from  Benzol ,  which  is  called  Benzene  by  Eng¬ 
lish  chemists.  In  pharmacy  it  has  many  uses,  on  account  of  its  powers 
as  a  solvent  for  oils,  fats,  resins,  caoutchouc  and  some  alkaloids.  Dose, 
gtt.  v-x,  on  sugar  or  in  mucilage. 


BENZOINUM. 


129 


Physiological  Action  and  Therapeutics. 

Benzin  is  reported  to  have  caused  death  in  one  case  from  gastro-enteritis, 
but  ordinarily  it  does  not  produce  vomiting  or  diarrhoea.  It  has  been 
used  with  some  success  externally  as  a  remedy  for  rheumatic  pain,  neural¬ 
gia,  itch  and  prurigo  ;  and  internally  as  a  vermicide  against  tapeworm. 
Its  chief  value  is  that  of  a  solvent  in  cleaning  old  clothing  and  in  phar¬ 
maceutical  operations. 


BENZOINUM,  Benzoin,  — is  a  balsamic  resin  obtained  from  Styrax 
Benzoin ,  a  tree  of  the  nat.  ord.  Styraceae,  native  in  Sumatra  and  Siam,  by 
incision  of  its  bark.  It  occurs  in  agglutinated  tears  or  a  brown,  mottled 
mass,  is  soluble  in  alcohol  and  solution  of  potassa,  and  is  composed  of 
Resins  80  per  cent.,  Benzoic  Acid  10  to  20  per  cent.,  and  a  trace  of 
Volatile  Oil.  Some  varieties  of  benzoin  yield  also  Cinnamic  Acid. 

Preparations  of  Benzoin. 

Adeps  Benzoinatus ,  Benzoinated  Lard, — has  of  Benzoin  2  parts  in  100  parts  of  Lard. 

Tinctura  Benzoini ,  Tincture  of  Benzoin, — has  of  Benzoin  20  parts,  Alcohol  q.  s.  ad 
100.  Dose,  5  ss-j . 

Tinctura  Benzoini  Composita,  Friar’s  Balsam, — has  of  Benzoin  12,  Aloes  2,  Styrax  8, 
Balsam  of  Tolu  4,  Alcohol  q.  s.  ad  100  parts.  Dose,  ^ss-ij. 

Preparations  of  Benzoic  Acid. 

Acidum  Benzoiaim,  Benzoic  Acid,  HC7H-02, — occurs  in  light,  feathery  plates  and 
needles,  and  is  obtained  from  Benzoin  by  sublimation.  It  is  soluble  in  500  of  water,  and 
in  3  of  alcohol  at  950  F.,  but  its  solubility  in  water  is  aided  by  Borax,  one  part  of  each 
being  soluble  in  100  parts.  It  is  a  constituent  of  Tinctura  Opii  Camphorata.  Dose,  gr. 
x-xxv,  in  wafers. 

Ammonii  Benzoas,  Benzoate  of  Ammonium, — is  soluble  in  5  parts  of  water  and  in  28 
of  alcohol.  Dose,  gr.  v-xxx. 

Lithii  Benzoas,  Benzoate  of  Lithium, — soluble  in  4  parts  of  water  and  in  12  of  alcohol. 
Dose,  gr.  v-xxx. 

Sodii  Benzoas,  Benzoate  of  Sodium, — is  efflorescent  on  exposure  to  air,  soluble  in  2, 
parts  of  water  and  in  45  of  alcohol.  Dose,  gr.  v-gj. 

Physiological  Action. 

Benzoin  is  decidedly  antiseptic  and  disinfectant,  and  when  used  exter¬ 
nally  is  somewhat  stimulant  to  the  vessels.  Its  actions  are  due  to  its 
Benzoic  Acid,  which  taken  internally  produces  slight  epigastric  heat, 
increases  the  pulse-rate,  and  stimulates  the  action  of  the  skin,  the  salivary 
glands,  and  of  the  bronchial  mucous  membrane.  It  is  chiefly  excreted 
by  the  kidneys,  in  part  as  hippuric  acid  by  combination  with  glycocoll, 
and  in  part  unchanged.  It  renders  the  urine  acid  and  increases  its  quan¬ 
tity.  Benzoin  is  irritant  to  the  fauces,  and  the  powder  inhaled  excites 
sneezing  and  coughing. 

Therapeutics. 

Benzoin  is  principally  used  as  a  stimulant  expectorant,  especially  in  the 
chronic  bronchitis  of  the  aged,  and  by  atomization  in  laryngeal  affections. 
The  compound  tincture,  5j  to  3j  in  a  pint  of  boiling  water,  is  a  useful 
9 


130 


BERBERIS. 


sedative  inhalation  for  the  irritation  and  cough  of  subacute  laryngitis  and 
tracheitis.  It  has  also  been  used  beneficially  in  chlorosis  and  some 
uterine  disorders.  The  compound  tincture  is  a  good  local  application 
(i  to  4  of  glycerin  and  water)  for  sore  nipples  and  chaps  of  the  hands 
and  lips.  For  use  as  a  cosmetic,  either  tincture  is  mixed  with  20  parts 
of  water,  and  employed  to  remove  freckles  and  other  skin  affections, 
especially  urticaria.  They  are  excellent  applications  to  foul-smelling 
wounds,  and  form  the  basis  of  all  the  proprietary  preparations  sold  for 
that  purpose. 

Benzoic  Acid  and  its  salts  are  the  only  certain  means  we  possess,  by 
which  to  neutralize  morbid  alkalinity  of  the  urine.  In  cystitis,  with 
phosphatic  deposits  and  alkaline  urine,  they  are  extremely  valuable,  acid¬ 
ulating  the  secretion,  and  stimulating  and  disinfecting  the  mucous  sur¬ 
faces  involved.  Phosphatic  calculi  are  said  to  be  dissolved  by  the  long- 
continued  use  of  Ammonium  Benzoate. 

Benzoate  of  Sodium  has  been  largely  used  as  a  substitute  for  the 
salicylates  in  the  septic  diseases,  being  equally  antiseptic  and  antipyretic. 
Though  slower  in  action,  its  effects  are  more  permanent,  and  it  is  capable 
of  being  used  in  larger  doses  (3ij-iij  daily).  In  diphtheria  and  scarlet 
fever  it  has  been  highly  efficient,  and  in  acute  rheumatism,  typhoid  and 
the  malarial  fevers,  it  has  rendered  good  service.  In  phthisis,  its  use  by 
inhalation  to  the  extent  of  °f  body-weight  daily  has  seemed  to 
be  of  value  in  some  cases.  It  has  also  proven  very  efficient  in  whooping- 
cough. 

Benzoate  of  Lithium  is  intended  for  use  in  gout  and  the  uric 

acid  diatheses,  with  the  object  of  forming  the  very  soluble  urate  of 

lithium  in  the  system,  as  also  on  the  theory  that,  as  benzoic  acid  is 

•  * 

converted  into  hippuric  acid  at  the  expense  of  nitrogenous  material 
which  would  otherwise  become  uric  acid,  the  latter  product  will  be 
lessened. 


BERBERIS,  Barberry  (Unofficial),  is  the  root  of  several  species 
of  the  nat.  ord.  Berberidaceae,  the  one  generally  used  being  the  Berberis 
aquifolium ,  or  Oregon  grape,  which  grows  on  the  Pacific  slope  of  the 
United  States.  Its  value  is  probably  due  to  its  alkaloid,  Berberine , 
C20H17NO4,  a  yellow,  crystalline  body,  soluble  in  hot  water  and  alcohol, 
but  not  in  ether,  which  is  found  also  in  several  other  plants,  as  Hy¬ 
drastis,  Coptis,  Podophyllum,  Menispermum,  Calumba,  Xanthoxylum, 
etc. 

Preparations. 

Extraction  Berberidis  Fluidum  (Unofficial), — Dose,  rrpv-xxx. 

Tinctura  Berberidis  (Unofficial), —  1  to  5.  Dose,  npx- 3 j. 

Berberina ,  Berberine  (Unofficial), — Dose,  gr.  j-x.  Usually  occurs  in  commerce  as 
“  Hydrastin,”  which  is  a  Muriate  of  Berberine,  prepared  from  Hydrastis. 


BERGAMII  OLEUM - BISMUTHUM. 


I  31 


Physiological  Action  and  Therapeutics. 

Berberis  is  an  astringent  bitter,  a  tonic  and  stomachic  in  small  doses, 
but  in  large  doses  it  is  cathartic,  producing  watery  diarrhoea  with  abdom¬ 
inal  pain.  It  is  also  believed  to  possess  considerable  alterative  powers. 

Berberine  has  some  antiseptic  and  antiperiodic  value,  and  in  large 
doses  is  a  gastro-intestinal  irritant. 

Berberis  has  been  successfully  used  as  a  local  application  in  conjunc¬ 
tivitis,  and  internally  as  a  remedy  for  intermittent  remittent  and  typhoid 
fevers,  diarrhoea  and  dyspepsia.  As  an  alterative  and  tonic  it  has  been 
found  useful  in  syphilitic  and  strumous  affections,  and  in  pain,  soreness 
and  burning  sensations  along  the  biliary  or  urinary  tracts  with  a  tendency 
to  gravel  or  gall-stones  it  will  be  found  a  useful  remedy. 

The  Muriate  of  Berberine  is  a  useful  injection  in  gonorrhoea,  in  which 
it  acts  by  virtue  of  its  antiseptic  and  astringent  powers. 

BERGAMII  OLEUM,  Oil  of  Bergamot, — is  a  volatile  oil, 
extracted  from  the  rind  of  the  fresh  fruit  of  Citrus  Bergamia,  an  orange- 
tree  of  the  nat.  ord.  Aurantiacese,  native  in  Southern  Europe.  It  is  of 
greenish  color,  faintly  acid,  sp.  gr.  0.87,  and  is  soluble  in  alcohol,  glacial 
acetic  acid  and  liquor  potassse.  It  contains  several  hydrocarbons  of  the 
formula  C10H16,  together  with  Bergaptene  or  Bergamot  Camphor.  It  is 
an  ingredient  of  Spiritus  Odoratus,  and  is  exclusively  used  as  a  perfume 
in  the  manufacture  of  toilet  articles. 


BISMUTHUM,  Bismuth,  Bi, — is  represented  by  three  of  its  salts, 
and  one  combination  of  the  Citrate  with  Aqua  Ammonise. 

Preparations. 

Bismuthi  Citras ,  Citrate  of  Bismuth,  BiC6H507, — is  a  white,  amorphous  powder, 
odorless  and  tasteless,  insoluble  in  water  or  alcohol,  but  soluble  in  water  of  ammonia. 
Used  only  for  pharmaceutical  purposes. 

Bismuthi  et  Aimnonii  Citras ,  Citrate  of  Bismuth  and  Ammonium, — is  not  proven  to 
have  any  definite  composition.  Small,  pearly  scales,  very  soluble  in  water.  Dose,  gr.  j-v. 

Bismuthi  Subcarbonas ,  Subcarbonate  of  Bismuth  (Bi0)2C03.II20,  is  a  white  or 
yellowish- white  powder,  tasteless,  insoluble  in  water  or  alcohol.  Dose,  gr.  x-^j,  in  pow¬ 
der  or  emulsion. 

Bismuthi  Subnitras,  Subnitrate  of  Bismuth,  Bi0N03.H20, — a  heavy,  white  powder, 
odorless  and  almost  tasteless,  slightly  acid,  insoluble  in  water  or  alcohol.  Dose,  gr.  x-sjj. 

Physiological  Action. 

The  action  of  the  last  two  Bismuth  salts  is  chiefly  a  local  one,  being 
sedative  to  the  end-organs  of  the  nerves,  though  a  minute  quantity  passes 
into  the  blood  and  acts  as  a  tonic,  promoting  constructive  metamorphosis 
by  increasing  the  appetite  and  digestion.  They  are  also  feebly  astringent, 
and  produce  constipation  after  a  time,  coloring  the  stools  and  tongue  a 
dark  clay  color,  from  their  conversion  in  part  into  the  sulphide.  Toxic 


132 


BOLDUS - BRAYERA. 


effects  when  occurring  are  due  to  Arsenic,  with  which  the  commercial 
preparations  are  usually  contaminated. 

The  Citrate  of  Bismuth  and  Ammonium,  being  soluble,  is  more  rapid 
in  action,  more  astringent  and  probably  more  irritant,  though  it  is  prob¬ 
ably  precipitated  in  the  stomach  by  the  hydrochloric  acid  of  the  gastric 
juice. 

Therapeutics. 

The  insoluble  Bismuth  salts  are  used  internally  in  many  forms  of  dis¬ 
ordered  digestion,  gastralgia,  vomiting  and  diarrhoea,  especially  in  chil¬ 
dren,  but  large  doses  are  necessary  for  efficiency.  The  best  vehicle  for 
them  is  milk.  Locally  they  are  used  with  advantage  in  acne  rosacea, 
stomatitis,  nursing  sore  mouth,  eczema,  intertrigo,  ulcers,  conjunctivitis, 
coryza,  gonorrhoea,  gleet  and  leucorrhoea.  The  Citrate  is  not  used 
except  for  pharmaceutical  purposes,  and  the  Citrate  of  Bismuth  and 
Ammonium  is  only  serviceable  in  diarrhoea  without  irritation  of  the 
intestinal  mucous  membrane,  but  rather  with  relaxation  thereof. 

The  Subiodide  of  Bismuth  makes  an  excellent  antiseptic  dressing  for 
ulcers  and  wounds. 

BOLDUS,  Boldo  (Unofficial), — the  leaves  and  stems  of  Peutnus 
Boldus ,  an  evergreen  shrub  of  the  nat.  ord.  Monimiaceae,  found  in  Chili. 
It  contains  a  volatile  oil  and  a  bitter  alkaloid,  Boldine.  A  tincture  is 
made  (i  to  5),  of  which  the  dose  is  n^v-viij,  gradually  increased,  but 
large  doses  have  a  somewhat  narcotic  effect,  besides  causing  vomiting 
and  purging. 

Boldo  is  used  in  anaemia,  rheumatism,  dyspepsia  and  general  debility, 
also  in  catarrhal  affections  of  the  urinary  passages,  and  as  a  substitute  for 
Quinine.  In  France  it  is  employed  as  a  tonic,  especially  for  cases  with 
chronic  torpor  of  the  liver ;  and  in  South  America  it  is  much  used  in 
gonorrhoea  and  in  chronic  cystitis. 

BRAYERA,  Kousso  , — is  the  female  inflorescence  of  Brayera 
anthelmintic  a ,  an  Abyssinian  tree  of  the  nat.  ord.  Rosaceae.  It  occurs 
in  bundles  or  rolls,  of  fragrant,  tea-like  odor,  and  bitter,  nauseous  taste, 
and  contains  tannic  acid,  a  volatile  oil,  and  a  crystalline  principle  named 
Koussin ,  which  by  itself  is  apparently  inert.  Dose  of  Brayera  5ij~oj- 

Preparations. 

Extraction  Brayera  Flnidum , — Dose,  3  ij-  3  j. 

Infusum  Brayera , — 6  per  cent.  Dose,  3  iv-viij  or  more. 

Physiological  Action  and  Therapeutics. 

Kousso  has  little  or  no  effect  except  the  nausea,  vomiting,  colic  and 
slight  diarrhoea  produced  by  large  doses.  Its  chief  action  is  anthelmintic 


BROMUM. 


133 


against  both  varieties  of  tape-worm,  but  it  rarely  expels'  the  head  of  the 
parasite,  and  is  very  nauseous  to  the  taste  and  difficult  of  retention  by 
the  stomach  in  the  large  doses  necessary  to  efficiency.  3ij  to  5j  of  the 
flowers  infused  in  %\v  of  boiling  water  is  the  usual  dose,  and  should  be 
taken  on  an  empty  stomach  and  followed  by  a  castor-oil  or  saline  purge 
after  3  or  4  hours.  An  emulsion  of  the  official  infusion  with  castor-oil, 
yolk  of  egg,  a  few  drops  of  ether  and  oil  of  anise  with  10  to  20  drops  of 
Oleoresin  of  Male-fern,  is  more  agreeable  and  efficient  than  the  infusion 
alone. 


BROMUM,  Bromine,  Br., — is  a  dark,  brownish-red,  volatile 
liquid,  evolving  an  irritant  vapor  of  peculiar  and  suffocating  odor.  It  is 
soluble  in  33  of  water  at  590  F.,  very  soluble  in  alcohol,  ether,  chloro¬ 
form  and  carbon  disulphide  ;  is  a  non-metallic  element  found  in  sea¬ 
water,  and  in  the  mother-liquor  of  certain  salt-works,  usually  in  combi¬ 
nation.  It  is  only  used  by  inhalation  and  as  an  escharotic. 

Bromides  and  their  Preparations. 

Potassii  Bromidum ,  Bromide  of  Potassium,  KBr, — colorless,  cubical  crystals,  soluble 
in  1.6  of  water,  and  200  of  alcohol.  Dose,  gr.  v-^j. 

Sodii  Bromidum ,  Bromide  of  Sodium,  NaBr, — colorless,  monoclinic  crystals,  soluble 
in  1.2  of  water,  and  13  of  alcohol.  Dose,  gr.  v-gj. 

Lithii  Bromidum,  Bromide  of  Lithium,  LiBr, — a  white,  granular,  deliquescent  salt, 
very  soluble  in  water  and  alcohol.  Dose,  gr.  v-xx. 

Ammonii  Bromiduni,  Bromide  of  Ammonium,  NH4Br, — colorless,  prismatic  crystals, 
soluble  in  1.5  of  water,  and  150  of  alcohol.  Dose,  gr.  v-xx. 

Calcii  Bromidum,  Bromide  of  Calcium,  CaBr2, — a  white,  granular,  deliquescent  salt, 
very  soluble  in  water  and  alcohol.  Dose,  gr.  v-^j. 

Zinci  Bromidum ,  Bromide  of  Zinc,  ZnBr2, — a  white,  granular,  deliquescent  powder, 
very  soluble  in  water  and  alcohol.  Dose,  gr.  yz- ij. 

Arsenii  Bromidu7ii,  Bromide  of  Arsenic, — see  under  Arsenium,  ante,  page  117. 

Syrupus  Ferri  Bromidi,  Syrup  of  Bromide  of  Iron, — is  a  syrupy  liquid  containing  10 
percent,  of  Ferrous  Bromide,  FeBr2 ,  prepared  by  acting  on  Iron  Wire  35  parts  with 
Bromide  75,  adding  Sugar  600  and  Water  up  to  1000  parts.  A  translucent,  pale-green, 
odorless  liquid  of  sweet,  ferruginous  taste  and  neutral  reaction.  Dose,  gss-j. 

\_Hydrobromic  Acid  is  described  on  page  64,  Ethyl  Bromide  on  page  79,  and  Cam- 
phora  Monobromata  under  Camphora.~\ 

Physiological  Action. 

Bromide  is  an  active  and  very  painful  escharotic,  a  deodorant  and  an 
antiseptic,  setting  free  ozone.  Its  vapor  is  highly  irritant  to  the  respira¬ 
tory  mucous  membrane  and  the  eyes,  producing  cough,  hoarseness  and 
dyspnoea.  Internally,  it  is  an  active,  corrosive  poison,  causing  violent 
gastritis,  depression  and  collapse. 

The  Bromides  are  preeminently  depressants  of  the  cerebral  and  spinal 
functions,  also  alterative,  antispasmodic  and  hypnotic.  The  Potassium 
salt  is  especially  a  cardiac  and  muscular  paralyzant. 

They  have  a  saline  taste,  and  are  very  diffusible,  but  slowly  eliminated. 
They  are  decomposed  in  the  blood,  and  reformed  at  the  points  of  elimi¬ 
nation  (fauces,  bronchi,  intestines,  skin  and  kidneys),  where  they  irritate 


134 


BROMUM, - BROMIDES. 


the  mucous  membranes.  Continued  for  some  time,  they  produce  severe 
gastric  catarrh.  They  reduce  the  number  of  the  respirations,  and  the 
heart’s  action  and  force ;  and  though  diminishing  the  calibre  of  the  arte¬ 
rioles,  they  lower  arterial  tension.  They  lessen  the  activity  of  the  brain 
cells,  producing  somnolence ;  diminish  the  sensibility  of  the  peripheral 
nerves,  causing  anaesthesia  of  the  skin  and  mucous  membranes.  They 
impair  motility  and  the  sexual  function,  cause  great  pallor  and  emacia¬ 
tion,  lowered  body-temperature,  acne  on  the  face  and  upper  extremities, 
fetid  breath,  dysphagia,  sluggish  reflexes  and  defective  coordination  ;  and 
if  long  continued  may  even  impair  the  mental  faculties,  producing  hallu¬ 
cinations  in  some  cases,  in  others  melancholia  with  suicidal  tendency  ; 
also  incompetence  of  the  sphincters  and  paralysis,  beginning  at  the  pe¬ 
riphery  and  extending  to  the  centres.  They  sometimes  cause  maniacal 
excitement,  as  in  the  case  of  a  physician  who  committed  suicide  in  a 
frenzy  caused  by  bromidizing  himself  for  sea-sickness. 

The  general  result  of  their  action  is  termed  “  Bromism,”  and  is  her¬ 
alded  by  the  acne  and  lowered  faucial  sensibility.  It  is  probably  due  to 
the  sedative  influence  of  these  agents  on  the  sympathetic  system,  causing 
general  anaemia  of  the  brain,  spinal  cord,  sexual  organs,  and  skin. 

Difference  in  Action  between  the  Bromides. 

Potassium  Bromide  is  the  most  toxic  to  the  heart  and  the  muscular 
system,  and  is  the  least  hypnotic.  It  contains  66  per  cent,  of  Bromine. 

Sodium  Bromide  is  the  least  toxic,  but  the  most  hypnotic,  and  acts 
most  energetically  on  the  circulation.  It  contains  78  per  cent,  of  Bromine. 

Ammonium  Bromide  resembles  the  Potassium  salt  in  action,  except  that 
it  exerts  less  influence  on  the  heart  and  muscular  system,  and  is  somewhat 
more  stimulating. 

Lithium  Bromide  contains  the  most  Bromine,  92  per  cent.,  and  resem¬ 
bles  the  sodium  salt  in  action.  It  has  proved  better  than  the  others  in 
some  cases  of  epilepsy,  and  is  by  several  authorities  considered  to  be  the 

best  hypnotic  of  the  series. 

* 

Calcium  Bromide  is  an  efficient  hypnotic,  but  otherwise  much  less 
active  than  the  other  salts. 

Zinc  Bromide,  in  large  doses,  is  violently  irritant.  It  is  supposed  to 
combine  the  tonic  effects  of  zinc  with  the  sedative  actions  of  the  bromides. 

Ferrous  Bromide  is  official  only  in  the  Syrup.  It  is  supposed  to 
combine  the  actions  of  iron  and  the  bromides,  and  to  produce  the  effects 
of  a  sedative  chalybeate  tonic.  It  is  not  an  eligible  chalybeate. 

Antagonists  and  Incompatibles . 

Vaso-motor  stimulants,  as  Digitalis,  Ergot,  Belladonna,  antagonize  many  of  the  effects 
of  the  Bromides,  but  Morphine  is  the  most  efficient  antagonist,  especially  for  the  mental 
symptoms.  Nitrous  Ether  is  incompatible  with  the  Bromide  of  Ammonium,  and  Acids 
and  metallic  salts  are  so  with  all  the  Bromides. 


BRYONIA. 


135 


Therapeutics. 

The  Bromides  are  used  as  sedatives  to  the  nervous  system,  to  lower 
reflex  activity,  to  produce  sleep,  to  subdue  excitement  of  the  genital  appa¬ 
ratus,  and  to  antagonize  congestion  of  the  brain.  Their  use  is  terribly 
abused,  by  patients,  nurses,  and  even  by  physicians, — as  Dr.  Hammond 
well  elucidates  in  the  last  chapter  of  his  book  on  Nervous  Diseases. 
They  should  not  be  used  in  anaemic  conditions,  and  never  for  any  length 
of  time  without  the  daily  supervision  of  a  physician.  The  combination 
of  Potassium  Bromide  with  Chloral  is  very  unsafe  in  cases  where  fatty  or 
weak  heart  exists,  both  drugs  being  active  cardiac  depressants.  In  con¬ 
vulsive  and  spasmodic  affections  the  bromides  are  very  efficient,  and  in 
epilepsy,  especially  when  the  seizures  are  diurnal,  the  sodium  salt  is  used 
with  great  advantage  over  a  long  period,  in  sufficient  quantity  to  maintain 
anaesthesia  of  the  fauces.  It  requires  occasional  purgation  to  prevent  its 
accumulation,  and  arsenic  to  combat  the  acne.  In  diabetes  of  nervous 
origin,  the  ammonium  salt,  long  used,  has  proved  curative  by  its  sedative 
influence  on  the  medulla;  and  in  acute  rheumatism  it  is  an  excellent 
alkali.  In  muscular  rheumatism,  rheumatic  arthritis  and  myalgia,  also  in 
the  uric  acid  diathesis,  and  the  various  affections  due  to  undeveloped  gout, 
the  lithium  salt  gives  good  results.  In  tetanus  and  strychnine-poisoning 
the  potassium  salt,  in  large  doses,  is  antagonistic.  The  agents  are  gen¬ 
erally  efficient  in  nervous  erethism,  insomnia  with  congestion,  infantile 
colic,  cholera  infantum,  vomiting  of  cerebral  origin,  cardiac  irritability 
when  not  due  to  anaemia,  delirium  tremens,  melancholia,  whooping-cough 
and  other  reflex  coughs,  seminal  losses  when  plethora  exists,  and  nympho¬ 
mania.  The  potassium  salt  is,  by  some  writers,  considered  almost  spe¬ 
cific  in  subinvolution  of  the  womb,  and  uterine  hemorrhage  not  due  to  a 
mechanical  cause. 

Bromine  is  not  much  used.  Its  vapor  may  be  inhaled  from  hot  water 
in  acute  coryza,  hay-asthma,  etc.,  and  in  chancre  and  hospital  gangrene 
it  is  the  best  escharotic.  In  diphtheria  and  membranous  croup,  a  solution 
of  t0  the  used  internally,  and  inhalation  of  the  vapor  have  been 

used  successfully  in  the  most  severe  cases. 

The  Syrup  of  the  Bromide  of  Iron  has  been  reported  by  some  observers  as 
very  efficient  in  chorea,  and  its  usefulness  as  strenuously  denied  by  others. 

[The  therapeutics  of  Hydrobromic  Acid  are  detailed  on  page  65,  ante.~\ 


BRYONIA,  Bryony  , — is  the  root  of  Bryonia  alba  and  of  Bryonia 
dioica,  European  perennial  plants  of  the  nat.  ord.  Cucurbitaceae.  It  occurs 
in  transverse  sections  about  2  inches  in  diameter,  having  numerous  small 
wood-bundles  arranged  in  circles  and  projecting  lines  in  the  central  por¬ 
tion,  which  is  white  or  grayish.  Its  taste  is  acrid  and  bitter,  but  it  is 


136 


BRYONIA. 


inodorous.  The  active  principle  is  the  glucoside  Bryonin ,  C48H80O19,  which 
is  intensely  bitter,  and  soluble  in  water  and  in  alcohol,  but  insoluble  in 
ether.  Dose,  of  the  powdered  root,  gr.  x-xxx. 

Preparations. 

Tinctura  Bryonia,  Tincture  of  Bryonia, — a  10  per  cent,  solution  of  the  root  in  alcohol. 
Dose,  rrpv-5  ss. 

Bryonin  (Unofficial), — is  a  violent  poison  in  doses  of  from  3  to  4  grains.  Dose,  as  a 
drastic  purgative,  gr.  y&-y$ . 


Physiological  Action. 

Bryonia  is  a  pure  irritant,  setting  up  local  inflammation  wherever 
applied,  with  febrile  phenomena.  It  has  a  vesicant  action  on  the  skin, 
and  is  violently  irritant  to  the  serous  and  mucous  membranes.  Taken 
internally,  it  has  caused  fatal  gastritis ;  introduced  into  the  pleura,  fatal 
pleuritis  has  resulted  with  fibrinous  effusion.  It  has  a  specific  determina¬ 
tion  to  serous  and  synovial  membranes,  especially  the  pleurae,  and  is  also 
irritant  to  muscular  fibre,  and  to  the  bronchial  mucous  membrane,  causing 
dry,  continuous,  shaking  cough,  with  soreness  behind  the  sternum.  It 
produces  cerebral  congestion,  with  frontal  headache,  vertigo,  and  epis- 
taxis ;  also,  hepatic  and  renal  congestion,  burning  pain  and  tenderness 
in  the  hepatic  region  with  bilious  disturbance  amounting  sometimes  to 
severe  jaundice,  vesical  tenesmus,  and  depression  of  the  action  of  the 
heart.  It  is  a  drastic  purgative  and  a  powerful  diuretic. 

Therapeutics. 

Bryonia  is  a  very  old  medicine,  its  most  ancient  reputation  having  been 
in  epilepsy,  hysteria  and  mania,  conditions  in  which  it  is  now  superseded 
by  other  agents.  It  is  a  most  valuable  drug  in  the  second  stage  of  serous 
inflammations,  especially  in  pleurisy,  pleuro-pneumonia,  and  pericarditis, 
after  Aconite  has  reduced  pyrexia,  to  limit  the  extent  of  the  effusion  and 
to  promote  its  absorption.  For  this,  small  doses  frequently  repeated  are 
required.  Also,  in  rheumatic  fever,  after  the  swelling  of  the  joints  has 
been  reduced  by  other  means,  Bryonia  is  extremely  efficient  for  the  pain 
and  stiffness.  It  is  one  of  the  best  remedies  for  a  “  cold-on-the-chest,” 
with  dry,  shaking  cough,  soreness,  or  shooting  pains.  It  has  been  used 
with  success  in  common,  continued,  or  “  gastric  ”  fever,  relapsing  fever, 
congestive  headaches  increased  by  stooping,  bilious  headache  with  vomit¬ 
ing,  gastralgia  with  pyrosis  and  soreness  of  the  epigastrium,  constipation, 
cholera  infantum  during  dry,  hot  weather,  congestion  of  the  liver,  croup, 
and  threatened  mammitis.  Pains  of  shooting  or  tearing  character,  which 
are  increased  by  movement,  are  often  quickly  relieved  by  this  drug.  In 
dropsies  of  various  forms  it  is  used  as  a  drastic  purgative  and  diuretic  to 
remove  the  accumulated  fluid. 


BUCHU - CADMIUM. 


137 


BUCHU  , — is  the  leaf  of  Barosma  betulina ,  B.  crenulata,  and  B  serra- 
tifolia ,  S.  African  shrubs,  of  the  nat.  ord.  Rutaceae,  each  species  having 
differently-shaped  leaves,  but  all  the  leaves  having  crenated  or  serrated 
margins,  and  conspicuous  oil-glands  at  the  edges  and  on  their  under  sur¬ 
face.  They  contain  a  Volatile  Oil,  which  is  probably  the  active  principle, 
and  gives  them  a  peculiar  and  penetrating  odor,  resembling  that  of  pepper¬ 
mint;  also,  Barosmin ,  a  bitter  extractive,  and  resin,  gum,  lignin,  etc. 
Dose,  of  the  leaves,  gr.  xv-xxx. 

Preparations. 

Rxtractum  Buchu  Fluidum , — Dose,  tr^x—  ^  j. 

Infusum  Buchu  (Unofficial), —  to  the  pint.  Dose,  J;ss-ij. 

Physiological  Action. 

Buchu  in  small  doses  causes  a  sense  of  heat  in  the  stomach,  which  is 
gradually  diffused  over  the  body.  It  increases  the  pulse-rate,  stimulates 
the  appetite,  and  produces  slight  moisture  of  the  skin.  It  increases  the 
flow  of  urine,  which  becomes  of  darker  color  and  strongly  aromatic  odor, 
and  deposits  a  brownish  sediment. 

In  large  doses,  it  produces  vomiting,  purging,  and  strangury,  with  a 
burning  sensation  at  the  stomach. 

Therapeutics. 

Buchu  is  of  especial  value  in  chronic  affections  of  the  genito-urinary 
mucous  membrane,  on  which  the  volatile  oil  acts  topically,  being  elimi¬ 
nated  by  the  kidneys.  It  is  a  very  useful  remedy  in  pyelitis,  cystitis,  and 
urethritis  ;  also,  in  lithiasis,  chronic  bronchitis,  and  affections  of  the 
prostate  gland.  It  is  recommended  in  atonic  dyspepsia,  chronic  rheuma¬ 
tism,  affections  of  the  skin,  and  for  dropsy,  but  it  is  not  so  actively 
diuretic  as  to  be  very  efficient  in  the  latter  condition. 

The  infusion  makes  an  excellent  vehicle  for  saline  diuretics. 


CADMIUM,  Cd  (Unofficial). — This  metal  was  official  in  the  Phar¬ 
macopoeia  of  1870,  but  is  no  longer  so.  In  its  physiological  action  it 
resembles  both  Antimony  and  Zinc,  being  escharotic,  astringent,  and  a 
very  depressant  emetic.  In  over-doses,  its  salts  act  as  irritant  poisons, 
with  cerebro-spinal  symptoms,  such  as  coma  and  convulsions.  It  is  never 
used  internally.  Its  salts  in  general  use  are — • 

Cadmii  Sulphas  (Unofficial), — transparent  oblique  prisms,  efflorescent,  and  very  soluble 
in  water.  Used  externally  in  a  solution  of  gr.  ss-iv  ad  aq.  destil. ,  or  as  an  ointment 
(1  to  40  of  fresh  lard). 

Cadmii  Iodidum  (Unofficial), — large,  white,  pearly  crystals,  soluble  in  water  and  alco¬ 
hol.  Used  as  an  ointmen*-,  1  to  8  of  lard. 

Therapeutics. 

The  Sulphate  has  been  used  almost  exclusively  as  a  stimulating 
astringent  in  gonorrhoea  and  diseases  of  the  eye.  Corneal  opacities  are 


133 


CAFFEA. 


absorbed  under  the  use  of  a  solution  of  gr.  ij  to  the  and  in  gonorrhoea 
a  mild  injection  (gr.  ^  ad  3j)  is  very  beneficial.  The  ointment  of  the 
Iodide  has  been  usefully  employed  for  enlarged  glands,  chronic  joint 
affections,  cutaneous  diseases,  nodes  and  chilblains. 


CAFFEA,  Coffee,  the  seed  of  Coffea  Arabica ,  is  officially  repre¬ 
sented  only  by  its  active  principle,  Caffeine.  The  coffee-plant  is  a  small 
tree,  of  thenat.  ord.  Rubiaceae,  15  to  30  feet  high,  native  of  South  Arabia 
and  Abyssinia,  but  cultivated  in  various  parts  of  the  world.  Its  seeds 
contain  Caffeine  (partly  free,  partly  as  a  tannate),  tannic  and  caffeic 
acids,  sugar,  legumin,  etc.  By  roasting  them,  part  of  the  caffeic  acid  is 
converted  into  methylamin,  the  sugar  is  changed  into  caramel,  and  several 
volatile  substances  are  formed,  which  give  to  coffee  its  peculiar  aroma  and 
some  of  its  stimulant  qualities,  and  are  collectively  known  as  Caffeone 
one  of  them  being  called  Caffeol. 

Preparations. 

Caffeina,  Caffeine,  C8Hj  0N4O2.H2O.  The  U.  S.  Phar.  of  1880  defines  Caffeine  as 
“  a  proximate  principle  of  feebly  alkaloidal  power,  generally  prepared  from  the  dry  leaves 
of  Camellia  Then ,  *  *  or  from  the  dried  seeds  of  Coffea  arabica ,  *  *  or  from  Guarana, 
and  occurring  also  in  other  plants.”  According  to  this,  the  principles  severally  named 
Caffeine,  Theine  and  Guaranine,  were  officially  declared  identical,  and  such  was  the 
general  opinion  until  very  recently ;  their  composition  being  expressed  by  the  formula 
C8H10N4O2,  and  the  physiological  action  of  one  being  accepted  for  the  others.  Recent 
investigations,  however,  leave  no  doubt  as  to  the  non  identity  of  the  first  two,  and  some 
observers  maintain  that  Guaranine  also  is  a  separate  body,  distinct  from  either  of  the 
others.  For  the  present,  however,  we  must  look  upon  it  as  identical  with  Caffeine.  The 
Caffeine  of  commerce  is  usually  obtained  from  old  tea-leaves,  and  is  in  reality  Theine. 
It  contains  more  nitrogen  than  almost  any  other  proximate  vegetable  principle.  It  occurs 
in  colorless,  flexible  crystals,  which  are  soluble  in  75  of  water  and  35  of  alcohol  at  590  F. 
Dose,  gr.  j-v. 

Extraction  Caffece  Viridis  Fluidum  (Squibb),  Fluid  Extract  of  Green  Coffee  (Un¬ 
official), — is  intended  as  a  substitute  for  the  Fluid  Extract  of  Guarana.  Dose,  ^  ss— ij. 
[Compare  the  title  Guarana.'] 

CaffeincB  Citras ,  Cirate  of  Caffeine  (B.  P.).  A  very  uncertain  mixture,  not  considered 
a  definite  compound.  Dose,  gr.  ij-x. 

Theina,  Theine, — that  from  Merck  the  most  reliable.  Its  solubility  in  water  is  much 
increased  by  adding  an  equal  part  of  Sodium  Benzoate,  say  3  j  of  each  to  the  fluid  3  , 
with  gr.  x  of  Sodium  Chloride.  Of  this,  n\vj  equals  gr.  yz  of  Theine.  Dose,  gr.  j4-j, 
hypodermically,  several  times  a  day,  for  relief  of  pain. 

Theine  is  contained  in  the  leaves  of  Camellia  Thea ,  the  tea-plant,  a  native  of  China 
and  Japan,  and  a  member  of  the  nat.  ord.  Ternstromiacese.  The  tea-plant  also  contains 
tannic  acid,  and  a  volatile  oil,  the  latter  being  most  abundant  in  green  teas. 

Physiological  Action. 

Coffee  is  a  cerebro-spinal  stimulant,  a  stomachic  tonic,  and  a  laxative. 
It  is  decidedly  diuretic,  and  is  somewhat  antiperiodic  and  highly  anti¬ 
septic.  The  green  bean  produces  very  different  effects  from  those  of  the 
roasted  one,  exhibiting  the  action  of  Caffeine  alone,  unmodified  by  that 
of  the  empyreumatic  products.  A  tincture  of  green  coffee,  besides  being 
an  efficient  diuretic,  has  marked  anti-lithic  powers,  and  promotes  the 
elimination  of  the  poison  of  gout  from  the  system. 


CAFFEA. 


139 


As  a  beverage,  if  used  with  moderation  Coffee  assists  digestion,  promotes 
intestinal  peristalsis,  allays  the  senses  of  fatigue  and  hunger,  lessens 
tissue-waste  and  consequently  decreases  the  formation  and  excretion  of 
urea  (?).  Used  to  excess  it  disorders  digestion,  and  causes  functional  dis¬ 
turbances  of  the  nervous  system,  shown  by  headache,  vertigo,  mental  con¬ 
fusion,  and  palpitation  of  the  heart. 

It  increases  secretion,  blunts  sensation,  exalts  reflex  excitability,  in¬ 
creases  mental  activity,  and  may  produce  insomnia  and  great  nervous 
restlessness.  It  first  briefly  stimulates  the  heart  and  raises  arterial  tension, 
but  soon  depresses  both.  The  wakefulness  is  usually  preceded  by  a  brief 
period  of  drowsiness. 

The  brief  stimulation  of  the  intellect,  consequent  on  drinking  a  cup  of 
good  coffee,  cannot  be  obtained  from  an  infusion  of  raw  coffee,  and  is 
probably  due  to  the  volatile  constituents  developed  in  roasting.  Caffeone 
opposes  Caffeine  in  its  action  on  the  circulation,  as  it  quickens  the  pulse 
and  lowers  arterial  tension.  Its  action,  however,  is  of  brief  duration,  and 
soon  gives  way  to  the  influence  of  the  principal  constituent.  The  Tannin 
is  the  ingredient  which  enables  it  to  produce  dyspepsia,  and  is  most  abun¬ 
dant  in  those  infusions  which  are  kept  a  long  time  on  the  stove  before 
being  served. 

The  Common  Stimulant  Beverages  Compared. 

The  Qualities  possessed  in  common  by  these  substances,  and  for  which 
they  are  so  universally  esteemed  by  mankind,  are  three-fold.  They  all 
(1)  retard  the  retrograde  metamorphosis  of  the  body-tissues  (tissue- 
waste)  ; — thereby  enabling  the  work  of  the  individual  to  be  done  upon  a 
smaller  supply  of  reparative  material  (food),  and  with  less  fatigue. 
Furthermore,  when  used  in  moderation,  they  are  all  (2)  more  or  less  stimu¬ 
lating  to  the  mental  processes,  and  (3)  sedative  to  the  nervous  system. 

This  similarity  of  action  they  owe  to  the  possession  of  principles,  which,  if  not  iden¬ 
tical,  are  so  closely  related  to  each  other  that  until  very  recently  they  have  been  so  con¬ 
sidered  both  by  chemists  and  pharmacologists.  Their  divergence  from  each  other,  in  the 
finer  shades  of  their  action,  depends  most  probably  on  the  existence  in  each  of  differing 
aromatic  and  volatile  principles,  which  modify  the  action  of  the  alkaloid  in  some  degree. 
Similar  principles  are  developed  in  them  by  the  various  processes  of  preparation  (as 
roasting,  drying,  etc.),  all  of  which  have  some  part  in  determining  the  general  action  of 
the  beverage  containing  them. 

Coffee  is  more  stimulating  than  Coca,  and  less  sustaining.  It  is  apt 
to  cause  severe  palpitations  of  the  heart ;  and  may  disorder  digestion,  if 
long  stewed.  The  Coffee-bean  contains  only  0.2  to  0.8  per  cent,  of 
Caffeine. 

Tea  ( Camellia  Thea)  is  the  most  refreshing  and  stimulating  member  of 
the  group.  Used  to  excess,  it  powerfully  affects  the  stability  of  the  motor 
and  the  vaso-motor  nerves,  the  action  of  the  heart,  and  the  digestive 
function, — producing  flatulent  dyspepsia,  tremulousness  of  the  limbs, 


140 


CAFFEA. 


pallor  of  the  surface,  irregular  cardiac  action,  and  feeble  impulse,  hallu¬ 
cinations,  night-mare,  anorexia,  headache,  nausea  and  vomiting,  obstinate 
neuralgiae — especially  of  the  supra-orbital  and  occipital  nerves;  also  con¬ 
stipation,  and  a  pain  in  the  left  side  are  not  infrequent.  The  condition 
of  chronic  tea-poisoning  is  termed  “Theism,” — and  is  very  often  seen 
among  women  of  the  lower  class  in  cities,  who  do  not  indulge  in  alcoholic 
beverages,  but  freely  accept  the  dominion  of  the  “cup  that  cheers  ”  and 
worse  than  inebriates. 

Mate  ( Ilex  Paraguay ensis,  Paraguay  tea),  is  supposed  to  be  inter¬ 
mediate  in  its  effects  between  tea  and  coffee.  It  also  contains  Caffeine, 
in  the  proportion  of  1.2  per  cent. 

Guarana  (. Paullinia  sorbilis  of  Brazil),  contains  an  alkaloid  —  Guara- 
?iine ,  in  the  proportion  of  5  per  cent.,  which  is  probably  identical  with 
Caffeine,  though  some  think  it  more  analogous  to  Theine.  It  is  especially 
noted  for  relieving  a  nervous  headache,  for  which  purpose  the  official  fluid 
extract  may  be  used  in  doses  of  n^xx,  three  or  four  times  daily,  when  the 
basis  of  that  preparation  happens  to  be  of  good  quality. 

Coca,  or  Cuca  ( Erythroxylon  Coca),  is  more  sustaining  and  less  of  a 
direct  stimulant,  than  either  tea  or  coffee.  The  proportion  of  Cocaine 
in  the  leaves  varies  greatly  in  different  samples,  as  they  occur  in  commerce. 

Cocoa  ( Theobroma  Cacao ,  the  Chocolate-tree),  is  more  directly  nutri¬ 
tious  than  any  of  the  group,  containing  a  large  quantity  of  fat,  Oleu?n 
Theobromce  (cacao-butter),  which  makes  it  difficult  of  digestion  to  many 
persons.  Its  alkaloid,  Theobromine ,  is  closely  allied  to  Caffeine,  the  latter 
being  considered  a  Methyl-theobromine.  The  various  preparations  of 
this  agent  are  made  from  the  seeds,  after  the  oil  has  been  expressed  from 
them.  They  are  ground  in  a  mill,  mixed  with  rice,  barley,  sugar,  flour, 
etc.,  and  put  up  in  powdered  form,  called  Cocoa , — but  if  flavored  with 
vanilla  and  pressed  into  a  cake,  the  product  is  Chocolate.  The  thin  husks 
which  envelope  the  seeds  are  known  as  “  Shells,'1'  and  are  used  to  make 
a  beverage  similar  to  but  milder  than  cocoa  or  chocolate. 

Caffeine  in  general  terms  is  a  stimulant  at  first,  and  subsequently  a 
paralyzant,  to  the  nerve-centres  in  the  cerebrum,  medulla  and  cord.  In 
small  doses  it  quickens  the  action  of  the  heart  and  raises  arterial  tension ; 
stimulates  the  cerebral  functions,  by  increasing  the  supply  of  blood  to  the 
brain ;  increases  the  respiration  rate  and  the  secretion  of  urine.  Larger 
doses  (gr.  v-viij),  often  over-stimulate  the  cerebral  circulation,  causing 
threby  great  heaviness  of  the  head,  flashes  of  light  before  the  eyes, 
tinnitus  aurium,  insomnia,  restlessness,  and  even  delirium, — the  pulse 
becoming  rapid,  feeble,  irregular  and  intermittent,  and  the  general  body- 
temperature  elevated,  though  that  of  the  periphery  may  be  lowered. 
Large  doses  depress  the  heart  and  respiration,  and  lower  the  blood-pres¬ 
sure  ; — in  the  smaller  animals  exalting  the  reflex  excitability  of  the  cord 


CAFFEA. 


141 

and  producing  tetanic  convulsions ; — and  in  lethal  doses  paralyzing  the 
cardiac  muscle  as  well  as  its  motor  ganglia,  but  causing  death  by  paralysis 
of  respiration.  It  powerfully  affects  muscular  fibre,  both  voluntary  and 
involuntary  kinds,  throwing  it  into  a  state  of  tetanic  contraction  resem¬ 
bling  rigor  mortis.  If  administered  in  sufficient  quantity  it  would  doubt¬ 
less  prove  fatal  to  man, — but  its  lethal  dose  for  him  would  be  very  large, 
Caffeine  is  excreted  unchanged  in  the  bile  and  urine,  and  is  a  reliable 
hydragogue  diuretic  ;  acting  by  stimulation  of  the  secreting  apparatus  in 
the  kidney,  as  well  as  by  generally  raising  the  arterial  tension.  (Brunton.) 

Theine,  upon  the  smaller  animals,  agrees  in  most  respects  with  Caffeine, 
except  that  it  requires  much  larger  doses  to  produce  the  same  effects.  It 
differs,  however,  in  some  important  particulars.  Theine  chiefly  affects 
the  sensory,  Caffeine  the  motor  system.  Theine  causes  spasms  and  con¬ 
vulsions,  and  impairs  the  nasal  reflex,  early  in  the  course  of  the  poisoning 
process; — while  Caffeine  does  so  late,  if  at  all.  Theine  decreases  the 
body-temperature, — Caffeine  increases  it.  Theine  causes  convulsions  in 
frogs,  a  power  now  denied  to  Caffeine,  though  hitherto  ascribed  to  it. 
Both  alkaloids  tend  to  produce  muscular  contraction,  but  Theine  causes 
a  peculiar  rhythmical  contraction  in  voluntary  muscles,  which  lasts  for 
several  hours,  and  seems  to  act  transversely  across  the  fibre,  as  the  muscle 
is  elongated  at  each  contraction.  In  man,  the  principal  action  of  the 
hypodermic  injection  of  Theine  is  the  production  of  a  profound  local 
anaesthesia  at  and  below  the  point  of  injection, — acting  therefore  outwards 
along  the  nerve-trunk,  and  not  towards  the  centre.  It  does  not  affect  the 
motor  apparatus,  nor  does  it  seem  to  produce  narcosis. 

Guaranine  is  generally  considered  as  identical  with  Caffeine,  though 
some  few  observers  find  in  its  action  a  closer  analogy  to  Theine.  It  affects 
both  sensory  and  motor  nerves,  the  sensory  first,  paralyzing  them  from  the 
centres  outwards.  [1 Cocaine  and  Brucine  act  from  the  periphery  inwards.] 
It  causes  general  hypersesthesia,  and  subsequently  convulsions  of  spinal 
origin, — at  first  increases  and  afterwards  depresses  respiration  and  the  action 
of  the  heart.  It  seems  to  have  a  stronger  affinity  for  the  sensory  than  for 
the  motor  nerves,  and  hence  resembles  Theine  more  than  Caffeine. 

Theobromine  has  the  formula  C7H8N402,  and  is  closely  allied  to  Caf¬ 
feine,  physiologically  and  chemically.  In  fact,  Caffeine  maybe  considered 
a  Methyl-theobromine,  C7H9(CH3)N402.  During  roasting  the  cocoa-bean 
develops  an  aromatic  principle  which  gives  to  chocolate  its  peculiar  flavor. 
In  large  doses  Theobromine  is  fatal  to  small  animals. 

Therapeutics. 

Although  without  a  very  extensive  range  of  usefulness,  Caffeine  is  a 
valuable  stimulant  in  many  forms  of  nervous  and  cardiac  depression,  and 
has  proved  especially  efficacious  in  headaches  of  neuralgic  or  nervous 


142 


CAJUPUTI  OLEUM. 


type,  the  pain  being  general  over  the  head,  gr.  j  of  Caffeine  every  half 
hour,  or  the  fluid  extract  of  Guarana,  in  20-minim  doses  every  2  or  3 
hours.  In  choleraic  diarrhoea,  and  that  of  phthisis,  it  checks  outward 
osmosis  by  stimulating  the  depressed  nervous  apparatus.  In  dropsy,  car¬ 
diac  and  renal,  Caffeine  is  a  diuretic  and  cardiac  stimulant.  In  cervico- 
brachial  neuralgia,  Caffeine  hypoder.,  gr.  j,  increased  to  gr.  v.  In 
lithaemia  and  gout,  a  tincture  of  the  green  bean  has  marked  diuretic 
and  antispasmodic  powers,  and  is  very  useful  in  these  conditions.  In 
insomnia  of  chronic  alcoholism,  gr.  of  Caffeine  hypodermically.  For 
adynamic  fevers,  it  may  well  be  used  in  place  of  alcoholic  stimulants. 
In  intermittents,  Coffee  has  a  curative  reputation  among  the  inhabitants 
of  the  Philippines,  which  is  corroborated  by  the  Dutch  physicians.  In 
asthma,  if  not  used  habitually,  Coffee  is  valuable  in  the  paroxysm.  In 
opium  narcosis,  Caffeine  hypodermically,  or  better  still  strong  black 
coffee,  to  antagonize  the  increasing  torpor  of  the  nervous  centres. 

Therapeutics  of  Theine. 

This  alkaloid  is  a  valuable  analgesic,  especially  so  by  reason  of  its  pro¬ 
longed  influence  over  sensation.  Its  great  field  of  employment  is  in  neu¬ 
ralgia  of  any  kind,  cervico-brachial,  sciatic,  etc.,  doses  of  gr.  to  gr.  y2 
hypodermically,  are  efficient,  and  may  be  kept  up  as  long  as  required. 
To  make  a  cure,  however,  the  nutrition  of  the  nerves  must  be  attended  to. 
In  locomotor  ataxia,  lumbago,  etc.,  it  has  been  used  with  prompt  benefit, 
in  the  same  manner,  promptly  relieving  pain,  without  producing  any 
narcotic  effect.  (Mays.) 


CAJUPUTI  OLEUM,  Oil  of  Cajuput,  — is  a  volatile  oil  distilled 

from  the  leaves  of  Melaleuca  Cajuputi ,  a  tree  of  the  nat.  ord.  Myrtaceae, 
native  of  the  Molucca  Islands.  It  is  a  bluish-green  or  colorless  liquid, 
of  camphoraceous  odor,  and  neutral  reaction.  Specific  gravity  about 
0.920,  freely  soluble  in  alcohol.  It  contains  Cajuputol  or  Bihydrate  of 
Cajuputene,  which  forms  2/i  of  it,  the  other  yi  being  another  oil.  Dose, 

"lj-v. 

Physiological  Action  and  Therapeutics. 

Cajuput  Oil  resembles  Oil  of  Turpentine,  and  has  similar  actions  to 
those  of  the  other  volatile  oils,  being  a  stimulant  carminative,  somewhat 
diuretic  and  diaphoretic,  antiseptic,  parasiticide  and  anthelmintic.  Exter¬ 
nally  used,  it  is  irritant  to  the  skin.  Swallowed,  it  produces  a  sense  of 
warmth  in  the  stomach  and  accelerates  the  pulse. 

It  is  not  much  used  internally,  though  it  has  been  given  with  benefit 
in  flatulent  colic,  dropsy,  hysteria,  chronic  rheumatism,  scrofula,  syphilis, 
elephantiasis  and  other  cutaneous  disorders.  Externally,  as  a  strong, 


CALAMUS - CALCIUM.  1 43 

stimulating  rubefacient,  it  is  efficient  in  chilblains,  muscular  rheumatism 
and  nervous  headaches. 


CALAMUS,  Sweet  Flag  , — is  the  rhizome  of  Acorus  Calamus ,  a 
plant  of  the  nat.  ord.  Araceae,  native  in  Europe  and  North  America, 
having  an  aromatic  odor  and  pungent  taste.  The  unpeeled  root  should 
only  be  used,  peeled  or  bleached  calamus  being  almost  inert.  It  contains 
a  volatile  oil  and  Acorin ,  which  is  a  nitrogenous,  bitter  principle,  also 
benzoic  acid,  starch,  etc.  Dose,  indefinite. 

Preparation . 

Extractum  Calami  Fluidum , — is  made  with  Alcohol  as  a  menstruum.  Dose, 

"l*v-3j. 

Calamus  is  an  aromatic  bitter,  and  stomachic  tonic,  increasing  the 
appetite  and  stimulating  digestion.  It  is  one  of  the  constituents  of  the 
preparations  termed  “bitters,”  and  is  chewed  as  an  appetizer. 


CALCIUM,  Ca,  — is  the  metal  characteristic  of  Lime,  Chalk,  and  all 
calcareous  substances,  and  though  itself  unofficial  is  represented  by  several 
official  salts  and  preparations. 

Official  Salts  of  Calcium. 

Calcii  Carbonas  Prcecipitatus ,  Precipitated  Carbonate  of  Calcium,  CaC03, — a  fine  im¬ 
palpable,  white  powder,  odorless  and  tasteless,  insoluble  in  water  or  alcohol,  but  soluble  in 
mineral  acids  or  acetic  acid  with  effervescence.  Creta  (chalk)  is  the  native  carbonate  of 
calcium  (see  below).  Dose,  gr.  v-xx. 

Calx,  Lime,  Oxide  of  Calcium,  CaO, — hard,  white  masses,  gradually  resolving  to  a 
white  powder  in  the  air,  odorless,  of  sharp,  caustic  taste  and  alkaline  reaction,  soluble  in 
750  of  water  and  1300  of  boiling  water,  insoluble  in  alcohol.  Not  used  internally  except 
in  solution.  Is  a  constituent  of  Potassa  cum  Calce.  (See  under  Potassium.) 

Calcii  Chloridum ,  Chloride  of  Calcium,  CaCl2, — hard,  colorless  masses,  deliquescent, 
of  sharp,  saline  taste,  soluble  in  \  l/z  of  water  and  8  of  alcohol  at  590  F.  Dose,  gr.  x-xx 
in  solution. 

Calcii  Bromidum , — described  under  Bromides,  ante  page  133. 

Calcii  Hypophosphis, — described  under  Phosphorus. 

Calcii  Phosphas  Prcecipitatus , — described  under  Phosphorus. 

Calcii  Sulphidum , — described  under  Sulphur. 

Preparations  of  the  Carbonate. 

Creta  Preparata ,  Prepared  Chalk, — is  native  carbonate  of  Calcium  freed  from  most 
of  its  impurities  by  elutriation ;  a  white,  amorphous  powder,  odorless  and  tastless,  insol¬ 
uble  in  water  or  alcohol.  Dose,  gr.  v-xx.  Is  a  constituent  of  Hydrargyrum  cum  Creta, 
and  also  of  the  following  : 

Pulvis  Cretce  Compositus,  Compound  Chalk  Powder, — has  of  Prepared  Chalk  30, 
Acacia  20,  Sugar  50  parts.  Dose,  gr.  v-^j. 

Mistura  Cretce ,  Chalk  Mixture, — has  of  the  preceding  20  parts,  Cinnamon  Water  40, 
Water  40,  rubbed  together  and  made  fresh  as  required.  Dose,  35s. 

Trochisci  Cretce ,  Troches  of  Chalk, — each  contains  of  Prepared  Chalk  4  grains,  Acacia 
1,  Sugar  6,  with  a  little  Nutmeg.  Dose,  indefinite. 

Testa  Preparata ,  Prepared  Oyster-shell  (Unofficial), — contains  animal  matter  intimately 
mixed  with  the  carbonate  of  calcium.  Dose,  gr.  x-xx  or  more. 


144 


CALCIUM. 


Preparations  of  the  Oxide. 

Liquor  Calcis ,  Solution  of  Lime,  Lime-water, — contains  about  0.15  per  cent,  oi  Cal¬ 
cium  Hydrate,  Ca(HO)2.  A  clear,  colorless  liquid,  of  saline  taste  and  alkaline  reaction. 
Dose,  ^ss-ij. 

Syrupus  Calcis ,  Syrup  of  Lime,  Saccharated  Solution  of  Lime, — contains  5  per  cent, 
of  Lime,  30  of  Sugar,  the  latter  aiding  the  solvent  powder.  Dose,  3  ss— ij .  Is  the  antidote 
to  poisoning  by  carbolic  or  oxalic  acid. 

Linimentum  Calcis ,  Lime  Liniment, — contains  equal  parts  of  Liquor  Calcis  and  Cotton¬ 
seed  Oil.  Is  nearly  the  same  as  the  application  known  as  “  Carron  Oil.” 

Calx  Chlorata , — described  under  Chlorine. 

Calx  Sulphurata , — described  under  Sulphur. 

Potassa  cum  Calce, — described  under  Potassa. 

Preparations  of  the  Phosphate  and  Hypophosphite. 

Syrupus  Calcii  Lactophosphatis,  ] 

Syrsipus  PLypophosphitum,  [  are  described  under  Phosphorus. 

Syrtipus  Hypophosph itu m  cum  Ferro ,  J 


Physiological  Action. 

Lime  before  it  assumes  the  condition  of  Hydrate  is  irritant  and  caustic, 
and  if  inhaled  or  swallowed  may  produce  dangerous  inflammation.  The 
preparations  of  Lime  and  Chalk  are  feebly  alkaline  and  astringent ;  they 
neutralize  the  acid  of  the  gastric  juice  and  are  sedative  to  the  mucous  mem¬ 
brane  of  the  stomach.  A  small  quantity  of  the  oxide  passes  into  the  blood 
and  promotes  constructive  metamorphosis, — but  if  used  in  large  quantity 
or  for  a  long  time  it  will  act  in  the  opposite  manner,  producing  waste. 

Calcium  Chloride  is  a  gastro-intestinal  irritant,  very  diffusible  and 
remarkably  alterative,  being  apparently  a  powerful  antagonist  to  the 
strumous  diathesis. 

[The  actions  of  the  other  salts  of  Calcium  are  described  under  the  titles 
of  their  respective  bases.] 

Antagonists  and  Incompatibles. 

The  preparations  of  Lime  and  Chalk  are  incompatible  with  acids  and  metallic  salts. 
In  poisoning  by  Lime  the  antidote  is  a  dilute  vegetable  acid,  followed  by  demulcents  or 
the  fixed  oils  to  protect  the  mucous  membrane. 


Therapeutics. 

Lime  may  be  used  as  a  caustic  and  depilatory,  but  is  better  known  as 
an  agent  for  hastening  decomposition  which  it  does  by  its  affinity  for  water, 
the  resulting  Hydrate  absorbing  many  of  the  products.  Chlorinated 
Lime  is  an  excellent  antiseptic  and  disinfectant,  but  as  it  owes  its 
energy  entirely  to  its  chlorine  it  will  be  noted  under  that  title.  Lime- 
water  is  a  favorite  remedy  for  vomiting,  especially  in  children,  and  is 
added  to  milk  to  increase  its  digestibility.  It  is  also  efficient  for  acid 
dyspepsia  and  mucous  enteritis,  as  an  antacid  and  astringent.  Locally  it 
is  usefully  employed  as  an  enema  against  thread-worms,  as  a  lotion  in  many 
mucous  and  purulent  discharges,  and  in  aphthae.  The  vapor  of  slaking 


CALENDULA - CALUMBA. 


145 


lime  or  lime-water  as  spray  are  often  very  serviceable  inhalations  in  diph¬ 
theria.  Syrup  of  Lime  contains  more  lime  in  solution  than  lime-water, 
and  may  be  used  instead  of  the  latter  where  a  diluent  is  not  advisable. 
It  is  the  antidote  for  poisoning  by  Carbolic  or  Oxalic  Acid,  while  lime  in 
any  form  (as  wall-plaster)  is  a  valuable  antidote  for  poisoning  by  any 
mineral  acid. 

Chalk-mixture  is  used  in  the  diarrhoeas  of  children  with  sour-smelling, 
watery  stools ;  and  maybe  conveniently  prescribed  in  combination  with 
other  astringents.  Lime  Liniment  is  used  on  cotton  or  lint  as  a  dressing 
for  burns. 

Calcium  Chloride  has  been  advantageously  employed  in  the  various 
manifestations  of  the  strumous  diathesis.  It  sometimes  resolves  glandular 
enlargements,  calcifies  tubercular  deposits,  aids  the  cicatrization  of  ulcer¬ 
ating  cavities,  and  has  been  curative  in  eczema  and  lupus.  It  is  strongly 
recommended  in  chorea,  phthisis  and  in  the  colliquative  diarrhoea  of 
strumous  children.  In  solution  externally  as  a  fomentation  it  will  hasten 
the  maturation  of  boils. 

[The  therapeutics  of  the  other  salts  of  Calcium  are  included  under  those 
of  their  respective  bases.] 

CALENDULA,  Marigold  , — is  the  fresh,  flowering  herb  of  Calen¬ 
dula  officinalis ,  the  common  Garden  Marigold,  a  plant  of  the  nat.  ord. 
Compositse,  frequently  cultivated  for  ornament.  The  tincture  (20  per 
cent.)  is  also  official,  and  is  exclusively  used  as  a  local  application  to  pro¬ 
mote  the  healing  process  in  wounds,  ulcers,  burns  and  other  breaches  of 
tissue.  Extravagant  views  of  its  powers  as  a  vulnerary  are  promulgated 
by  the  so-called  “  homoeopathic  surgeons,”  and  serve  as  one  of  their 
excuses  for  professing  an  exclusive  position  in  the  art  of  surgery. 


CALUMBA,  Columbo, — is  the  root  of  Jateorrhiza  Calumba ,  a  plant 
of  the  nat.  ord.  Menispermacese,  native  in  southeastern  Africa,  but  culti¬ 
vated  in  the  East  Indian  Islands.  It  occurs  in  nearly  circular  disks, 
having  two  or  three  interrupted  circles  of  projecting  wood-bundles,  odor 
slight,  taste  mucilaginous,  aromatic  and  bitter.  It  contains  the  alkaloid 
Berberine  (see  under  Berberis,  ante ,  page  130),  a  bitter  principle  named 
Calumbin ,  also  Calumbic  Acid  and  Starch,  but  no  Tannin.  Dose,  gr. 
v-xxx. 

Preparations. 

Extraclum  Calumba  Fluidum. — Dose,  rrpv-xxx. 

Tinctura  Calumba , —  1  in  10.  Dose,  3  ss-ij. 

Calumba  is  the  first  in  alphabetical  order  of  the  simple  bitters,  having 
no  astringency  or  aroma,  and  its  action,  as  herein  described,  will  apply 
10 


146 


CAMBOGIA. 


to  the  other  members  of  that  class  (Quassia,  Gentian,  Cornus).  It  stimu¬ 
lates  the  nerves  of  taste,  increases  the  flow  of  saliva,  excites  the  flow  of  the 
gastric  juice  and  the  gastric  circulation,  thus  increasing  the  appetite  and 
promoting  digestion,  and  so  promoting  the  constructive  metamorphosis. 
As  it  also  increases  the  gastric  mucus,  its  continued  use  will  set  up  catarrh 
of  the  stomach,  and  interfere  with  digestion,  though  it  is  one  of  the 
least  irritant  of  stomachic  tonics. 

Therapeutics. 

As  Calumba  contains  no  Tannin,  it  may  be  administered  with  the  salts 
of  Iron,  and  is  often  prescribed  with  the  sub-carbonate.  It  is  useful  in 
atonic  dyspepsia  with  pain  after  eating,  in  the  convalescent  stage  of  dis¬ 
ease  to  promote  appetite  and  digestion,  in  diarrhoea  and  dysentery, 
vomiting,  sea-sickness,  cholera  morbus  and  cholera  infantum.  An  Infu¬ 
sion  of  Calumba  with  Ginger  and  Senna  is  effective  in  flatulence,  and  the 
same  preparation  is  a  good  vehicle  for  the  administration  of  acids  and 
alkalies,  tonics,  aromatics  and  mild  cathartics.  Having  little  or  no  irritant 
quality,  it  is  an  excellent  tonic  in  the  hectic  of  phthisis. 


CAMBOGIA,  Gamboge, — is  a  gum-resin,  obtained  from  Garcinia 
Ha?iburii ,  a  Siamese  tree  of  the  nat.  ord.  Guttiferse.  It  occurs  in  cylin¬ 
drical  pieces,  of  orange-red  color,  but  yellow  when  powdered.  Its  taste 
is  very  acrid.  It  contains  73  per  cent,  of  Gambogic  Acid ,  a  resinous 
substance,  also  25  per  cent,  of  gum  and  2  of  water.  It  is  partly  soluble 
in  alcohol  and  ether.  The  only  official  preparation  is  the  Pil.  Catharticae 
Co.  (described  under  Colocynthis),  each  pill  containing  gr.  %  of  Gam¬ 
boge.  Its  dose,  as  a  cathartic,  is  gr.  ij-v, — as  a  diuretic,  gr.  j  at  short 
intervals. 

Physiological  Action  and  Therapeutics. 

Gamboge  is  an  irritant  purgative,  decidedly  diuretic,  and  its  powder 
is  sternutatory.  Its  catharsis  is  accompanied  by  vomiting  and  colic,  and 
the  stools  produced  are  watery,  but  not  so  much  so  as  generally  believed. 
It  has  no  cholagogue  action.  Full  doses  are  liable  to  produce  violent 
gastro-enteritis,  and  incautiously  used  (as  in  Morrison’s  pills)  it  has  fre¬ 
quently  caused  death.  On  the  other  hand,  large  doses  have  been  given 
continuously  in  some  cases,  without  producing  any  dangerous  symptoms. 

Gamboge  was  formerly  much  used  as  a  hydragogue  cathartic  and  diuretic 
in  dropsies,  but  its  irritant  qualities  have  caused  it  to  be  superseded  by 
other  agents  (elaterium,  digitalis,  etc.).  However,  for  dysentery,  espe¬ 
cially  when  in  young  subjects,  very  small  doses  (gr.  y1^)  at  short  intervals, 
up  to  gr.  ^  in  24  hours,  have  proven  to  be  remarkably  efficacious. 


CAMPHORA. 


147 


CAMPHORA,  Camphor,  C10H16O, — is  a  stearopten  (solid  volatile 
oil),  derived  from  Cinnamomum  Camphora ,  a  tree  of  the  nat.  ord.  Laura- 
ceae,  and  purified  by  sublimation.  Occurs  in  white,  translucent,  waxy 
masses,  of  penetrating  odor  and  pungent  taste,  lighter  than  water,  in  which 
it  is  sparingly  soluble  (1  to  1300),  but  dissolves  readily  in  alcohol,  ether, 
chloroform,  benzin,  oils,  etc.  The  camphor-tree  is  indigenous  in  China, 
Japan,  Formosa  and  other  parts  of  eastern  Asia.  Borneo  Camphor  has 
the  formula  C10H18O  bears  the  same  relation  to  Japanese  Camphor  as 
alcohol  bears  to  aldehyde,  and  is  heavier  than  water.  Dose,  gr.  j-xx. 

Derivatives  of  Camphor  are — Camphor-cymol  which  is  obtained  by 
its  distillation  with  zinc  chloride, — Camphoric  a?ui  Camphretic  Acids, 
which  result  respectively  from  its  lesser  or  greater  oxidation. 

Preparations. 

Aqua  Camphorce ,  Camphor- water, — Camphor  8,  Alcohol  16,  Distilled  Water  q.  s.  ad 
1000  parts.  Used  externally  or  as  a  vehicle.  Dose,  ^j-iv. 

Spiritus  Camphorce ,  Spirit  of  Camphor, — Camphor  10,  Alcohol  70,  Water  20  parts. 
Dose,  rrpv-xx. 

Linimentum  Camphorce ,  Camphor  Liniment, — Camphor  20,  Cotton-seed  Oil  80  parts. 
For  external  use. 

Ceratum  Camphorce ,  Camphor  Cerate, — has  of  the  Liniment  3,  Olive  Oil  12,  Cerate 
85  parts.  Used  for  itching  skin-affections. 

Camphora  Monobromata ,  Monobromated  Camphor,  C10H15BrO, — colorless,  prismatic 
needles  or  scales,  of  mild  camphoraceous  odor  and  taste,  and  neutral  reaction,  almost 
insoluble  in  water,  slightly  in  glycerin,  freely  in  alcohol,  ether,  oils,  etc.  Dose,  gr.  j-x, 
in  emulsion. 

Rubin? s  Tincture  of  Camphor  (Unofficial), — is  a  saturated  solution  in  alcohol,  $}  in 
°f  which  the  dose  is  from  4  to  10  drops,  rrpvij  have  caused  toxic  symptoms  in 
an  adult. 

RaspaiVs  “Eau  Sedative  ”  (Unofficial), — contains  Aq.  Ammoniae  3  ij ,  Sodii  Chlori- 
dum  Jij,  Camphorated  Spirits  of  Wine  ^iij,  Water  Oij.  Used  externally. 

Camphor  is  also  an  ingredient  of  Linimentum  Saponis,  Linimentum  Sinapis  Composi- 
tum,  and  Tinctura  Opii  Camphorata. 


Physiological  Action. 

Camphor  is  antispasmodic,  anodyne,  antiseptic,  diaphoretic,  a  stimu¬ 
lant  expectorant,  a  cerebral  excitant,  a  gastro-intestinal  irritant,  and  a 
rubefacient.  It  has  an  acrid,  hot  taste,  and  irritates  the  skin  and  mucous 
membranes,  in  quantity  exciting  severe  gastric  inflammation  with  all  the 
effects  of  an  irritant  poison.  In  medicinal  doses,  it  stimulates  the  vaso¬ 
motor  system  and  the  cardiac  motor  ganglia,  and  lessens  the  influence  of 
the  pneumogastric, — thus  increasing  the  circulation  and  raising  arterial 
tension.  It  also  stimulates  respiration  and  mental  activity,  even  produc¬ 
ing  intoxication ;  promotes  diaphoresis,  allays  pain,  and  increases  the 
menstrual  flow  and  the  sexual  appetite,  but  its  continued  use  depresses 
the  generative  function.  “  Camphora  per  nares  castrat  odore  mares.” 

Large  doses  cause  gastro-intestinal  inflammation,  depress  the  heart  and 
lower  arterial  tension,  diminish  the  reflex  function  of  the  spinal  cord, 
produce  coldness  of  the  surface,  insensibility,  coma,  convulsions  and 
perhaps  death. 


148 


CAMPHORA. 


As  many  as  200  grains  have  been  taken  without  fatal  result,  yet  6  or  7 
grains  have  produced  extreme  drowsiness  and  weakness  of  the  pulse,  and 
20  grains  laid  an  Alpine  guide  up  for  a  day. 

It  is  eliminated  by  the  bronchial  mucous  membrane,  skin  and  kidneys, 
and  has  often  caused  dysuria. 

Monobromated  Camphor  resembles  the  bromides  in  action,  but  is  not 
identical  therewith.  In  mammals  it  produces  muscular  weakness  passing 
into  paralysis,  lowered  temperature  and  respiration,  stupor  and  death.  In 
some  cases  its  use  by  man  has  been  followed  by  epileptiform  convulsions. 
It  is  a  nervous  sedative  and  hypnotic,  and  a  gastric  irritant. 

Antagonists  and  I?ico?npatibles. 

Arterial  sedatives  coffee,  cold,  etc.,  antagonize  its  action.  Water  precipitates  it  from 
the  alcoholic  solution,  alkalies  and  earthy  salts  precipitate  even  the  small  quantity  which 
is  soluble  in  water.  Emetics  to  remove  as  much  as  possible.  Opium  and  Bromides  for 
the  convulsions. 

Therapeutics. 

Camphor  was  much  used  by  the  older  physicians  as  an  antispasmodic, 
and  is  yet  greatly  valued  in  China  and  Japan.  It  has  a  reputation  for 
uncertainty  of  therapeutic  action,  but  is  usefully  administered  in  cholera 
and  choleraic  diarrhoea,  summer  diarrhoea  and  that  of  infants,  vomit¬ 
ing,  gastralgia,  cardiac  depression,  nervousness  and  nervous  headache, 
nymphomania,  capillary  bronchitis,  typhoid  and  eruptive  fevers,  dysmen- 
orrhcea,  afterpains,  chordee,  strangury,  and  catarrhal  colds.  Locally  it  is 
effective  in  myalgia,  lumbago,  toothache,  gangrene,  and  other  conditions 
where  counter-irritation  or  a  local  anodyne  are  required.  A  solution  in 
ether  has  been  found  to  be  a  beneficial  application  in  erysipelas. 

Monobromated  Camphor  is  used  as  a  nerve  sedative  and  hypnotic, 
but  is  not  particularly  efficient  in  this  regard.  It  has  been  used  with 
advantage  in  whooping-cough,  neuralgia,  chorea,  hysteria,  delirium  tre¬ 
mens  and  epilepsy. 

Camphora  Carbolata  is  a  name  given  to  a  mixture  of  2 y2  parts  of 
camphor  with  one  each  of  carbolic  acid  and  alcohol.  This  preparation, 
mixed  with  olive-oil,  is  a  good  non-irritating  and  antiseptic  dressing  for 
wounds  and  breaches  of  surface. 

Camphor-Chloral  is  a  fluid  obtained  by  triturating  together  equal 
parts  of  camphor  and  chloral  hydrate.  It  has  decided  solvent  powers, 
dissolving  sulphate  of  morphine  readily  (gr.  xx  in  5ij)>  and  many  other 
salts  of  alkaloids.  It  is  often  a  serviceable  application  in  superficial 
neuralgia,  and  is  said  to  allay  spasmodic  cough  if  painted  over  the  larynx. 

Camphora  Salicylata  is  obtained  by  heating  together  11  parts  of 
salicylic  acid  and  14  of  camphor.  An  ointment  prepared  from  this  sub¬ 
stance  has  been  used  with  very  satisfactory  results  in  the  treatment  of 
phagedena,  spreading  syphilitic  sores,  epithelioma,  lupus,  etc. 


CANNABIS. 


149 


CANNABIS,  Hemp  , — is  Cannabis  sativa,  the  hemp-plant,  a 
coarse,  pubescent,  somewhat  viscid  annual  of  the  nat.  ord.  Urticaceae, 
having  an  erect,  branching  stem  3  to  6  feet  high,  with  alternate  or  oppo¬ 
site  digitate  leaves  on  long,  weak  petioles;  and  dioecious  flowers,  the 
staminate  clusters  being  lax,  drooping,  leafless  at  the  base  ;  the  pistillate 
clusters  erect  and  leafy  at  the  base.  It  is  indigenous  to  Asia,  but  is  culti¬ 
vated  in  most  civilized  countries  for  its  textile  bast-fibres  and  its  oily 
fruit.  The  two  official  varieties  are  specifically  identical  with  each  other, 
differing  only  in  the  degree  of  their  action,  that  grown  in  India  being 
the  most  powerful.  They  contain  a  resin  named  Cannabin ,  and  a  Vola¬ 
tile  Oil ,  from  the  latter  of  which  are  obtained  Cantiabene ,  a  light  hydro¬ 
carbon,  and  Hydride  of  Cannabene ,  a  crystalline  body.  Cannabis  should 
not  be  confounded  with  the  so-called  “  Indian  or  Canadian  Hemp,” 
Apocynum  cannabinum  (see  ante ,  page  107).  The  official  varieties  of 
Cannabis  are  as  follows  : — 

Cannabis  Americana,  American  Cannabis, — is  Cannabis  sativa ,  grown 
in  the  Southern  United  States  and  collected  while  flowering,  having  a  stem 
about  six  feet  long  and  rough,  leaves  petiolate  and  digitate,  opposite 
below,  alternate  above,  flowers  dioecious,  odor  heavy,  taste  bitter  and 
slightly  acrid.  No  official  preparations. 

Cannabis  Indica,  Indian  Cannabis,  Indian  Hemp, — the  flowering  tops 
of  the  female  plant  of  Cannabis  sativa ,  grown  in  the  East  Indies.  Is 
about  two  inches  long,  branching,  compressed  and  brittle,  having  a  few 
digitate  leaves  with  linear-lanceolate  leaflets,  and  numerous  bracts,  each 
containing  two  small  pistillate  flowers,  sometimes  with  the  nearly  ripe 
fruit,  the  whole  agglutinated  with  a  resinous  exudation.  Color  brownish, 
odor  peculiar  and  narcotic,  taste  slightly  acrid. 

Preparations. 

Extradum  Cannabis  Indices , — Dose,  gr.  £-j,  if  active. 

Extr actum  Cannabis  Indices  Fluidum , — an  alcoholic  preparation  which  in  mixtures 
must  be  emulsified  with  Gum  Acacia,  otherwise  the  resin  will  separate  and  float  to  the 
top  or  adhere  to  the  sides  of  the  bottle.  Dose,  rrp  j-v,  but  the  author  has  frequently  taken 
of  a  good  fluid  extract  without  experiencing  untoward  effects.  Whatever  may  be  the 
reason,  it  is  a  fact  which  he  has  often  verified,  that  if  the  precipitate,  formed  when  the 
alcoholic  preparation  is  added  to  water,  be  of  a  brownish  hue,  a  dirty,  yellow-brown,  the 
sample  will  prove  to  be  almost  inert; — but  if  of  a  decided  olive-green  color,  the  prepara¬ 
tion  will  be  active.  The  activity  will  be  found  to  increase  almost  in  direct  proportion  to 
the  decided  green  of  the  precipitate.  Samples  from  the  same  manufacturer  show  this 
difference,  often  seen  between  two  bottles  in  the  same  shipment.  The  active  principle 
seems  to  be  intimately  connected  with  the  chlorophyll  or  other  coloring  matter  present, 
and  to  be  destroyed  therewith  by  whatever  injures  the  latter. 

Tindzira  Cannabis  Indices , — strength  20  per  cent.  Dose,  rtpxx-  ^j.  The  above  re¬ 
mark  on  mixtures  containing  the  fluid  extract  applies  also  to  the  tincture. 

Similar  preparations  of  Cannabis  Americana  are  prepared  by  the  manufacturers  and 
may  be  used  in  larger  quantities.  The  dosage  of  all  preparations  of  hemp  is  uncertain, 
as  specimens  of  the  plant  vary  very  much  in  activity.  The  best  rule  is  to  begin  with  a 
small  dose,  gradually  testing  the  activity  of  the  drug  and  the  susceptibility  of  the  patient 
by  carefully  increased  doses. 

Cannabin  Tannate  (Unofficial), — is  a  yellowish-brown  permanent  powder,  insoluble  in 
water  and  ether,  slightly  soluble  in  alcohol,  having  a  not  unpleasant  odor  and  a  bitterish, 
astringent  taste.  No  formula  has  been  published  for  it,  but  it  is  claimed  to  be  the  tannate 


CANNABIS. 


150 

of  a  glucoside  by  Merck  of  Darmstadt,  who  placed  it  on  the  market.  Dose,  as  a  hyp¬ 
notic,  gr.  v-x. 

Preparations  used  in  the  East. 

Churrus  is  an  impure  resin,  prepared  by  rubbing  the  leaves  of  the  plant  together  and 
scraping  off  the  adhering  resin. 

Gunjah  is  the  dried  leaf  and  tops  as  sold  in  the  bazaars  for  smoking  purposes. 

Hashish ,  Bhang  or  Siddhi  is  a  confection  consisting  of  the  leaves  and  small  stalks 
coarsely  broken  and  mixed  with  fruits  and  aromatics.  It  is  employed  in  the  preparation 
of  various  electuaries  and  beverages,  and  is  also  smoked  with  or  without  tobacco. 

Physiological  Action. 

Cannabis  is  an  antispasmodic,  analgesic,  anaesthetic  and  narcotic,  a 
cerebro-spinal  stimulant  and  a  powerful  aphrodisiac.  It  increases  intel¬ 
lectual  and  motor  activity,  stimulates  the  vaso-motor  nerves  raising  arterial 
tension,  depresses  sensation,  and  strengthens  the  energy  of  the  uterine 
muscular  fibre,  but  has  no  power  to  initiate  uterine  contractions.  In 
large  doses  it  causes  a  pleasurable  intoxication  during  which  the  peculiar 
traits  of  the  individual  are  exalted,  and  the  ideas  follow  each  other  so 
rapidly  as  to  produce  a  sense  of  great  prolongation  of  time,  minutes  seem¬ 
ing  as  if  hours  or  even  days.  With  this  occurs  increased  sexual  desire, 
great  uterine  activity,  and  sensations  of  double  consciousness  and  enor¬ 
mous  dimensions.  The  sight  and  hearing  are  exalted,  pupils  dilated, 
anaesthesia  sets  in,  the  reflexes  are  lowered  by  stimulation  of  inhibition 
(Setchenow’s  centre?),  and  if  the  dose  be  a  heavy  one  a  cataleptic  state 
is  induced.  Sleep  or  coma  follows  according  to  the  size  of  the  dose,  but 
death  has  never  been  produced  by  this  drug. 

After-effects  are  dullness,  heaviness,  vertigo,  headache,  and  confused 
thought,  anaesthesia  of  the  skin,  and  marked  diuresis, — but  no  nausea, 
no  vital  depression,  no  constipation.  Repeated  use  of  the  drug  causes 
mental  weakness  and  impotence,  the  result  of  over-stimulation.  A  raven¬ 
ous  appetite  is  usually  one  of  its  effects. 

Antagonists  and  hicompatibles. 

Strychnine  and  faradism  are  antagonistic.  Caustic  alkalies  are  incompatible.  In 
poisoning  by  it  the  stomach  should  be  evacuated,  stimulants  given  cautiously,  and  respira¬ 
tion  maintained.  The  effects  of  a  large  dose  last  over  24  hours.  Lemon-juice  is  said  to 
antagonize  its  effects. 

Therapeutics. 

Cannabis  was  formerly  much  employed  as  an  anodyne  and  hypnotic, 
also  as  an  anaesthetic  during  surgical  operations.  It  is  now  somewhat  out 
of  fashion.  In  migraine  it  is  useful  to  prevent  recurrence  of  the  attack, 
and  in  neuralgia  it  is  often  very  efficient.  Uterine  affections,  as — chronic 
metritis,  subinvolution,  menorrhagia,  dysmenorrhoea,  etc.,  are  greatly 
benefited  by  its  anodyne  quality  and  its  power  over  the  uterine  muscular 
fibre.  It  is  the  best  hypnotic  in  delirium  tremens,  and  in  traumatic 
tetanus  and  paralysis  agitans  large  doses  will  lower  the  reflex  activity. 
Dysuria  and  retention  of  urine  are  often  relieved  by  it,  while  in  spasm  of 
the  bladder  and  other  painful  affections  of  that  organ  it  will  be  found  a 
most  efficient  remedy.  It  is  useful  in  functional  impotence,  especially  if 


CANTHARIS. 


15  I 

combined  with  Ergot  and  Nux-vomica.  In  gonorrhoea  it  lessens  the 
discharge,  relieves  the  inflammation,  burning  pain  and  restlessness,  and 
allays  chordee.  The  tincture  of  C.  Americana  is  the  most  useful  in  this 
affection,  being  fully  as  efficient  as  Copaiba  or  Sandal  Oil,  and  much 
more  agreeable.  It  should,  however,  be  prepared  from  the  fresh  plant, 
and  be  given  in  3  to  5  drops  doses  3  or  4  times  daily  after  the  subsidence 
of  the  acute  symptoms.  Full  doses  of  the  tincture  of  the  Indian  plant  are 
extremely  efficient  in  many  cases  of  headache  at  the  menopause,  but 
should  be  used  cautiously  until  the  activity  of  the  sample  and  the  suscep¬ 
tibility  of  the  patient  are  tested. 

Tannate  of  Cannabin  is  recommended  as  a  powerful  hypnotic,  not 
in  any  degree  dangerous  and  neither  disturbing  the  secretions  nor  leaving 
unpleasant  after-effects.  It  has  been  used  with  benefit  in  acute  mania. 


CANTHARIS,  Cantharides,  Spanish  Flies, — is  the  dried  beetle 
Cantharis  vesicatoria ,  an  insect  of  the  nat.  ord.  Coleoptera,  about  an  inch 
long,  of  a  shining  green  color,  the  powder  being  grayish-brown,  with 
green  particles,  odor  very  disagreeable.  Contains  Cantharidin ,  C10H12O4, 
the  active  principle, — also  a  greenish  volatile  oil  and  peculiar  fatty  bodies. 

Preparations. 

Tindura  Cantharidis, — strength  5  per  cent.  Dose,  TT\J-xx. 

Ceratum  Cantharidis,  Cantharides  Cerate,  Blistering  Cerate, — Cantharides  35,  Yellow 
Wax  20,  Resin  20,  Lard  25  parts. 

Ceratum  Extradi  Cantharidis, — Cantharides  30,  Resin  15,  Yellow  Wax  35  parts, 
Lard  35  parts,  Alcohol  q.  s. 

Charta  Cantharidis , — Cantharides  I,  Canada  Turpentine  I,  Olive  Oil  4,  Spermaceti  3, 
White  Wax  8,  Water  10  parts — spread  on  paper. 

Linimentnm  Cantharidis, — Cantharides  15,  Oil  of  Turpentine  q.  s.  ad  100. 

Efnplastrum  Picis  cum  Cantharide ,  Pitch  Plaster  with  Cantharides,  Warming  Plaster, 
— Burgundy  Pitch  92  parts,  Ceratum  Cantharidis  8  parts. 

Collodium  cum  Cantharide,  Cantharidal  Collodion, — Cantharides  60,  Flexible  Collo¬ 
dion  85,  Commercial  Chloroform  q.  s. 

Physiological  Action. 

Cantharis  applied  to  the  skin  is  a  rubefacient  and  vesicant,  acting  more 
slowly  than  mustard  but  much  more  severely.  Internally  it  is  also  irri¬ 
tant,  causing  heat  of  stomach,  gastralgia,  nausea,  and  vomiting,  the  circu¬ 
lation  is  stimulated,  temperature  elevated,  urine  becomes  scanty  and 
irritating,  is  voided  with  difficulty  and  pain,  and  often  contains  blood  and 
albumen.  Afterwards  the  pulse  falls,  temperature  and  arterial  tension  are 
lowered,  and  depression  ensues.  A  toxic  dose  produces  severe  gastro¬ 
enteritis,  abdominal  tenderness,  tenesmus,  mucous  or  bloody  stools,  pain 
in  the  stomach  and  loins,  dysphagia,  ptyalism,  strangury,  priapism,  hema¬ 
turia,  swollen  genitals,  abortion,  muscular  tremor,  convulsions,  coma  and 
insensibility.  Post-mortem  shows  evidences  of  violent  metritis,  gastro¬ 
enteritis  and  general  peritonitis.  Cantharis  is  aphrodisiac  by  causing 
vascular  turgescence  of  the  genital  apparatus,  but  only  in  doses  which 


152 


CANTHARIS. 


produce  dangerous  symptoms.  It  is  only  abortive  in  toxic  dose.  In 
small  doses  it  is  diuretic  and  emmenagogue. 

Counter-irritation  by  rubefacients  or  blisters  acts  on  disease  probably 
through  the  nervous  system.  Its  influence  is  explained  by  the  theory  that 
the  peripheral  extremities  of  the  nerves  supplying  the  skin  of  the  part  to 
which  the  agent  is  applied  undergo  some  molecular  change,  which  extends 
to  the  nerve  centre  and  is  thence  radiated  to  centrifugal  or  trophic  nerves, 
effecting  various  changes  in  nutrition  and  secretion  over  the  areas  to  which 
they  are  distributed.  In  addition  to  this  method  of  action,  neighboring 
parts  are  affected  by  direct  extension  of  the  inflammation  produced,  and 
distant  parts  are  also  affected  by  absorption  through  the  vesicated  surface 
of  agents  having  special  affinities  for  certain  organs. 

Blisters  act  primarily  as  a  stimulant  to  the  body  generally  as  well  as  to 
the  organs  in  its  vicinity,  but  if  permitted  to  remain  long  enough  to  pro¬ 
duce  large  blebs,  the  result  is  a  depression  proportionate  to  the  amount 
of  serum  abstracted,  the  serum  containing  nearly  as  much  albumen  as  the 
blood  itself. 

Antagonists. 

There  is  no  chemical  or  physiological  antagonist  to  Cantharis.  Evacuation  of  the 
stomach,  mucilaginous  drinks  freely,  Opium  for  the  gastro-enteritis,  are  the  best  measnres 
in  poisoning  by  this  agent. 

Therapeutics. 

As  a  counter-irritant  and  vesicant  Cantharis  is  of  great  value  in  neu¬ 
ralgia  if  applied  close  to  the  emergence  of  the  nerve  from  the  spinal 
column,  also  in  sciatica  and  neuritis,  and  in  acute  rheumatism  around  the 
affected  joints.  A  blister  at  the  nape  of  the  neck  controls  many  head¬ 
aches,  and  one  behind  the  ear  will  modify  inflammatory  affections  of  the 
eye.  In  pleuritic  effusions  a  succession  of  small  blisters  (flying-blisters) 
will  promote  absorption  of  the  pleural  contents,  and  a  blister  applied  to 
the  perineum  will  often  cure  a  rebellious  gleet.  Though  valuable  as  a 
therapeutic  measure  in  very  many  conditions,  blistering  is  going  out  of 
fashion  except  in  hospitals  and  among  people  who  believe  in  heroic 
treatment. 

As  an  internal  remedy  Cantharis  must  be  employed  in  very  small  doses 
(npj-iij  of  the  tincture)  in  order  to  be  efficient.  When  so  used  it  is  an 
admirable  agent  in  acute  desquamative  nephritis  after  the  active  inflamma¬ 
tion  and  fever  have  subsided,  to  reduce  the  albumen  and  blood  in  the 
urine.  Drop-doses  are  particularly  useful  in  irritable  bladder  with  frequent 
desire  to  micturate,  so  often  observed  in  women,  also  in  the  incontinence 
of  the  aged  and  of  children,  and  in  cystitis,  gonorrhoea  and  gleet.  The 
same  dose  thrice  daily  will  generally  abate  chordee.  In  spermatorrhoea, 
prostatorrhoea,  scanty  menstruation  and  menorrhagia  in  subjects  of  lax 
fibre  and  general  want  of  tone  it  is  often  very  serviceable.  Cutaneous 
squamae  and  vesiculae  are  greatly  improved  by  small  doses  frequently  ad¬ 
ministered  and  gradually  increased,  and  it  is  one  of  the  best  remedies  for 


CAPSICUM. 


153 


psoriasis.  For  alopecia  areata  it  is  of  the  utmost  value  as  an  external 
application,  and  the  tincture,  greatly  diluted,  is  an  ingredient  of  all  the 
hair-renewers  in  common  use.  In  pleurisy,  after  effusion  has  taken  place, 
it  will  be  found  admirable  in  1  to  2  drop  doses  every  2  or  3  hours,  and  in 
the  after  prostration  of  diphtheria  it  proves  a  serviceable  stimulant.  One 
of  the  best  applications  to  burns  or  scalds  is  a  cloth  dipped  in  a  lotion  of 
the  tincture  one  part  to  thirty  or  forty  of  water.  The  same  lotion  is  an 
efficient  application  to  vesicular  erysipelas  and  herpes  zoster. 

CAPSICUM,  Cayenne  Pepper, — is  the  fruit  of  Capsicum  fasti- 
giatum,  a  plant  of  the  nat.  ord.  Solanaceae,  native  in  tropical  Africa  and 
America.  Occurs  in  small  red  pods,  enclosing  two  cells  containing  flat, 
yellowish  seeds,  and  has  a  peculiar  odor  and  an  intensely  hot  taste.  It 
contains  Capsicin ,  which  is  a  thick,  red  liquid,  and  is  the  active  principle, 
— also  a  volatile  alkaloid  having  the  odor  of  Conine.  Dose  of  the  pow¬ 
dered  drug,  gr.  v-x. 

Preparations. 

Extractum  Capsici  Fluidum, — alcoholic.  Dose,  nyv-3  j. 

Tinctura  Capsici , — 5  per  cent,  strength.  Dose,  rtpx-^j. 

Oleoresina  Capsici ,  prepared  by  ether.  Dose,  tip  j-v. 

Emplastrutn  Capsici ,  Capsicum  Plaster, — prepared  from  the  oleoresin  of  capiscum  and 
resin  plaster. 

Physiological  Action. 

Capsicum  is  irritant  to  the  skin  and  mucous  membranes.  Externally 
used  for  sufficient  length  of  time  it  will  produce  vesication,  internally  in 
quantity  it  will  excite  gastritis.  In  medicinal  doses  it  increases  the  saliva, 
excites  a  sensation  of  warmth  in  the  stomach,  promotes  appetite  and 
digestion,  and  produces  more  easy  and  copious  alvine  evacuations.  It 
stimulates  the  action  of  the  heart,  is  diaphoretic  and  diuretic,  also 
decidedly  aphrodisiac.  It  is  a  general  stimulant  to  the  nervous  system, 
but  in  repeated  doses  produces  a  slight  narcotic  effect  upon  the  brain. 
On  the  vascular  system  it  acts  like  ergot,  powerfully  constringing  the 
vessels  by  influencing  the  unstriped  muscular  fibre  in  their  walls,  either 
directly  or  through  the  vaso-motor  nerves. 

Therapeutics. 

Capsicum  is  an  excellent  stomachic  tonic  in  atonic  dyspepsia  and  in 
that  of  chronic  alcoholism  with  tremor  and  insomnia.  In  acute  dipso¬ 
mania  and  delirium  tremens  large  doses  are  efficient  in  producing  sleep 
and  promoting  appetite.  It  is  the  best  substitute  for  alcohol  and  opium 
in  attempts  to  cure  those  habits.  It  is  well  used  in  intermittents,  chiefly 
as  an  adjuvant  to  more  active  drugs, — in  flatulent  colic  especially  when 
occurring  in  hysterical  women  and  hypochondriacs, — also  in  low  fevers 
and  cholera  as  a  stimulant.  It  gives  good  results  in  functional  impotence, 
in  spermatorrhoea  from  loss  of  tone,  in  chronic  parenchymatous  nephritis 


154 


CARBO. 


to  check  the  waste  of  albumen,  and  is  beneficial  in  chronic  cystitis  and  in 
prostatorrhoea.  The  tincture  internally  and  a  plaster  externally  over  the 
loins  are  efficient  in  cases  of  renal  congestion  with  habitual  pain  in  the 
back  and  a  trace  of  albumen  in  the  urine. 

Locally  the  tincture  diluted  (5j  to  Sviij)  or  the  powder  with  honey, 
form  excellent  gargles  for  relaxed  throat  and  its  accompanying  cough, 
relaxed  uvula,  inflammatory  sore  throat,  and  the  cynanche  of  scarlet  fever, 
but  they  must  be  used  with  caution  as  such  applications  are  sometimes 
very  irritating. 

The  Capsicum-plaster  is  a  mild  counter-irritant,  of  great  value  in  lum¬ 
bago  and  other  muscular  rheumatisms  as  a  palliative  application. 

CARBO,  Carbon  , — exists  in  nature  in  many  forms,  of  which  two 
are  official,  namely,  the  charcoals  specified  below. 

Carbo  Animalis,  Animal  Charcoal, — prepared  from  bone,  occurring 
in  dull  black  fragments  or  powder,  odorless  and  nearly  tasteless,  insoluble 
in  water  or  alcohol. 

Carbo  Ligni,  Charcoal, — prepared  from  soft  wood,  is  black,  shining, 
brittle,  inodorous,  tasteless  and  insoluble. 

Preparations. 

Carbo  Animalis  Purificatus ,  Purified  Animal  Charcoal, — the  bone-phosphate  and  cal¬ 
cium  carbonate  being  removed  by  digesting  with  Hydrochloric  acid  and  washing.  Dose, 

gr-  xx- 3 j. 

Carbonei-  Bi-sulphidum ,  Bisulphide  of  Carbon,  CS2, — is  a  clear,  colorless,  diffusive 
liquid,  of  strong,  offensive  odor,  aromatic  taste  and  neutral  reaction;  soluble  in  alcohol, 
ether,  chloroform  and  oils,  insoluble  in  water;  vaporizes  at  ordinary  temperatures,  and  is 
highly  inflammable.  Dose,  Tr^ss-p 

Physiological  Action. 

Charcoal  is  an  efficient  deodorant  and  disinfectant,  as  it  absorbs  and 
condenses  many  gaseous  bodies  and  vapors.  It  is  evacuated  unchanged 
by  the  bowel  and  exerts  no  specific  action  on  the  body. 

Carbon  Bisulphide  is  largely  used  in  the  arts,  hence  its  effects  are  fre¬ 
quently  observed.  Persons  exposed  to  its  fumes  are  affected  by  headache, 
vertigo,  over-excitement  of  the  nervous  system,  emaciation,  incoordination 
of  movement,  depression  of  all  the  special  senses  with  impairment  of  sen¬ 
sation  and  motility  and  perhaps  insanity.  Inhaled  directly,  it  excites  vio¬ 
lent  coughing  and  produces  anaesthesia  characterized  by  great  muscular 
rigidity.  Being  a  powerful  cardiac  paralyzant,  it  is  extremely  dangerous 
as  an  anaesthetic.  In  3-drop  doses,  it  produces  severe  nausea  and  vomit¬ 
ing,  with  a  sense  of  heat  in  the  stomach  and  a  weak  and  rapid  action 
of  the  heart.  It  is  a  good  solvent  for  Caoutchouc  and  many  other 
substances. 

Therapeutics. 

Charcoal  is  used  in  pharmacy  for  decolorizing  vegetable  principles, 


CARDAMOMUM - CARDUUS.  I  5  5 

removing  alkaloids  from  infusions  of  plants,  and  making  several  prepara¬ 
tions,  as  acidum  sulphurosum,  potassii  iodidum,  etc. 

Externally,  it  makes  an  efficient  disinfectant,  absorbent  and  deodorant 
application  to  cancerous  discharges,  foul  ulcers  and  gangrenous  wounds. 
Having  no  odor  it  is  not  open  to  the  charge  of  substitution  of  one  smell 
for  another.  A  small  quantity  added  to  water  will  keep  it  sweet  for  a  long 
time.  It  is  an  excellent  dentifrice  if  finely  powdered. 

Internally,  it  is  used  for  the  same  purposes,  namely,  to  absorb  gases  and 
offending  products  of  indigestion.  In  flatulent  dyspepsia,  gastralgia, 
pyrosis,  diarrhoeas,  nausea  of  pregnancy,  epidemic  cholera,  and  consti¬ 
pation,  it  has  warm  advocates.  When  used  internally  for  any  time,  an 
occasional  purgative  should  be  given  to  prevent  its  accumulation  in  the 
intestines.  It  has  been  proposed  as  an  antidote  for  several  alkaloidal  poi¬ 
sons  on  theoretical  grounds,  but  its  efficacy  in  this  respect  is  doubtful. 

Carbon  Bisulphide  has  such  a  horribly  offensive  odor  that  it  will  never 
be  used  for  any  purpose  for  which  another  agent  can  be  found.  It  relieves 
the  pain  of  gastric  cancer,  and  in  ^-drop  doses  will  alleviate  nausea  and 
vomiting,  also  gastralgia.  Locally  it  has  been  used  as  a  counter-irritant 
and  a  local  anaesthetic,  for  deafness  due  to  want  of  nervous  energy,  in 
facial  neuralgia  and  various  local  pains. 

CARDAMOMUM,  Cardamon,  — is  the  fruit  of  Elettaria  Carda- 
momum ,  a  plant  of  the  nat.  ord.  Zingiberaceae,  cultivated  in  Malabar. 
Occurs  as  dried  capsules,  containing  small,  reddish-brown  seeds,  of  warm? 
aromatic  taste  and  agreeable  odor.  Contains  about  4^  per  cent,  of  a 
Volatile  Oil ,  C10H16,  isomeric  with  Oil  of  Turpentine,  which  oil  is  the 
active  principle,  also  a  fixed  oil,  coloring  matter,  etc.  It  is  an  ingredient 
of  Pulvis  Aromaticus  and  of  Extractum  Aromaticum  Fluidum  (see  under 
Cinnamomum),  as  well  as  of  several  compound  preparations. 

Preparations. 

Tinctura  Cardai?iomi , — 15  per  cent,  strength.  Dose,  gj-ij. 

Tinctura  Cardamomi  Composita, — Cardamon  20,  Cinnamon  20,  Caraway  10,  Cochi¬ 
neal  5,  Glycerin  60,  Diluted  Alcohol  q.  s.  ad  1000.  Dose,  ^i-ij. 

Infusum  Cardamomi  (Unofficial), — may  be  made  in  the  strength  of  gj  to  0)4,  and 
used  in  wineglassful  doses. 

Physiological  Action  and  Therapeutics. 

Cardamon  is  aromatic,  carminative  and  stomachic,  and  is  used  as  an 
agreeable  flavoring  for  bitter  mixtures  in  dyspepsia  and  other  stomach 
affections.  It  is  especially  useful  when  combined  with  purgatives  to  check 
flatulence  and  griping,  and  it  makes  the  best  flavoring  for  saline  solutions 
or  mineral  waters. 

CARDUUS  (Unofficial), — the  seeds  of  Carduus  tnarianus ,  or  St. 
Mary’s  thistle,  an  annual  European  plant  of  the  nat.  ord.  Compositae.  A 
decoction  (^ij  ad  Oj)  is  the  preparation  usually  employed.  It  is  an  old 


156 


CARUM - CARYOPHYLLUS. 


remedy  recently  revived  as  a  hemostatic,  and  reported  as  very  efficient  in 
hemoptysis,  uterine  hemorrhage,  melaena  and  amenorrhoea  connected  with 
derangement  of  the  portal  circulation.  It  has  proved  curative  in  conges¬ 
tion  of  the  liver  and  simple  jaundice,  and  in  Germany  it  has  long  been 
popularly  deemed  efficacious  in  gall-stones,  and  liver  affections  generally. 
Dose  of  the  decoction,  5j-3ss, — of  a  tincture,  npx-xx. 

Carduus  Benedictus,  the  “blessed  thistle,”  also  called  Cnicus  bene- 
dictus  and  Centaurea  benedicta,  is  another  plant  of  the  same  order,  formerly 
held  in  high  esteem  as  a  popular  “cure-all.”  It  contains  Cnicin ,  an 
amorphous  bitter  principle,  which  has  been  used  as  an  antiperiodic  in 
doses  of  gr.  v-x,  but  generally  produces  burning  sensations  and  pharyn¬ 
geal  constriction,  with  nausea,  vomiting,  colic  and  diarrhoea.  It  acts 
chiefly  as  a  bitter  tonic,  resembling  Calumbaand  Taraxacum  most  closely. 

CARUM,  Caraway, — is  the  fruit  of  Carum  Carvi ,  a  European  plant, 
of  the  nat.  ord.  Umbelliferae,  and  is  of  oblong  shape,  i^th  of  an  inch  in 
length,  separating  into  two  parts,  each  having  5  ribs  and  6  oil-tubes.  Its 
odor  and  taste  are  aromatic  and  agreeable.  The  active  principle  is  the 
Volatile  Oil ,  which  is  also  official.  Caraway  is  an  ingredient  of  Tinct. 
Cardamomi  Composita. 

Preparations. 

Oleum  Cari, — is  the  volatile  oil  distilled  from  Caraway,  and  is  resolvable  into  Carueny 
C10H16,  isomeric  with  Turpentine,  and  Caruol ,  C10HnO,  isomeric  with  Thymol.  It  is 
an  ingredient  of  Spiritus  Juniperi  Compositus.  Dose,  rrpj-v. 

Infusum  Cari  (Unofficial), —  £j-ij  ad  Oss.  Dose,  Jjss-ij. 

The  Oil  of  Caraway  is  fatal  to  small  animals,  and  in  one  case  5j  pro¬ 
duced  cerebral  congestion,  delirium  and  rigors  in  man.  The  chief  use 
of  Caraway  is  as  a  flavoring  agent,  but  it  is  efficient  in  the  flatulent  colic 
of  children,  and  to  prevent  griping  from  the  use  of  purgatives. 

CARYOPHYLLUS  Cloves, — are  the  unexpanded  flowers  of 
Eugenia  caryophyllata ,  a  handsome  evergreen  tree  of  the  nat.  ord.  Myr- 
taceae,  cultivated  in  the  East  and  West  Indian  Islands.  They  are  about 
^4-inch  long,  of  a  dark-brown  color,  consist  of  a  calyx-tube  terminated 
by  four  teeth  and  surmounted  by  a  globular  head  formed  by  four  petals, 
which  cover  numerous  curved  stamens  and  one  style.  They  emit  oil 
when  scratched,  have  an  aromatic  odor,  and  a  pungent,  spicy  taste,  and 
are  contained  in  Tinctura  Lavandulae  Composita,  Tinctura  Rhei  Aromatica 
and  Vinum  Opii.  They  contain  a  heavy  Volatile  Oil,  which  is  official, — 
also  Eugenin ,  CioH^O.,,,  a  crystalline  body  ;  Caryophyllin ,  C10H16O,  a 
camphor;  Caryophyllic  Acid,  and  tannin,  gum,  etc. 

Preparations. 

Oleum  Caryophylli ,  Oil  of  Cloves — a  volatile  oil  distilled  from  Cloves,  soluble  in  alcohol, 
and  of  sp.  gr.  1.050.  It  consists  of  a  light  and  a  heavy  oil,  the  latter  containing  Eugenol, 
CiqHiA  a  phenol  like  compound,  and  Caryophyllin ,  C10H16O,  which  yields  as  a  product 
of  its  oxidation  Cary ophyllinic  Acid,  C.20H.V2O6.  Dose  of  the  oil,  rrpj-iv. 

Infusum  Caryophylli  (Unofficial),  may  be  made  of  strength  I  to  40,  and  used  in  doses 
of  one  to  two  fluid  ounces. 


CASCA  BARK - CASCARA  AMARGA. 


157 


Physiological  Action  and  Therapeutics. 

Cloves  may  be  considered  as  a  type  of  several  agents  yielding  aromatic 
oils,  which  as  a  rule  consist  of  terpenes  with  camphors,  resins,  fatty  and 
other  acids,  etc.,  closely  allied  to  phenol  and  benzoic  acid,  the  balsams 
and  gum-resins.  Such  are  Orange,  Lemon,  Allspice,  Cajuput,  Caraway, 
Peppermint,  etc.  Their  oils  are  antiseptic,  locally  anaesthetic,  stimulant 
and  irritant,  antispasmodic,  stomachic  and  carminative.  Internally  they 
inarease  circulation  and  temperature,  promote  digestion  and  nutrition 
(in  quantity  may  cause  inflammation),  relieve  pain  and  spasm,  and  are 
excreted  by  the  kidneys,  skin,  liver  and  the  bronchial  mucous  membrane, 
stimulating  and  disinfecting  their  routes  through  the  organism. 

These  agents  are  used  to  flavor  pharmaceutical  preparations,  to  correct 
the  griping  tendency  of  many  purgatives,  to  correct  flatulence,  to  relieve 
pain  in  the  stomach  and  bowels,  and  to  promote  the  flow  of  saliva  and 
gastric  juice.  As  external  applications  they  are  efficiently  employed  for 
anaesthetic  and  counter-irritant  purposes,  to  relieve  pain  in  chronic  rheu¬ 
matism,  myalgia,  lumbago,  superficial  neuralgia,  toothache,  etc.  The 
Oil  of  Cloves  is  an  effective  deodorizer  for  sponge-tents,  a  good  applica¬ 
tion  to  a  painful  tooth,  and  is  occasionally  applied  over  the  course  of  an 
aching  nerve  with  relief  to  the  pain. 

CASCA  BARK,  Sassy  Bark,  Ordeal  Bark,  (Unofficial) — is  the 
bark  of  E7ythrophl(ziim  Guinense ,  an  African  tree  used  by  the  negroes  as 
an  ordeal  in  trials  for  witchcraft.  It  contains  a  poisonous  glucoside, 
Erythrophlein ,  and  when  used  in  quantity  produces  nausea  and  vomiting, 
stricture  across  the  brow,  severe  cephalalgia,  narcosis  and  death.  It  is 
used  as  a  remedy  in  Africa  for  intermittent  fever,  dysentery,  diarrhoea  and 
colic,  and  in  England  is  considered  to  resemble  Digitalis  in  action  and 
uses.  A  tincture  is  made  (§ij  ad  Oj)  of  which  the  dose  is  up  x,  or  a  watery 
Extract  may  be  used  in  doses  of  gr.  j. 

Erythrophlcein,  the  active  principle,  is  a  glucoside,  and  is  said  to  be  a  local  anaesthetic 
of  extraordinary  power,  even  surpassing  Cocaine.  It  is  found  in  Africa  in  a  red  mass, 
called  “  Hayah,”  which  is  proven  to  be  identical  with  an  extract  of  the  original  plant 
described  by  CErtel  early  in  this  century,  and  deposited  by  him  in  the  Berlin  museum.  It 
closely  resembles  Digitalis  in  action,  being  a  cardiac  tonic  and  a  hydragogue  diuretic. 

CASCARA  AMARGA,  Honduras  Bark  (Unofficial,) — is  the 
bark  of  a  Mexican  tree  of  the  nat.  Ord.  Simarubaceae,  which  has  been 
used  with  apparent  success  as  an  alterative  tonic  and  diuretic  in  syphilis 
and  various  chronic  skin  affections.  The  use  of  tobacco  and  alcohol 
seems  to  counteract  its  usefulness.  It  is  certainly  a  very  powerful  tonic 
and  has  been  employed  by  competent  observers  with  uniformly  good 
results  in  syphilis  and  syphilodermata,  chronic  liver  complaints,  chronic 
eczema,  chronic  nasal  catarrh  and  psoriasis.  A  Fluid  Extract  is  on  the 
market  of  which  the  dose  is  5ss-j  thrice  daily. 


158  CASCARA  SAGRADA - CASCARILLA - CASSIA  FISTULA. 

CASCARA  SAGRADA,  Chittem  Bark,  Sacred  Bark  (Un¬ 
official), — is  the  bark  of  Rhanmus  Purshiana ,  or  California  Buckthorn,  a 
small  tree  of  the  nat.  ord.  Rhamnaceae  growing  on  the  Pacific  coast  of 
the  United  States.  It  contains  a  Volatile  Oil ,  a  neutral  crystalline  sub¬ 
stance,  several  Resins ,  with  tannic,  malic  and  oxalic  acids.  A  Fluid 
Extract  is  on  the  market,  of  which  the  dose  is  5ss-j,  two  or  three  times 
a  day.  It  has  been  found  very  serviceable  in  the  treatment  of  chronic 
constipation,  given  in  gradually  diminished  doses.  It  produces  large, 
soft  and  painless  evacuations,  and  the  bowels  are  said  to  act  naturally  and 
regularly  after  its  disuse. 

Cascara  Cordial  is  a  trade  preparation,  intended  as  a  remedy  for 
constipation,  dyspepsia  and  hemorrhoids,  and  as  a  pleasant  excipient  for 
nauseous  and  bitter  drugs.  A  similar  preparation  may  be  made  by  com¬ 
bining  the  fluid  extract  with  the  official  Elixir  Aurantii  in  the  proportion 
of  5j  to  §ij,  of  which  teaspoonful  doses  or  more  may  be  administered. 

Another  species  of  the  same  genus,  Rhamnus  Frangula ,  is  official 
under  the  title  Frangula,  which  see. 

CASCARILLA  , — is  the  bark  of  Croton  Eluteria ,  a  shrub  or  small 
tree  of  the  nat.  ord.  Euphorbiaceae,  growing  in  the  Bahamas.  It  occurs 
in  grayish-brown  quills,  having  a  warm,  bitter  taste,  and  a  fragrant  odor 
when  burned.  Contains  Cascarillin  a  crystalline  principle,  two  resinoid 
extracts,  aromatic  volatile  oils,  with  tannic  acid,  etc.  There  are  no 
official  preparations,  but  an  Infusion  (1  to  10)  or  a  Tincture  (1  to  10) 
may  be  prepared  and  given  in  doses  of  5j-3j- 

Physiological  Action  and  Therapeutics. 

Cascarilla  is  an  aromatic  bitter.  It  increases  appetite  and  digestion, 
the  mucous  secretion,  the  flow  of  saliva  and  gastric  juice,  stimulates  the 
intestinal  secretions,  and  acts  as  a  mild  astringent  by  the  influence  of  its 
tannin.  Large  doses  produce  nausea,  vomiting  and  diarrhoea,  and  in 
medicinal  doses  continued  it  will  set  up  gastric  catarrh  and  consequently 
indigestion.  It  has  slight  antiperiodic  powers. 

It  has  been  used  with  success  in  epidemic  dysentery,  flatulent  dyspepsia, 
debility,  chronic  bronchitis,  intermittents,  and  low  nervous  fevers.  It  is 
difficult  to  dispense,  as  the  infusion  decomposes  quickly,  and  acids  pre¬ 
cipitate  the  resin  from  the  tincture. 

CASSIA  FISTULA,  Purging  Cassia, — is  the  fruit  of  Cassia 
Fistula ,  a  tree  of  the  nat.  ord.  Leguminosae,  growing  in  tropical  regions 
of  Asia,  Africa  and  America.  It  occurs  in  long,  brown  pods  which  are 
divided  into  numerous  transverse  cells,  each  containing  a  dark  pulp  in 
which  is  a  glossy  seed.  No  active  principle  has  been  isolated  as  yet. 
The  pulp  is  the  only  valuable  part  of  the  drug.  There  are  no  official 
preparations,  but  it  is  one  of  the  ingredients  of  Confectio  Sennae. 


CASTANEA - CATECHU - CAULOPHYLLUM. 


159 


Cassia-pulp  is  laxative  in  doses  of  5j-ij>  and  purgative  in  large  quan¬ 
tities,  producing  nausea,  flatulence  and  griping.  It  is  rarely  prescribed 
alone,  owing  to  its  tendency  to  cause  colic  and  flatulence. 

CASTANEA,  Chestnut, — the  leaves  of  Castanea  vesca,  a  stately 
tree  of  the  nat.  ord.  Cupuliferae,  and  should  be  collected  while  green. 
Chestnut  leaves  are  5  to  10  inches  long  and  about  2  broad,  have  a  slight 
odor  and  somewhat  of  an  astringent  taste.  They  contain  tannic  and 
gallic  acids,  salts,  gum,  etc. 

Preparation. 

Extractum  Castanece  Fiuidum, — Dose,  ^ss-^ij. 

This  drug  has  not  been  studied  as  to  its  physiological  actions,  if  it  has 
any.  It  is  classed  among  the  vegetable  astringents  by  reason  of  its  con¬ 
taining  tannin.  Its  only  reputation  therapeutically  is  as  a  remedy  for 
whooping-cough,  in  which  it  is  said  to  be  very  efficacious.  An  infusion 
or  decoction  of  the  leaves  has  been  used  in  indefinite  doses. 

CATECHU  , — is  an  extract  prepared  from  the  wood  of  Acacia  Cate¬ 
chu ,  a  tree  of  the  nat.  ord.  Leguminosse,  native  of  the  East  Indies. 
Occurs  in  irregular  masses,  dark  brown  and  brittle,  nearly  inodorous,  but 
of  astringent  and  sweetish  taste,  soluble  in  alcohol,  and  partly  so  in  water. 
It  contains  Catechutannic  Acid  50  per  cent.,  and  Catechuic  Acid  which  is 
converted  into  the  former  by  heat.  Dose,  gr.  j-3ss. 

Preparations. 

Tinctura  Catechu  Composita, — contains  Catechu  12,  Cinnamon  8,  Diluted  Alcohol  q.  s. 
ad  100  parts.  Dose,  nux-^j. 

Trochisci  Catechu , — each  troche  contains  of  Catechu  1  grain,  mixed  with  Sugar, 
Tragacanth  and  Orange-flower  water. 

Physiological  Action  and  Therapeutics. 

Catechu  is  a  powerful  astringent,  acting  by  virtue  of  its  tannic  acid, 
(See  ante ,  page  74,  for  actions  and  incompatibles).  Its  uses  depend  en¬ 
tirely  on  its  astringency.  In  the  diarrhoea  of  children  the  Tincture  with 
Chalk-mixture  is  very  serviceable,  and  with  Opium  it  is  efficient  in  dysen¬ 
tery.  It  is  also  used  as  a  gargle  and  mouth-wash  in  relaxed  conditions  of 
the  pharyngeal  mucous  membrane,  as  an  injection  in  leucorrhoea,  and  to 
control  passive  hemorrhages,  spongy  gums,  etc. 

CAULOPHYLLUM,  Blue  Cohosh,-  is  the  rhizome  and  rootlets 
of  Caulophyllum  thalictroides ,  a  plant  of  the  nat.  ord.  Berberidaceae 
growing  in  Canada  and  the  northern  United  States.  Rhizome  about  4 
inches  long,  thick  and  bent,  rootlets  numerous  and  matted,  taste  sweetish, 
bitter  and  acrid.  Contains  Saponin  a  glucoside,  and  two  resins.  Dose, 
gr.  v-xx.  There  are  no  official  preparations.  The  eclectic  preparation 
Caulophyllin  is  a  resinous  precipitate  obtained  by  pouring  an  alcoholic 
extract  into  water. 


i6o 


CERA - CERII  OXALAS. 


Physiological  Action  and  Therapeutics. 

Caulophyllum  is  a  new  addition  to  the  pharmacopoeia,  and  has  not  yet 
been  made  the  subject  of  experimental  work  by  reliable  observers.  It 
was  much  used  by  the  aborigines  of  this  country  in  all  affections  to  which 
their  women  were  peculiarly  subject,  and  was  known  among  them  by  the 
name  “squaw-root.”  It  is  said  to  produce  intermittent  contractions  of 
the  gravid  uterus,  to  have  diuretic,  emmenagogue  and  antispasmodic 
powers  ;  and  is  used  as  a  remedy  for  deficient  labor-pains,  spasmodic  after- 
pains,  spasmodic  pains  in  the  uterus  at  any  time,  spasmodic  dysmenorrhoea, 
and  pains  in  other  organs  seemingly  in  sympathy  with  uterine  affections. 
It  has  somewhat  of  a  reputation  in  acute  rheumatism  of  the  hands  and 
fingers,  and  as  a  preparative  medicine  for  labor. 

CERA,  Wax  , — is  a  mixture  of  Myricin,  Cerotic  Acid  and  Cerolein , 
is  formed  by  the  honey-bee,  and  exists  in  the  pollen  and  leaves  of  many 
plants,  particularly  in  Myrica  cerifera ,  the  wax  myrtle.  That  produced 
by  the  bee  is  alone  official. 

Cera  Alba,  White  Wax, — is  yellow  wax  bleached. 

Cera  Flava,  Yellow  Wax, — is  a  peculiar  concrete  substance  prepared 
by  Apis  mellifica,  the  honey-bee.  It  is  a  yellowish  solid,  of  agreeable 
odor  and  faint,  balsamic  taste,  melting  at  145. 40  to  1470  F.,  of  sp.  gr. 
0.955-0.967,  insoluble  in  water  and  almost  so  in  cold  alcohol,  but  soluble 
in  35  of  ether,  n  of  chloroform,  boiling  alcohol,  fixed  and  volatile  oils. 

Preparations. 

Ceratum,  Cerate, — consists  of  White  Wax  30,  Lard  70. 

Unguentum,  Ointment,  consists  of  Yellow  Wax  20,  Lard  80. 

Wax  is  also  a  constituent  of  the  7  compound  Cerates,  5  of  the  25  compound  Ointments, 
and  8  of  the  17  Plasters. 

Physiological  Action  and  Therapeutics. 

Wax  owes  its  value  to  its  power  of  resistance  to  decomposition  and  to 
many  chemical  agents.  Its  fusibility  at  a  moderate  degree  of  heat,  and 
its  solidity  at  the  temperature  of  the  body,  together  with  its  unirritating 
quality,  make  it  a  valuable  ingredient  of  the  cerates  and  ointments  to 
give  them  consistence. 

Ceratum  and  Unguentum  may  be  used  as  simple  protective  applica¬ 
tions.  They  form  the  bases  of  most  of  the  compound  preparations  so 
named. 

CERII  OXALAS,  Oxalate  of  Cerium,  Ce2(C204)3.9H20, — 
is  a  white,  slightly  granular  powder,  odorless  and  tasteless,  insoluble  in 
water  or  alcohol,  but  soluble  in  hydrochloric  acid.  Dose,  gr.  j-x,  in 
pill. 

Physiological  Action  and  Therapeutics. 

Oxalate  of  Cerium  is  a  gastric  sedative  (like  Bismuth),  and  is  thought 


CETACEUM - CETRARIA - CHAULMOOGRA  OIL.  1 6 1 

to  have  selective  action  as  a  sedative  to  the  motor  distribution  of  the 
pneumogastric  nerve.  It  is  considered  to  be  particularly  useful  in  vomit¬ 
ing  of  reflex  origin,  especially  in  the  vomiting  of  pregnancy,  but  it  often 
fails,  probably  because  not  given  in  sufficient  doses.  To  be  effective  at 
least  4  or  5  grains  should  be  given  3  times  a  day  to  adults,  and  no  results 
promised  until  after  it  has  been  used  several  days.  It  is  also  recom¬ 
mended  in  the  vomiting  of  phthisis  and  bronchitis,  cough  with  vomiting, 
gastralgia,  chorea  and  diarrhoea. 

CETACEUM,  Spermaceti, — is  a  peculiar,  concrete,  fatty  sub¬ 
stance  obtained  from  Physeter  macrocephcihis ,  the  sperm  whale.  Occurs 
in  white,  pearly  masses,  odorless,  of  bland  taste,  and  neutral  reaction, 
becoming  rancid  in  the  air,  soluble  in  ether,  chloroform,  carbon  bisul¬ 
phide  and  boiling  alcohol.  Is  a  constituent  of  Unguentum  Aquae  Rosae, 
and  Charta  Cantharidis. 

Ceratian  Cetacei ,  Spermaceti  Cerate, — consists  of  Spermaceti  10,  White  Wax  35, 
Olive  Oil  55  parts. 

Spermaceti  consists  of  Cetin  or  Palmitate  of  Cetyl  with  several  other 
fats  in  small  quantities.  Its  action  is  solely  that  of  an  emollient,  and  it 
is  rarely  used  internally.  The  Cerate  is  used  as  a  bland  ointment  in 
blisters,  abrasions,  and  ulcers. 

CETRARIA,  Iceland  Moss,  — is  the  lichen  Cetrai'ia  islandica , 
found  in  northern  latitudes.  Occurs  about  2  to  4  inches  long,  brown 
above,  whitish  beneath,  taste  mucilaginous  and  bitter.  Contains  Lichenin 
or  lichen  starch,  which  forms  as  a  jelly  when  the  plant  is  boiled  in  water ; 
— also  Ceiraric  Acid. 

Decodum  Cetrarice, — 5  per  cent,  strength.  Dose,  3  ij-iv. 

Cetraria  is  nutrient,  demulcent  and  feebly  tonic.  It  has  a  popular 
reputation  in  pulmonary  affections,  and  is  of  value  in  chronic  catarrhs, 
chronic  bronchitis,  purulent  discharges  from  mucous  surfaces  generally, 
also  in  chronic  diarrhoea  and  dysentery. 

CHAULMOOGRA  OIL  (Unofficial), — is  a  fixed  oil  expressed 
from  the  seeds  of  Gynocardia  odorata ,  an  East  Indian  tree  of  the  nat.  ord. 
Bixaceae.  It  is  nauseous  and  bulky,  solid  at  62.6°  F.,  and  soluble  in 
alcohol,  ether,  choloform,  etc.  Its  active  principle,  Gynocardic  Acid , 
is  the  best  preparation  for  use,  and  may  be  given  internally  in  doses  of 
gr.  ss-iij,  or  applied  as  an  ointment,  gr.  xx  ad  5j  of  Petrolatum.  Dose 
of  the  oil,  gtt.  v-x,  in  capsules. 

Chaulmoogra  Oil  is  credited  with  a  few  cures  of  leprosy,  and  several 
cases  improved  by  its  use  both  internally  and  externally.  It  is  recom¬ 
mended  as  an  external  application  in  scaly  eczema,  psoriasis,  syphilitic 


162 


CHELIDONIUM - CHENOPODIUM - CHIMAPHILA. 


skin-diseases,  chronic  rheumatism,  rheumatic  arthritis  and  tabes  mesen- 
terica. 

CHELIDONIUM,  Celandine  , — is  the  plant  Chelidonium  majus , 
nat.  ord.  Papaveraceae,  which  grows  in  Europe,  and  N.  America  about 
rocky  places.  It  has  a  peculiar,  unpleasant  odor,  and  a  pungent,  acrid 
taste.  Contains  2  alkaloids,  Chelidonine ,  C19H17N303,  and  Chelerythrine , 
the  latter  being  identical  with  Sanguinarine  :  also  Chelidoxanthin ,  a  yellow, 
crystalline  substance,  and  Chelidonic  Acid,  supposed  to  be  identical  with 
Succinic  Acid.  Dose  of  the  plant,  gr.  x-xxx, — of  the  fresh  juice  Tipv-xx. 
There  are  no  official  preparations. 

Chelidonium  used  externally  is  irritant,  internally  it  is  a  drastic  purga¬ 
tive  but  an  unreliable  one.  It  is  also  perhaps  diuretic,  diaphoretic  and 
expectorant.  In  overdoses  it  is  considered  poisonous.  It  is  an  old  remedy 
for  jaundice  and  liver  affections,  but  has  been  obsolete  for  some  time. 
The  fresh  juice  is  a  popular  application  for  warts  and  corns,  and  a  tincture 
in  whiskey  is  used  in  Indiana  as  a  remedy  for  phthisis,  the  menstruum 
being  probably  the  most  useful  agent.  It  seems  to  be  of  real  service  in 
simple  jaundice,  whooping-cough,  right-sided  pneumonia  with  hepatic 
involvement,  and  the  catarrhal  pneumonia  of  children. 

CHENOPODIUM,  American  Wormseed, — is  the  fruit  of 

Chenopodium  ambrosioides,  var.  anthelmintic um,  a  plant  of  the  nat.  ord. 
Chenopodiaceae,  indigenous  in  the  United  States.  It  is  about  y1^  inch  in 
diameter,  and  contains  a  glossy,  black  seed,  has  a  peculiar,  terebinthinate 
odor,  and  a  pungent,  bitter  taste.  Its  active  principle  is  a  Volatile  Oil 
which  is  official. 

Oleum  Chenopodii, — a  thin,  colorless  or  yellowish  liquid,  of  aromatic  odorand  pungent, 
bitter  taste.  Dose,  rrpv-xv. 

% 

The  Oil  is  the  only  preparation  used  and  that  rarely,  its  odor  and  taste 
being  very  disagreeable.  It  increases  the  cardiac  rate,  and  promotes  the 
secretions  of  the  skin,  bronchi  and  kidneys.  It  is  an  efficient  anthel¬ 
mintic  against  the  round  worm  in  doses  of  gtt.  x  three  times  a  day  for 
two  days  and  followed  by  a  cathartic.  It  seems  to  possess  some  tonic 
properties,  and  certainly  is  a  diffusible  stimulant.  As  such  it  has  been 
used  with  benefit  in  chorea,  hysteria,  flatulent  dyspepsia,  and  chronic 
malaria. 

CHIMAPHILA,  Pipsissewa  , — the  leaves  of  Chimaphila  umbellata , 
or  Prince’s  Pine,  an  evergreen  plant  of  the  nat.  ord.  Ericaceae,  indigenous 
in  all  parts  of  the  United  States.  The  leaves  are  about  2  inches  long, 
serrate  above,  wedge-shaped  towards  the  base,  having  an  astringent  and 
bitter  taste.  Contains  Chimaphilin ,  a  yellowish  crystalline  principle, 
Arbutin,  also  crystalline  but  colorless,  with  tannic  acid,  etc. 


CHINOLINA. 


Extradum  Chimaphilce  Fluidittn, — Dose,  gss-ij. 

Decodum  Chimaphilce  (Unofficial), — i  to  17.  Dose,  ^j-iij. 

Chimaphila  is  a  tonic,  astringent  diuretic,  belonging  to  the  same  group 
as  Buchu,  Uva  Ursi,  Pareira  and  Scoparius.  It  is  probably  the  most 
active  diuretic  among  them,  stimulating  all  the  excretory  organs  but 
especially  the  kidneys.  It  is  an  agreeable  tonic,  excites  the  appetite  and 
promotes  digestion.  The  fresh  leaves,  bruised  and  applied  to  the  skin, 
are  rubefacient  and  vesicant,  showing  the  presence  of  some  irritant  prin¬ 
ciple. 

Chimaphila  is  a  good  diuretic  in  dropsy,  and  is  efficient  in  several  forms 
of  chronic  kidney  disease  with  albuminuria,  and  in  chronic  catarrhal 
affections  of  the  urinary  passages,  as  hematuria,  ischuria,  dysuria  and 
gonorrhoea.  It  is  believed  to  check  the  secretion  of  uric  acid,  and  should 
prove  useful  in  gout  and  rheumatism.  Externally,  it  has  been  applied  to 
ulcers  and  tumors  with  benefit. 

CHINOLINA,  Chinoline,  Leucoline,  C9H7N  (Unofficial),  a 
constituent  of  coal-tar  oil — but  may  be  obtained  from  Quinine  or  Cin¬ 
chonine  by  their  destructive  distillation  with  potassium  hydrate, — and 
may  be  artificially  prepared  by  heating  Anilin  or  Nitro-benzol  with  gly¬ 
cerin  in  the  presence  of  a  dehydrating  agent.  Chemically,  it  is  consid¬ 
ered  to  be  formed  by  a  union  of  Benzene  and  Pyridine  atoms.  (Compare 
the  article  Cinchona.)  It  is  a  colorless,  oily  liquid,  strongly  refractive, 
boiling  at  460°  F.  without  decomposition,  turns  dark  on  exposure  to  the 
air ;  soluble  in  alcohol,  ether  and  carbon  disulphide,  sparingly  so  in 
water.  It  combines,  like  an  alkaloid,  with  acids  to  form  crystalline  salts  ; 
all  of  which,  except  the  tartrate,  are  very  deliquescent. 

Chinolince  Tartras, — a  white,  micaceous,  crystalline  powder,  of  pungent  odor  and  sharp 
taste,  stable  in  the  air  and  soluble  in  water.  Dose,  gr.  v-xx. 

Physiological  Action  and  Therapeutics. 

Chinoline  is  a  valuable  antiseptic,  and  antipyretic,  being  nearly  as 
effective  in  this  respect  as  Quinine,  which  it  closely  resembles  in  chemical 
character  and  physiological  action.  It  is  one  of  the  most  powerful  anti¬ 
pyretics  of  all  the  substances  which  have  been  discovered  in  the  search 
for  an  artificial  quinine  (Hydroquinoine,  Antipyrin,  Pyrocatechin,  Resor¬ 
cin,  Thallin,  Kairine,  etc).  Chinoline  has  a  very  disagreeable  taste  and 
smell,  and  is  irritant  in  action,  hence  the  tartrate  is  preferred  for  medi¬ 
cinal  use.  It  has  been  extensively  used  as  an  antipyretic  in  pneumonia, 
typhus,  diphtheria,  typhoid  and  other  fevers,  with  varying  success.  In 
diphtheria,  a  5  per  cent,  solution  in  weak  alcohol  is  painted  on  the 
affected  surface  with  great  benefit.  The  tartrate  has  been  used  bene¬ 
ficially  in  neuralgia  and  whooping-cough,  and  as  an  antiperiodic  in  inter- 
mittents. 


164 


CHIRATA - CHLORAL. 


CHIRATA,  Chiretta, — is  the  Indian  plant  Ophelia  Chirata,  nat. 
ord.  Gentianacese,  occurring  in  bundles  composed  of  all  but  the  coarser 
woody  stems.  It  is  inodorous  but  intensely  bitter,  and  contains  Chiratin 
and  Ophelic  Acid ,  two  amorphous,  bitter  principles,  but  no  tannin. 
Dose  of  the  powdered  plant,  gr.  xv-xxx. 

Extractum  Chirata  Flaidum, — made  with  glycerin  and  diluted  alcohol.  Dose, 
rt\xv  -XXX. 

Tinctura  Chirata, — 10  per  cent.  Dose,  ^ss-ij. 

The  action  of  this  plant  is  that  of  a  simple  bitter,  like  its  congener 
Gentian.  It  is  an  excellent  tonic,  in  this  respect  rivalling  Cinchona,  and 
is  used  in  India  as  a  substitute  for  the  latter.  It  is  laxative  and  stomachic, 
diminishes  flatulency  and  acidity,  and  is  particularly  serviceable  in  the 
dyspepsia  of  gouty  subjects.  As  it  contains  no  tannin,  it  may  be  admin¬ 
istered  with  preparations  of  Iron. 

CHLORAL,  Hydrate  of  Chloral,  C2HC130,H20, — is  inaccurately 
named,  the  hydrate  being  the  official  preparation.  Chloral ,  properly 
so-called,  is  Tri-chlor-aldehyde ,  C2HC130,  an  unstable,  oily,  colorless 
fluid,  formed  by  the  action  of  Chlorine  upon  Alcohol,  whence  its  name 
Chlor-al.  Its  hydrate,  the  official  Chloral,  is  a  colorless,  crystalline  solid, 
which  slowly  evaporates  on  exposure  to  the  air,  of  aromatic  and  acrid 
odor,  bitter  and  caustic  taste,  and  neutral  reaction.  It  is  freely  soluble 
in  water,  alcohol,  ether,  glycerin,  oils,  etc.,  liquefies  when  mixed  with 
camphor  or  carbolic  acids,  melts  at  136°  F.  and  is  decomposed  by  alkalies 
into  chloroform  and  a  formiate  of  the  alkaline  base.  Its  aqueous  solu¬ 
tion  becomes  acid,  but  the  alcoholic  solution  remains  neutral. 

Dose  varies  much  with  individual  susceptibility  and  with  the  presence  or  absence  of 
cardiac  and  pulmonary  disease.  Death  has  been  caused  in  several  instances  by  gr.  xxx, 
in  one  case  by  gr.  x,  and  in  another  gr.  vijss  produced  alarming  symptoms,  all  being 
adults.  On  the  other  hand  several  hundred  grains  have  been  ingested  at  one  time  with¬ 
out  lethal  effects,  and  where  tolerance  has  been  established  by  habital  use,  ^ij-^iij  are 
frequently  taken  without  poisonous  symptoms.  An  average  dose  for  a  healthy  adult  is 
gr.  xv,  for  a  child  gr.  j  for  each  year  of  age  up  to  gr.  vj.  It  is  best  given  in  Syrup  of 
Tolu. 

Caution  is  necessary  when  prescribed  in  combination  with  alcoholic  preparations, 
as  Chloral  Hydrate  is  then  very  apt  to  separate  as  an  alcoholate,  especially  if  the 
Bromides  of  Potassium  or  Sodium  are  used  in  the  same  mixture  and  if  the  solutions  are 
at  all  concentrated.  In  this  way  great  danger  is  incurred  of  giving  a  heavy  overdose,  as 
the  alcoholate  floats  on  the  surface  of  the  mixture,  and  the  entire  Chloral  contained  therein 
may  be  taken  at  a  single  dose. 

Unofficial  Analogues  of  Chloral. 

Amylene  Hydrate,  C5H120,  Di-niethyl-ethyl-corbinol, — a  tertiary  alcohol,  occurring 
as  a  clear,  colorless  fluid,  of  peculiar  odor,  soluble  in  8  of  water  and  readily  miscible  with 
alcohol.  It  is  one  of  the  most  valuable  hypnotics,  in  power  standing  between  chloral 
and  paraldehyde,  but  being  much  more  agreeable  to  the  taste  and  safer  than  either  of 
those  agents.  Its  action  is  exerted  chiefly  on  the  cerebrum  in  doses  sufficient  to  produce 
profound  narcosis;  and  in  medicinal  doses  it  leaves  behind  no  unpleasant  effects,  and  has 
no  perceptible  influence  on  the  heart  or  respiration.  By  very  large  dosage  the  medullary 
centres  are  paralyzed,  including  those  governing  respiration  and  cardiac  action.  Dose, 

3j-3Jss- 


CHLORAL. 


165 


Cannabini  Tannas,  Tannate  of  Cannabin , —  (see  ante ,  page  149), — is  not  more 
reliable  than  the  Extract  of  Cannabis  Indica,  though  devoid  of  the  exciting  qualities  of 
the  latter  preparation.  Dose,  as  a  hypnotic,  gr.  ij-x,  the  average  being  gr.  v.  Fron- 
miiller  considers  it  a  very  useful  hypnotic,  powerful  and  not  dangerous,  not  disturbing  the 
secretions,  nor  leaving  unpleasant  after-effects,  if  used  in  proper  doses. 

Chloralamid,  Chloral  Formidate, — is  chemically  a  union  of  Chloral  anhydride  (C2H 
C130)  with  Formamide  (CHO.NH2).  It  is  a  proprietary  drug,  having  been  both  patented 
and  trade-marked,  wherever  possible,  by  its  proprietor  and  exclusive  manufacturer, 
Schering,  of  Berlin.  It  occurs  as  colorless,  faintly  bitter,  odorless  crystals,  which  are  de¬ 
composed  in  hot  water  or  warm  solutions.  Soluble  in  20  parts  of  cold  water,  or  in  1^ 
of  alcohol; — rapidly  decomposed  by  caustic  alkalies  and  slowly  by  alkaline  carbonates. 

The  Dose  is  put  at  from  10  to  60  grains.  The  average  adult  hypnotic  quantity  about 
30  grains,  given  in  a  teaspoonful  of  whiskey  or  brandy,  or  in  any  alcoholic  compound  ; — 
for  example,  30  grains  in  2  drachms  each  of  Tinct.  Cardamom.  Co.  and  Elixir  Simplex, 
as  one  dose.  By  some  observers  a  45 -grain  dose  is  considered  the  limit  of  safety  and 
equal  to  30  grains  of  Chloral  hydrate;  by  others  this  amount  is  considered  necessary  for 
its  certain  hypnotic  action.  Sixty  grains  have  frequently  been  administered  without  pro¬ 
ducing  unpleasant  symptoms; — but,  as  Dr.  Steele  has  pointed  out,  the  slow  solubility  of 
the  drug  in  the  watery  contents  of  the  stomach  must  be  taken  into  account,  and  when 
considering  its  action,  the  menstruum  and  the  condition  of  the  gastric  mucous  mem¬ 
brane  should  be  known. 

The  Action  of  Chloralamid  is  essentially  a  hypnotic  one,  and  it  is  extensively  advertised 
as  the  least  depressant  and  most  efficient  sleep-producer  at  our  command, — without  un¬ 
pleasant  after-effects  from  ordinary  doses,  except  in  2  per  cent,  of  the  cases  in  which  used, 
I  per  cent,  having  gastric  and  the  other  I  per  cent,  having  cerebral  symptoms ;  while 
these  were  always  slight  unless  the  dose  of  30  grains  had  been  exceeded.  The  more 
severe  and  unusual  effects  (from  doses  above  30  grains)  are  vertigo,  thirst,  nausea,  dry 
mouth,  vomiting,  anorexia,  slight  delirium,  cardiac  weakness,  rapid  and  feeble  pulse, 
and  restlessness.  The  drug  does  not  seem  to  have  any  cumulative  action,  nor  any  tend¬ 
ency  to  provoke  a  habit  of  using  it.  It  is  also  credited  with  considerable  analgesic  power 
in  certain  conditions  (see  below),  as  well  as  with  anti-dyspnoeic  and  anti-hydrotic  action. 

Therapeutically  the  main  field  of  Chloralamid  has  been  in  the  treatment  of  inso?nnia , 
particularly  the  simple  or  idiopathic  form,  and  when  not  due  to  excitement  or  severe  pain, 
but  from  nervousness,  hysteria,  chronic  alcoholism,  and  similar  states;  also  in  that  ac¬ 
companying  typhoid  fever,  asthma  (both  cardiac  and  bronchial),  organic  heart  disease,  the 
opium  habit,  and  diabetes  mellitus  (Steele).  It  is  less  effective  in  organic  nervous  affec¬ 
tions  and  mental  disorders,  and  is  useless  in  these  conditions  when  the  insomnia  is  due  to 
excitement, hallucinations,  or  severe  pain. 

As  an  analgesic,  it  has  lessened  and  checked  the  pains  of  aneurism,  carcinoma  of  the 
stomach  and  liver,  sarcoma  of  a  rib,  erysipelas,  rheumatic  fever,  gall-stone,  etc.  ;— and  in 
dysmenorrhoea  has  given  entire  relief,  used  just  as  the  painful  period  approached,  in  a 
single  dose  of  30  grains.  It  has  been  reported  curative  of  chorea,  in  doses  of  gr.  15  thrice 
daily  for  five  days,  in  a  boy  of  eleven  years  ;  and  in  a  girl  who  had  resisted  all  other  treat¬ 
ment  for  the  same  affection,  it  was  successful  in  8  days. 

Compared  with  Sulphonal,  Chloralamid  is  preferred  for  all  cases  in  which  collapse  is 
feared,  by  reason  of  its  apparent  freedom  from  depressant  action  on  the  cardiac  centres  or 
the  respiratory  mechanism.  In  phthisis  it  has  proven  efficient  against  the  most  obstinate 
night-sweats,  while  at  the  same  time  securing  rest  in  cases  in  which  the  cough  was  not  very 
violent.  To  secure  the  best  results  as  a  hypnotic,  the  drug  should  be  given  about  an 
hour  and  a  half  before  sleeping-time,  in  a  dilute  alcoholic  menstruum,  and  on  a  stomach 
containing  little  or  no  watery  fluids  to  interfere  with  its  solution  and  absorption. 

Croton  -  chloral,  C4H5C130,H20,  Butyl-chloral  Hydrate  (B.  P.), — a  crystalline 
body  formed  by  acting  on  Aldehyde  with  Chlorine.  It  is  sparingly  soluble  in  water  (1  in 
100),  but  is  readily  so  in  glycerin  (1  in  4).  In  action  it  closely  resembles  Chloral,  but  is 
feebler,  less  depressant  to  the  heart,  and  generally  less  poisonous,  but  more  disagreeable 
to  the  taste.  It  is  said  to  specifically  affect  the  fifth  nerve,  and  to  cause  anaesthesia  over 
its  distribution  long  before  producing  general  anaesthesia  (Liebreich).  Dose,  as  hypnotic, 
gr.  v-xx. 

Hyoscinae  Hydrobromas,  Ilydrobromate  of  Hyoscine , — is  an  efficient  hypnotic, 
with  the  advantage  of  being  tasteless,  and  having  a  very  small  dose,  (gr  so  that  it 
may  be  given  in  tea,  coffee,  etc.  It  is  apt  to  affect  the  head  afterwards,  and  soon  loses  its 
power  by  repetition.  In  large  doses  it  is  a  dangerous  respiratory  depressant. 

Hypnone,  C6H5(CO)(CH;j),  Phenyl-methyl-acetone , — a  member  of  the  Ketones, 
occurring  above  70°  F.  as  a  colorless,  mobile  liquid,  having  a  strong  almond  and  orange 


CHLORAL. 


1 66 

odor.  It  is  insoluble  in  water  or  glycerin,  and  is  best  given  in  capsules.  It  is  a  hypnotic, 
of  only  moderate  intensity,  but  said  to  be  especially  useful  in  the  insomnia  of  alcoholism. 
Its  use  is  devoid  of  danger,  and  leaves  behind  no  unpleasant  effects,  except  a  disagree¬ 
able  odor  of  the  breath,  the  drug  being  eliminated  by  the  lungs  as  well  as  by  the  kidneys. 
In  very  large  dosage  it  has  induced  coma,  followed  by  paralysis  of  the  heart  and  respira¬ 
tion.  Dose,  npv-x,  in  capsule,  rr^vij  to  rryvlij  being  usually  required. 

Methylal,  CH2(OCH3)2,  Methylene-di-methyl  Ether , — one  of  the  products  of  the 
oxidation  of  Methylic  Alcohol,  occurring  as  a  volatile,  mobile  liquid  of  pleasant,  aro¬ 
matic  odor  and  taste,  readily  soluble  in  water,  alcohol,  etc.  It  is  a  local  anaesthetic,  and 
an  efficient  hypnotic,  producing  a  deep  sleep  of  short  duration,  with  more  or  less  general 
anaesthesia  and  lowered  reflex  excitability.  It  is  depressant  to  the  heart,  respiration  and 
body  temperature,  but  in  medicinal  doses  does  not  leave  any  bad  after-affects.  Dose,  per 
orem,  rrpiv-v,  repeated  thrice  at  short  intervals. 

Paraldehyde,  C6H1203, — a  polymeric  form  of  Aldehyde,  if  represented  thus 
(C2H40)3.  Occurs  as  a  strong-smelling,  bad-tasting  fluid,  soluble  in  8  parts  of  water. 
It  is  a  reliable  hypnotic  of  about  one-half  the  power  of  chloral,  leaving  behind  no 
unpleasant  effects  except  a  very  disagreeable  odor  to  the  breath.  In  medicinal  doses  it 
slows  and  strengthens  the  heart,  but  in  very  large  dosage  it  is  paralyzant  to  both  heart 
and  respiration.  It  occasionally  causes  an  erythematous  eruption,  and  may  give  rise  to 
cerebral  congestion  and  vaso-motor  paralysis,  if  used  for  any  long  period.  Dose,  rtpxxx- 
3  j  in  water,  syrup,  etc, — rtpxl  being  about  the  average  hypnotic  dose. 

Sulphonal,  (CH3)2C(C2H2S02)2,  belongs  to  the  group  of  Disulphones,  and  has  the 
chemical  name  Di-ethyl-sulphon-di  methyl-methan.  It  is  a  whitish,  crystalline  substance 
without  odor  or  taste,  very  slightly  soluble  in  cold  water,  more  so  in  warm  water,  and 
still  more  so  in  alcohol,  ether,  etc.  The  dose  is  gr.  xv-xlv,  in  hot  soup  or  milk,  coffee, 
tea,  etc.,  administered  two  hours  before  the  effect  is  desired. 

Sulphonal  is  said  to  have  no  intoxicant  or  narcotic  action,  and  no  unfavorable  effect  on 
the  heart  or  circulation,  even  in  full  doses.  It  is  an  admirable  hypnotic  in  many  cases, 
but  its  efficacy  decreases  with  use. 

Urethane,  NH2C02C2H5,  Ethyl  Carbamate , — occurs  in  crystals  which  are  readily 
soluble  in  water,  with  scarcely  any  taste  or  odor.  It  is  devoid  of  irritant  action,  and  may 
be  administered  hypodermically.  It  is  a  pure  hypnotic,  but  not  so  reliable  as  paralde¬ 
hyde  or  chloral ;  neither  does  it  affect  the  circulation  nor  depress  (but  rather  stimulates) 
the  respiration.  It  acts  directly  on  the  cerebrum,  causing  a  sleep  which  closely  resembles 
the  normal,  and  has  no  unpleasant  after-effects.  In  very  large  doses  it  slows  the  heart, 
lowers  the  temperature,  and  induces  muscular  resolution  and  general  anaesthesia.  In 
small  animals  it  effectually  antagonizes  the  action  of  Strychnine.  Dose,  gr.  xv-  ^j,  an 
average  hypnotic  dose  being  gr.  xxx  ;  but  it  is  best  given  in  5 -grain  doses  repeated  fre¬ 
quently,  as  a  large  dose  may  cause  vomiting. 


Physiological  Action. 

Chloral  is  a  powerful  hypnotic,  also  an  antispasmodic,  an  antiferment, 
a  preventive  of  the  coagulation  of  fibrin,  indirectly  an  anaesthetic,  and 
especially  a  depressant  of  the  cerebral,  medullary  and  spinal  centres  and 
of  the  cardiac  muscle.  It  is  more  hypnotic  than  chloroform  but  less  of  an 
anaesthetic.  Applied  to  the  skin  or  mucous  membranes  a  1  per  cent,  solu¬ 
tion  (gr.  v  ad  3j)  is  antiseptic,  but  strong  solutions  are  irritant  and  vesi¬ 
cant,  may  produce  sloughing  ulcers,  and  if  taken  internally  may  excite 
gastritis  with  nausea  and  vomiting. 

After  a  brief  period  of  stimulation  a  medicinal  dose  depresses  the  heart 
and  lowers  arterial  tension,  diminishes  oxidation  and  decreases  the  body 
temperature.  On  the  brain  cells  it  has  a  selective  action,  producing  a 
deep  sopor  very  like  normal  sleep,  from  which  the  patient  may  be  awak¬ 
ened,  but  immediately  falls  asleep  again,  and  which  is  not  followed  by 
headache  or  depression.  This  effect  is  considered  by  some  authorities  to 
be  the  result  of  cerebral  anaemia  produced  by  the  drug.  In  some  persons, 


CHLORAL. 


167 


instead  of  sleep  it  causes  headache,  insomnia  and  delirious  excitement. 
It  is  not  an  anodyne,  as  it  does  not  affect  the  conductivity  of  the  sensory 
nerves,  and  does  not  interrupt  the  transmission  of  pain  ;  but  by  over¬ 
whelming  the  centres  it  drowns  the  consciousness  of  pain,  and  is  therefore 
only  indirectly  anaesthetic.  A  toxic  dose  produces  profound  narcotism, 
abolishment  of  reflexes  and  sensibility,  complete  muscular  relaxation  and 
a  great  fall  of  body  temperature.  Death  may  result  in  the  chloral  sleep 
from  paralysis  of  the  respiratory  centre  or  the  cardiac  motor  ganglia,  or 
by  sudden  failure  of  the  heart-muscle  in  cases  of  fatty  degeneration  or  in 
old  drunkards. 

The  Chloral-habit  produces  a  state  of  marked  anaemia  and  muscular 
weakness,  especially  of  the  legs  (DaCosta)  ;  its  subject  presenting  a  weak, 
irritable,  often  irregular  heart,  deranged  hepatic  functions,  jaundice, 
bileless  stools,  perhaps  purpura  and  sloughing  of  a  finger  from  decreased 
blood-supply.  Its  votaries  are  on  the  border  of  insanity,  excitable,  un¬ 
controllable  in  speech  and  action,  talking  in  a  silly  manner  and  very 
volubly,  and  showing  a  marked  loss  of  power  of  the  limbs,  so  much  so  as 
to  simulate  paralysis  thereof.  Many  cases  of  insanity  have  their  origin  in 
chloralism. 

On  the  blood  its  action  is  to  increase  the  fluidity,  crenate  the  red  corpus¬ 
cles,  and  to  destroy  the  leucocytes  if  used  in  large  quantity.  It  is  rapidly 
diffused,  and  is  excreted  by  the  kidneys  partly  unchanged,  but  chiefly  as 
urochloralic  acid,  producing  some  diuresis, — also  by  the  skin,  causing 
various  eruptions  if  used  for  any  lengthened  period.  It  has  been  held  that 
the  blood,  being  an  alkaline  fluid,  decomposes  it,  setting  free  chloroform, 
but  there  are  many  facts  against  this  theory. 

Chloral  and  Atropine,  though  antagonistic  in  their  action  on  the 
spinal  cord,  both  produce  motor  paralysis,  the  former  by  paralyzing  the 
cord,  the  latter  by  direct  paralysis  of  the  motor  nerves. 

Antagonists  and  Incompatibles. 

Atropine  antagonizes  its  cardiac,  respiratory  and  spinal  depression,  and  should  be  injected 
in  small  doses  frequently  repeated,  until  its  effects  are  apparent.  Morphine  administered 
with  Chloral  antagonizes  the  tendency  to  cardiac  failure,  while  synergistic  to  the  hypnotism. 
While  Chloral  is  the  antagonist  to  Strychnine,  opposing  the  spinal  action  of  that  drug,  the 
reverse  is  only  true  to  a  very  limited  extent.  Heat  is  a  necessary  application,  to  maintain 
the  body-temperature,  and  artificial  respiration  should  be  practiced  if  required.  All 
alkalies  are  incompatible. 

Therapeutics. 

Chloral  Hydrate  is  of  great  value  as  a  hypnotic  and  antispasmodic,  but 
must  be  cautiously  used  if  at  all  in  old  alcoholics  or  persons  with  weak  or 
fatty  hearts,  atheromatous  vessels  or  advanced  pulmonary  disease.  In 
combination  with  Potassic  Bromide  it  is  much  used  in  asylum  and  general 
practice,  and  equally  abused,  both  drugs  being  active  cardiac  poisons.  It 
is  highly  serviceable  in  fevers,  when  high  temperature  exists  with  excite¬ 
ment,  restlessness  and  a  sthenic  condition,  as  it  lowers  temperature  and 


1 68 


CHLORAL  BUTYLICUM — CHLOROFORMUM. 


prevents  the  coagulation  of  fibrin.  In  the  algid  stage  of  cholera  and  in 
violent  cases  of  cholera  morbus  it  may  be  injected  hypodermically  in 
15-grain  doses  with  extraordinary  efficacy.  In  sea-sickness  small  doses 
(gr.  v)  two  or  three  times  a  day  are  generally  very  efficient.  In  obstetrics 
it  is  used  to  relieve  suffering,  relax  the  os  uteri,  palliate  convulsions  and 
to  relieve  after-pains.  For  nocturnal  epilepsy  a  full  dose  at  bedtime  is  a 
useful  palliative.  In  neuralgia  it  may  be  triturated  with  camphor  and 
applied  over  the  course  of  the  affected  nerve.  Tetanus  is  best  treated  by 
chloral  and  potassic  bromide.  It  is  an  excellent  remedy  for  infantile 
convulsions  and  colic,  chorea,  spasmodic  asthma,  whooping-cough,  laryn¬ 
gismus  stridulus,  and  the  first  stage  of  diphtheria,  but  not  when  the  heart 
is  weak.  In  acute  mania  and  delirium  tremens  it  is  the  best  hypnotic, 
but  has  been  too  incautiously  employed.  In  cancers  and  ulcers  a  25  per 
cent,  solution  is  a  good  antiseptic  and  anodyne  application.  In  strych¬ 
nine-poisoning  Chloral  is  the  antagonist.  It  is  generally  given  by  the 
mouth  in  dilute  solution  with  some  simple  elixir  or  cinnamon-water,  but 
is  well  absorbed  by  the  rectum.  Its  hypodermic  administration  is  liable 
to  result  in  great  local  irritation  and  even  sloughing  ulcers. 

The  mixture  of  Chloral  and  Camphor  is  a  good  local  application  in 
superficial  neuralgia,  and  may  be  painted  over  the  larynx  for  spasmodic 
cough.  It  makes  a  good  remedy  for  internal  use  in  colic,  cholera  and 
cholera  morbus,  especially  if  combined  with  Morphine. 

CHLORAL  BUTYLICUM,  Butyl-chloral  Hydrate,  Croton- 

chloral,  C4H5C130,H20  (Unofficial), — is  formed  by  the  action  of  Chlo¬ 
rine  upon  Aldehyde,  then  adding  to  the  Butyl-Chloral  thus  produced  the 
necessary  water.  It  occurs  in  crystalline  scales,  insoluble  in  chloroform, 
sparingly  soluble  in  water,  but  freely  soluble  in  alcohol,  hot  water  and 
glycerin.  Dose  gr.  v-xx,  in  syrup  or  pill.  But  the  best  method  is  to  give 
5  grains  every  half-hour  until  20  grains  have  been  taken  or  relief  afforded. 

Physiological  Action  and  Therapeutics. 

Croton-chloral  so  far  as  is  ascertained  has  an  action  parallel  to  that  of 
Chloral  Hydrate,  but  feebler  and  less  certain.  It  is  said  to  have  a  specific 
paralyzant  power  over  the  5th  nerve,  and  to  have  no  paralyzant  effect  on 
the  heart.  It  has  been  used  with  benefit  in  various  neuralgiae,  especially 
tic-douloureux,  also  in  sciatica  and  dysmenorrhcea.  All  statements  of 
the  action  and  therapeutics  of  this  drug  are  to  be  received  with  hesitation, 
as  wide  differences  are  reported  by  the  best  authorities. 

CHLOROFORMUM,  Chloroform,  CHC13  or  CHC12C1,— the 

Terchloride  of  Methyl ,  or  the  Chloride  of  Bichlorinated  Methyl  (Di-chlor- 
methyl  Chloride), — is  formed  by  the  substitution  of  3  atoms  of  Chlorine 


CHLOROFORMUM. 


169 


for  3  of  Hydrogen  in  Methyl  Hydride  (marsh-gas,  CHJ.  In  practice  it 
is  obtained  from  Ethylic  Alcohol  or  Methylated  Spirit  by  the  action  of 
Chlorinated  Lime,  or  from  Chloral  by  an  alkaline  hydrate,  and  is  known 
chemically  as  Normal  Chloroform.  If  prepared  from  Methylic  Alcohol 
(wood-spirit)  it  is  called  Methylic  Chloroform ,  and  is  purified  with  great 
difficulty.  The  object  of  purification  is  to  remove  the  chlorinated  pyro- 
genous  oil.  Absolute  Chloroform  has  a  sp.  gr.  of  1.500,  and  decomposes 
easily  in  sunlight  or  diffused  daylight,  but  when  reduced  to  a  sp.  gr.  of 
1.485  to  1.490  by  alcohol  it  will  keep  well.  It  is  official  in  two  forms, 
viz. — 

Chloroformum  Venale,  Commercial  Chloroform, — is  a  liquid  con¬ 
taining  at  least  98  per  cent,  of  Chloroform,  and  having  a  sp.  gr.  not  lower 
than  1.470.  It  contains  sundry  Hydrocarbons,  free  Chlorine,  Aldehyde 
and  Hydrochloric  Acid,  and  is  used  only  for  external  applications,  or  to 
make  the  purified  article.  It  is  a  constituent  of  Linimentum  Chloroformi. 

Chloroformum  Purificatum,  Purified  Chloroform, — is  a  heavy,  clear, 
colorless,  diffusive  liquid,  of  characteristic  odor,  sweet,  burning  taste  and 
neutral  reaction,  soluble  in  200  of  water,  freely  so  in  alcohol  or  ether, 
also  in  oils,  benzol  or  benzin.  Sp.  gr.  1.485  to  1.490  at  590  F.,  and 
contains  ^  to  1  per  cent,  of  alcohol.  Dose,  internally,  npij-xx,  for  in¬ 
halation  about  3j>  repeated  until  the  desired  effect  is  produced. 

Preparations. 

Mistura  Chloroformi , — contains  of  Purified  Chloroform  8,  Camphor  2,  fresh  Yolk 
of  Egg  10,  Water  80  parts.  Dose,  3  j-^j. 

Spiritus  Chloroformi , — contains  of  Purified  Chloroform  10,  Alcohol  90  parts.  Dose, 
npx-^j,  well  diluted. 

Linimentum  Chloroformi, — Commercial  Chloroform  40,  Soap  Liniment  60  parts. 

Linimentum  Chloroformi  Compositum  (Unofficial), — Chloroform  ^j,  Oil  of  Turpentine 
^j,  Tincture  of  Opium  giv,  Tincture  of  Aconite  gij. 

Chlorodyne  (Unofficial), — a  celebrated  secret  mixture,  put  forth  by  Dr.  J.  Collis 
Browne,  of  London,  and  since  imitated  by  many  others.  It  is  supposed  to  contain 
Chloroform,  Ether,  Morphine,  Cannabis  Indica,  Hydrocyanic  Acid,  Capsicum,  etc.,  and  is 
powerfully  anodyne,  antispasmodic  and  narcotic,  and  therefore  highly  dangerous  in  non¬ 
professional  hands.  Dose,  rtpx-xxx,  according  to  the  quantities  of  Morphine  and  Chloro¬ 
form  present,  these  being  the  active  agents  in  the  preparation.  A  comparison  of  the 
principal  formulae  which  have  been  used  in  imitation  of  Browne’s  Chlorodyne  is  given  in 
the  appendix,  and  will  show  the  wide  differences  between  them.  A  list  of  25  formulae  for 
Chlorodyne  was  published  in  the  Therapeutic  Gazette  for  October,  1883. 

Tinctura  Chloroformi  et  Morphines  (B.  P.), — has  been  recently  made  official  as  a  sub¬ 
stitute  for  Chlorodyne.  Each  dose  of  10  minims  contains  of  Chloroform  npi^,  Ether 
TT^i,  Alcohol  rtpi|-,  Morphine  Hydrochlorate  gr.  Dilute  Hydrocyanic  Acid  TT^I,  Oil 
of  Peppermint  Fluid  Extract  of  Liquorice  Treacle  and  Syrup  q.  s. 

Tinctura  Chloroformi  Composites  (B.  P. ), — has  of  Chloroform  2,  Alcohol  8,  and  Com¬ 
pound  Tincture  of  Cardamoms  10.  Dose,  rr^xx-gj. 

Ancssthetic  Mixtures  containing  Chloroform, — see  under  tEther,  ante ,  page  79. 

Some  Chlorinated  Ancssthetic  Compounds. 

Ethylene  Bichloride ,  Dutch  Liquid,  Chloric  Ether,  C2H4C12, — is  a  rapid  and  powerful 
anaesthetic,  probably  safer  than  Chloroform  and  less  so  than  Ether.  It  always  paralyzes 
the  respiratory  centre  before  the  heart,  so  that  its  effects  may  be  easily  watched  and  con¬ 
trolled.  This  is  the  substance  which  Guthrie  supposed  he  had  obtained  when  he  dis¬ 
covered  Chloroform. 


lyo 


CHLOROFORMUM. 


Ethylidene  Chloride,  Chlorinated  Muriatic  Ether,  CH3,CHC12, — is  a  mixture  of 
varying  sp.  gr.,  and  is  not  inflammable.  It  closely  resembles  Chloroform  both  physically 
and  physiologically,  but  is  less  depressant  to  the  heart,  consequently  safer,  and  recovery 
from  its  effects  is  very  prompt. 

Methyl  Chloride,  CH3C1, — a  colorless  gas,  slightly  soluble  in  water,  of  sweetish  odor 
and  taste,  inflammable,  burning  with  a  greenish  flame.  Cold  liquefies  it,  and  the  liquid 
boils  at — 7.6°F.  It  is  used  locally  in  neuralgia  to  produce  intense  cold,  and  with  re¬ 
markable  success. 

Methylene  Bichloride,  Dichloro -methane,  CH2C12, — is  an  effective  anaesthetic  which 
it  was  supposed  would  displace  Chloroform  as  being  much  safer.  Dr.  Richardson  intro¬ 
duced  it  and  Mr.  Spencer  Wells  advocates  its  use,  but  though  little  used  as  compared 
with  other  anaesthetics  several  deaths  have  occurred  from  its  employment.  It  kills  by 
paralyzing  the  heart. 

Carbon  Tetrachloride,  CC14, — is  less  irritant  than  Chloroform,  but  far  more  dangerous 
to  the  heart. 

Physiological  Action. 

The  action  of  Chloroform  is  similar  to  that  of  Ether  (see  a?ite,  page  80) 
with  several  important  differences,  as  follows  :  It  is  more  irritant  to  the 
mucous  membranes,  and  if  swallowed  undiluted  it  produces  violent  gastro¬ 
enteritis,  which  becomes  apparent  after  the  subsidence  of  the  profound 
narcotism  which  at  first  follows  its  ingestion  in  quantity.  A  dose  of  3j 
internally  will  cause  death.  It  is  less  of  a  stimulant  than  Ether,  and  more 
depressant  to  the  heart  and  circulation.  It  clots  blood  outside  the  body, 
making  a  mass  like  sealing  wax. 

Inhaled  for  anaesthetic  purposes  it  is  considered  much  more  dangerous 
than  Ether  from  its  direct  paralyzant  effect  on  the  heart.  Its  vapor  requires 
admixture  with  g6j4  per  cent,  of  air  to  produce  anaesthesia  with  safety 
according  to  the  authorities  on  the  subject.  As  compared  with  Ether  its 
vapor  is  less  irritant  to  the  air-passages,  uninflammable,  more  pleasant, 
more  prompt  in  action,  has  a  shorter  stage  of  excitement  and  a  more  pro¬ 
found  narcosis,  and  produces  much  less  vomiting.  Its  mortality  is  greater, 
being  i  in  3000,  against  1  in  16,000  for  Ether,  about  500  fatal  cases  being 
reported,  none  of  which,  however,  were  in  obstetrical  practice.  Death 
from  Chloroform-inhalation  is  almost  always  sudden  and  by  cardiac  paraly¬ 
sis, — from  Ether  it  is  slow  and  usually  by  paralysis  of  respiration. 

[For  modes  of  death  from  anaesthetic  vapors  and  the  treatment  of  dan¬ 
gerous  symptoms,  see  ante ,  page  81.] 

A  nt agonists. 

There  is  no  chemical  antidote.  If  swallowed,  the  stomach  should  be  evacuated  and 
the  case  treated  as  one  of  poisoning  by  an  irritant.  Amly  Nitrite  by  inhalation,  and 
Atropine  hypodermically,  to  sustain  the  heart. 

Therapeutics. 

Chloroform  is  used  for  the  same  condition  as  is  Ether,  and  is  much 
employed  in  liniments  as  a  rubefacient  and  anodyne  application,  as  in 
pruritus,  rheumatic  and  neuralgic  pains,  etc.  Internally  it  is  advanta¬ 
geously  administered  in  true  cholera,  in  which  it  has  been  more  efficacious 
than  any  other  single  remedy,  in  cholera  morbus,  vomiting,  colic,  dys- 


CHLOROFORMUM. 


171 

menorrhcea,  hepatic  colic,  and  other  pains  of  internal  and  spasmodic 
character.  In  sciatica,  tic-douloureux  and  other  neuralgiae  of  important 
nerves  the  deep  injection  of  npv-xv  of  pure  Chloroform  in  the  vicinity  of 
the  nerve  is  highly  recommended,  though  it  may  cause  dangerous  local 
disturbance.  The  writer  has,  in  several  cases  of  severe  supra-orbital  neu¬ 
ralgia,  injected  two  or  three  minims  of  Chloroform  into  the  vicinity  of 
the  supra-orbital  nerve  just  above  its  foramen  of  exit,  with  the  most  grati¬ 
fying  results,  though  severe  local  pain  and  considerable  swelling  were 
experienced  for  several  days.  The  vapor  in  small  quantities  inhaled  from 
warm  water  is  useful  in  many  neuroses,  as  hay-fever,  spasmodic  asthma, 
reflex  cough. 

As  an  Anesthetic  the  use  of  Chloroform  is  decreasing  every  year  in 
favor  of  Ether,  except  for  young  children  and  in  obstetrical  practice.  Its 
vapor  being  four  times  denser  than  air,  and  the  rule  for  its  effective  use 
requiring  fully  96^  per  cent,  of  air  with  it,  its  administration  according 
to  the  orthodox  fashion  requires  most  careful  management,  and  should 
never  be  attempted  in  any  but  the  recumbent  posture.  An  ounce  of 
Brandy  and  a  hypodermic  injection  of  Morphine,  gr.  -J-,  with  Atropine, 
gr.  given  20  minutes  before  commencing  the  inhalation,  are  means 
of  great  utility  in  sustaining  the  heart  and  respiration,  as  well  as  in  ren¬ 
dering  the  anaesthesia  more  profound.  No  operation,  especially  on  parts 
supplied  by  the  fifth  nerve,  should  be  undertaken  during  partial  chloro¬ 
form  anaesthesia,  for  the  reasons  given  on  page  81. 

Dr.  Sayre  administers  Chloroform  in  a  manner  which  is  calculated  to 
strike  terror  to  the  heart  of  an  emotional  observer  who  is  impressed  by  the 
orthodox  rule  of  96*^  per  cent,  air  with  3^  per  cent,  of  the  anaesthetic 
as  the  only  safe  proportion.  Having  been  made  familiar  with  the  prac¬ 
tice  of  Dr.  Sayre  through  observance  of  the  method  employed  by  some  of 
his  pupils,  the  writer  sought  for  more  direct  instructions  from  that  distin¬ 
guished  surgeon,  and  received  from  him  a  letter  from  which  the  following 
paragraphs  are  extracted. 

“  I  have  employed  no  other  method  for  more  than  twenty  years,  have  used  it  in  this 
manner  in  some  thousands  of  cases  without  the  least  appearance  of  danger,  and  can  there¬ 
fore  speak  with  confidence  as  to  its  safety. 

“  My  plan  is  simply  to  anaesthetize  the  patient  with  the  smallest  amount  of  Chloroform 
possible ;  and  as  Oxygen  is  the  Antidote  to  the  anaesthetic  I  exclude  all  air  that  is  not 
i?npregnated  with  the  ancesthetic. 

“  In  this  manner  a  very  few  inspirations  will  produce  immediate  anaesthesia  without 
the  muscular  struggling  which  always  follows  when  pure  air  is  admitted  with  the  chloro¬ 
form.  I  always  measure  my  dose  with  the  same  care  as  if  I  were  administering  Arsenic, 
Strychnine,  Corrosive  Sublimate,  or  any  other  potent  agent ;  and  then  I  know  what  I  am 
doing.  If  by  accident  there  should  be  some  peculiarity  about  the  patient,  making  him 
unduly  susceptible,  a  few  artificial  respirations  would  soon  remove  the  influence  of  the  few 
drops  which  had  been  inhaled,  and  thus  all  danger  can  be  avoided.  Five,  ten  or  twenty 
drops  of  Chloroform  administered  in  this  manner  is  all  that  is  requisite  to  produce  imme¬ 
diate  and  profound  anaesthesia.  I  have  explained  my  method  hundreds  of  times  at  my 
clinical  lectures  in  Bellevue  Hospital,  many  of  which  have  been  published  at  different 
times  in  different  medical  journals  by  various  persons  who  have  made  stenographic  re- 


172 


CHLORUM. 


ports  of  my  lectures.  In  the  ‘  Transactions  of  the  International  Medical  Congress,’  held 
in  Philadelphia  in  1876,  is  a  verbatim  report  of  my  remarks  on  this  subject  made  while 
I  was  performing  an  exsection  of  the  hip-joint  in  the  hospital  before  the  Congress.” 

I  remain  yours  truly, 

Lewis  A.  Sayre. 

The  writer  can  add  his  testimony  to  that  of  the  above  letter  respecting 
the  thorough  anaesthetic  effect  and  freedom  from  unpleasant  symptoms 
observed  in  a  large  number  of  cases  in  which  Chloroform  was  administered 
in  the  manner  described  under  his  observation  during  the  past  six  years. 
As  to  the  safety  of  this  method  over  the  ordinary  way  no  conclusion  can 
be  reached  without  the  results  of  many  thousands  of  examples  in  the 
hands  of  many  different  observers. 

CHLORUM,  Chlorine,  Cl, — is  a  greenish-yellow  gas  having  a  suffo¬ 
cating  odor  and  belonging  to  the  group  of  Halogen  elements,  so  named 
(from  oM,  the  sea)  because  its  most  important  members  Chlorine,  Bro¬ 
mine  and  Iodine  are  derived  from  the  ocean,  Chlorine  being  obtained 
from  sea-salt,  Bromine  from  sea-water,  and  Iodine  from  sea-weed.  Chlo¬ 
rine  itself  is  not  official,  but  is  represented  in  medicine  by  2  Chlorates 
and  8  Chlorides  (of  Potassium,  Sodium,  Ammonium,  Calcium,  Iron, 
Gold,  Zinc  and  Mercury),  which  are  described  under  the  titles  of  their 
respective  bases;  also  by  Hydrochloric  Acid,  Chloral,  Chloroform,  etc., 
and  by  the  following  preparations  which  furnish  it. 

Preparations. 

Aqua  Chlori,  Chlorine  Water, — is  an  aqueous  solution  of  Chlorine,  containing  at  least 
0.4  per  cent,  of  the  gas ;  and  is  prepared  by  heating  together  Black  Oxide  of  Manganese 
10  parts  and  Hydrochloric  Acid  40  parts,  then  saturating  400  of  distilled  Water  with  the 
gas  so  obtained.  It  is  a  clear,  greenish-yellow  liquid,  of  suffocating  odor  and  disagreeable 
taste.  Dose,  ^j-^ss,  well  diluted,  as  a  lotion  or  spray;  internally,  rtpx-xx  in  water. 

Chlorine  Water  may  be  extemporaneously  prepared  by  mixing  in  a  mortar  Chlorate  of 
Potassium  40  grains  and  Hydrochloric  Acid  ounce,  and  adding  a  pint  of  distilled 
water  by  agitation  during  the  evolution  of  the  vapors.  If  done  in  a  closed  vessel  danger 
may  arise  from  the  explosive  gas,  C1204  which  is  liberated  at  the  same  time.  It  should 
be  quickly  bottled. 

Calx  Chlorata,  Chlorinated  Lime,  Chloride  of  Lime, — is  a  compound  resulting  from 
the  action  of  Chlorine  upon  Calcium  Hydrate,  and  containing  at  least  25  per  cent,  of 
available  Chlorine.  It  is  obtained  by  exposing  slaked  Lime  to  the  action  of  Chlorine  gas 
as  long  as  the  latter  is  absorbed,  and  should  not  be  confounded  with  Chloride  of  Calcium 
(see  ante ,  page  143).  It  occurs  as  a  whitish,  dry  powder  or  friable  lumps,  gradually 
decomposing  in  the  air,  of  saline,  disagreeable  taste  and  a  feeble  Chlorine  odor,  partially 
soluble  in  water  and  in  alcohol,  and  when  dissolved  in  dilute  Hydrochloric  acid  gives  off 
Chlorine  gas.  Dose,  gr.  iij-yj  in  water;  for  external  use  a  I  to  3  per  cent,  solution. 
Liquor  Calcis  Chlorates ,  B.  P.,  is  a  solution  of  I  pound  in  I  gallon  of  water. 

Liquor  Sodce  Chloratce ,  Solution  of  Chlorinated  Soda,  Labarraque’s  Solution, — a  pale- 
greenish  liquid,  of  faint  Chlorine  odor,  and  alkaline  taste  and  reaction  ;  prepared  by  add¬ 
ing  together  watery  solutions  of  Sodium  Carbonate  100  parts  and  Calx  Chlorata  80,  each 
in  400  parts  of  water,  then  adding  Water  up  to  1000.  Contains  Sodium  Hypochlorite 
and  Chloride.  Dose,  rr^x-^j  in  20  parts  of  water. 

Physiological  Action. 

Chlorine  is  actively  irritant  to  the  skin  and  mucous  membranes.  Locally 
applied  it  produces  heat,  burning  and  even  vesication.  Inhaled  in  any 


CHLORUM. 


173 


quantity  it  causes  cough,  sneezing  and  spasm  of  the  glottis,  also  inflam¬ 
mation  of  the  air-passages  and  of  the  lungs.  It  is  the  most  powerful  of 
all  disinfectants  and  deodorants,  also  an  antiseptic  and  antifermentative 
agent  of  the  highest  activity.  Its  power  in  all  these  respects  is  due  to  its 
affinity  for  hydrogen,  decomposing  all  bodies  in  which  hydrogen  enters 
as  a  molecular  constituent,  forming  chlorhydric  acid  and  setting  oxygen 
free  in  its  nascent  form  (ozone).  Used  internally  it  has  the  same  local 
action  on  the  parts  with  which  it  comes  in  contact,  and  on  reaching  the 
stomach  in  dilute  solution  it  is  converted  into  hydrochloric  acid  and 
chlorides,  losing  all  further  action  on  the  body  in  its  own  character. 

A  ntidotes . 

Ammoniacal  vapors  inhaled  after  Chlorine  from  Ammonium  Chloride.  Ammonium 
Sulphide  has  a  similar  reaction,  but  should  be  inhaled  in  great  moderation.  Albumen  is 
the  antidote  if  Chlorine  preparations  have  been  taken  into  the  stomach,  and  a  little  Aqua 
Ammoniae,  sufficiently  diluted,  may  also  be  administered  with  advantage. 


Therapeutics. 

The  chlorinated  preparations  are  used  as  disinfectants  and  deodorizers 
of  rooms,  drains  and  discharges  from  the  body.  They  are  rarely  used 
about  the  person  or  clothing  of  patients  by  reason  of  the  irritation  pro¬ 
duced  by  them  when  inhaled,  and  their  power  to  destroy  the  color  of 
fabrics.  In  dilute  solution  they  are  well  employed  as  local  applications 
in  aphthae,  gangrene,  scarlet  fever  and  diphtheria,  in  which  their  principal 
action  is  to  destroy  fetor.  The  same  may  be  said  of  their  use  in  sloughing 
ulcers  and  gangrenous  wounds,  foul  discharges,  etc.,  as  they  are  rarely 
employed  about  the  person  in  sufficient  strength  to  have  any  destructive 
effect  on  disease-germs.  A  strong  solution  of  Chlorinated  Soda  is  a  good 
application  to  bites  of  serpents  and  insects,  to  prevent  infection  by  the 
syphilitic  poison,  and  to  wash  the  hands  after  contact  with  infectious 
material. 

A  combination  of  Potassium  Chlorate  and  Tinctura  Ferri  Chloridi, 
makes  a  solution  of  Chlorine,  Euchlorine,  Potassum  Chloride  and  Ferric 
Chloride,  when  diluted  with  water,  and  gives  one  of  the  best  and  most 
innocuous  solutions  of  antiseptics.  It  makes  an  excellent  gargle  for  sore 
throats,  simple  or  diphtheritic.  Glycerin  should  never  be  added  to  it,  as 
the  resulting  mixture  will  be  liable  to  explode  violently. 

These  preparations  have  been  administered  internally  in  septic 
diseases,  low  fevers,  etc.,  but  without  producing  any  marked  bene¬ 
ficial  results. 

To  disinfect  unoccupied  rooms  all  means  of  exit  should  be  stopped  up, 
then  a  pound  of  Chlorinated  Lime  sewed  loosely  in  a  strong  canvas  bag 
is  immersed  in  a  mixture  of  a  pint  and  a  half  of  common  muriatic  acid 
with  4 y2  pints  of  water,  and  left  24  hours. 


174 


CHONDRUS — CHRYSAROBINUM - CIMICIFUGA. 


CHONDRUS,  Irish  M  oss, — consists  of  two  sea-algse,  Chondrus 
crispus  and  Chondrus  mammilosus ,  dried  and  bleached.  Is  horny,  trans¬ 
lucent,  pale  yellowish-white,  swelling  in  water,  of  sea-weed  odor  and 
mucilaginous,  saline  taste.  On  boiling  with  30  parts  of  water  for  ten 
minutes  it  yields  a  solution  which  gelatinizes  on  cooling.  It  contains  90 
per  cent,  of  mucilage  with  traces  of  Iodine  and  Bromine,  also  1  per  cent, 
of  Nitrogen.  There  are  no  official  preparations.  A  jelly  or  blanc  mange 
may  be  prepared  by  boiling  S’j  in  Sxxxiv  of  water  for  an  hour,  straining 
and  adding  %\\]  of  sugar  while  hot.  Dose,  indefinite. 

Physiological  Action  and  Therapeutics. 

Irish  Moss  is  a  demulcent  and  nutrient  substance  of  some  slight  value 
in  bronchial  and  catarrhal  affections.  Having  no  starch  in  its  composi¬ 
tion  it  is  not  so  valuable  as  Iceland  moss  (Cetraria)  as  an  article  of  food 
for  the  sick. 

CHRYSAROBINUM,  Chrysarobin,  — is  a  mixture  of  proximate 
principles  extracted  from  Goa-powder ,  a  substance  found  in  cavities 
formed  by  decay  in  the  wood  of  the  trunk  of  Andira  Araroba ,  a  Brazil¬ 
ian  tree  of  the  nat.  ord.  Leguminosse.  It  is  commonly  misnamed 
“  Chrysophanic  Acid”  (which  is  one  of  the  constituents  of  Rheum) — 
though  easily  converted  into  that  substance.  Occurs  as  an  orange-yellow 
powder,  odorless  and  tasteless,  nearly  insoluble  in  water  and  alcohol,  but 
readily  soluble  in  ether,  solutions  of  alkalies  and  sulphuric  acid.  Dose, 
gr.  xx. 

Preparation. 

Unguentum  Chrysarobini, — Chrysarobin  10,  Benzoinated  Lard  90  parts.  Should  be 
diluted  for  average  use  from  3  to  5  times. 

Physiological  Action  and  Therapeutics. 

In  20-grain  doses  Chrysarobin  is  a  gastro-intestinal  irritant,  producing 
large,  watery,  bilious  stools,  with  repeated  vomiting  but  not  much  nausea. 
Locally  it  produces  diffuse  dermatitis  often  followed  by  follicular  and  fu¬ 
runcular  inflammation.  It  stains  the  skin  a  dark  yellowish-brown  color, 
which  may  be  removed  by  a  weak  solution  of  chlorinated  lime.  The  use 
of  this  remedy  is  confined  to  superficial  parasitic  skin  diseases  of  vegeta¬ 
ble  origin,  and  for  psoriasis,  in  the  latter  affection  it  being  the  best 
remedy  known.  It  may  be  used  in  weak  ointment  locally,  and  internally 
in  yi -grain  doses. 

% 

CIMICIFUGA,  Black  Snake-root,  Black  Cohosh, — is  the 

rhizome  and  rootlets  of  Cimicifuga  racemosa,  a  plant  of  the  nat.  ord. 
Ranunculacese,  native  in  the  United  States.  Rhizome  horizontal,  2 


CIMICIFUGA. 


175 


inches  long  or  more,  about  1  inch  thick,  with  numerous  upright  , or  curved 
branches.  Rootlets  numerous,  containing  a  ligneous  cord  which  branches 
into  four  or  five  rays.  Contains  a  Volatile  Oil  when  fresh,  resin,  tannic 
and  gallic  acids,  also  an  acrid,  crystallizable,  neutral  principle.  Cimi- 
cifugin  or  Macrotin  is  an  impure  resin  obtained  by  precipitation  from  a 
concentrated  tincture  by  the  addition  of  water.  The  active  principle  has 
not  been  isolated. 

Preparations  of  the  Fresh  Root. 

Extraction  Cimicifugce  Fluidum , — alcoholic.  Dose,  TTpv-xxx. 

Tinctura  Cimicifugce , — 20  per  cent.  Dose,  nyxv-  3  j. 

Macrotin  (Unofficial), — Dose,  gr.  j^-ij. 

Physiological  Action. 

Cimicifuga  is  stomachic,  antispasmodic,  aphrodisiac,  diaphoretic,  diu¬ 
retic  and  expectorant.  Its  taste  is  bitter  and  nauseous,  resembling  that 
of  Opium.  It  acts  on  the  heart  and  circulation  similarly  to  Digitalis,  and 
on  unstriped  muscular  fibre  like  Ergot,  but  is  much  feebler  in  activity 
than  either  of  these  agents.  Small  doses  stimulate  digestion  and  secre¬ 
tion,  the  generative  function  and  the  menstrual  flow,  and  especially  the 
secretions  of  the  bronchial  mucous  membrane  and  the  kidneys.  Full 
doses  slow  the  heart  while  increasing  its  force,  raise  arterial  tension  and 
stimulate  uterine  contraction.  Large  doses  dilate  the  pupils  and  produce 
dimness  of  vision,  vertigo,  intense  headache,  nausea,  vomiting,  and  in 
some  persons  soporific  and  anodyne  effects. 

Therapeutics. 

Cimicifuga  closely  resembles  Digitalis  in  action,  but  it  is  safer,  and 
should  be  more  frequently  used  when  the  latter  drug  is  indicated.  In 
cardiac  diseases  it  is  very  efficient,  especially  in  weak  or  fatty  heart  where 
Digitalis  would  be  dangerous.  It  is  a  good  stomachic  tonic  particularly 
in  the  irritable  dyspepsia  of  alcoholism.  As  an  expectorant  it  is  used  in 
acute  and  chronic  bronchitis.  It  is  a  good  nerve-tonic  in  delirium  tre¬ 
mens,  and  in  functional  impotence  it  is  remarkably  efficient.  In  rheuma¬ 
tism  of  the  localized  muscular  variety,  as  lumbago,  torticollis,  pleuro¬ 
dynia,  intercostal  rheumatism,  etc.,  it  is  one  of  the  most  efficacious 
remedies,  having  a  strong  affinity  for  the  muscular  system.  Neuralgias  of 
various  kinds  are  benefited  by  it,  particularly  ovarian  neuralgia.  Chorea 
about  the  age  of  puberty  is  one  of  the  affections  in  which  it  is  most  effi¬ 
cient,  and  the  same  may  be  said  of  the  hysterical  form  of  this  disease. 

Many  uterine  disorders  are  remarkably  benefited  by  Cimicifuga,  such 
as  amenorrhcea,  neuralgic  and  congestive  dysmenorrhcea,  subinvolution, 
spinal  irritation  due  to  some  obscure  sympathetic  or  neuralgic  affection 
of  the  womb,  sympathetic  pains  and  neuralgise  arising  from  the  so-called 
irritable  womb,  passive  menorrhagia,  etc.  In  obstetrics  it  gives  excel- 


176  CINCHONA. 

lent  results  when  used  to  initiate  uterine  contractions,  check  hemorrhage, 
allay  afterpains  and  nervousness  after  delivery.  In  puerperal  mania  and 
peritonitis  its  good  effects  are  frequently  remarkable,  and  in  puerperal 
hypochondriasis  it  is  strongly  recommended  by  very  high  authority. 

CINCHONA,  Peruvian  Bark  . — The  Cinchona  tree  belongs  to 
the  nat.  ord.  Rubiaceae  and  is  a  native  of  the  eastern  slope  of  the  Andes, 
but  has  been  largely  planted  in  India,  Ceylon,  Java  and  Burmah,  with 
the  result  of  improving  the  quinine-yielding  value  of  many  species  by 
cultivation.  In  late  years  the  test  of  appearance  has  given  way  to  that  of 
assay  in  judging  of  the  various  barks  of  commerce,  and  only  those  are 
official  which  yield  3  per  cent,  of  total  alkaloids  of  which  at  least  2  per 
cent,  must  be  Quinine.  Yellow  bark  contains  most  Quinine  (as  high  as 
9  per  cent,  having  been  obtained  from  one  specimen),  pale  bark  contains 
most  Cinchonine  and  least  Quinine,  while  red  bark  contains  these  alka¬ 
loids  in  about  equal  proportions.  The  Columbian  varieties  afford  the 
largest  percentage  of  Cinchonidine. 

The  principal  varieties  of  the  sub-order  Cinchoneae,  the  barks  of 
which  are  found  in  commerce  and  used  by  manufacturers  of  the  alka¬ 
loids,  are — 

Cinchona  Calisaya ,  Yellow  Bark, — from  Peru,  Bolivia  and  India. 

Cinchona  Succirnba,  Red  Bark, — from  Ecuador,  Java  and  Ceylon. 

Cinchona  Condaitiinea ,  Pale  Bark, — from  Ecuador  and  Peru. 

Cinchona  Pitayensis ,  Pitaya  Bark, — from  New  Granada. 

Cinchona  Micrantha ,  Gray  Bark, — from  Peru  and  Bolivia. 

Altogether  there  are  some  31  species  acknowledged  by  botanists,  and 
the  list  is  constantly  increasing  from  the  tendency  of  the  different  trees 
to  hybridize.  Several  trees  formerly  acknowledged  as  Cinchonas  are  now 
placed  in  the  genus  Cascarilla,  but  their  barks  are  to  be  found  on  the 
market.  Cuprea  bark  is  from  trees  of  the  genus  Remijia,  growing  in 
Columbia ;  it  contains  Quinine  and  a  peculiar  alkaloid,  Cinchonamine , 
but  no  Cinchonidine. 

Official  Species. 

Cinchona, — is  the  bark  of  any  species  of  Cinchona  which  contains  at 
least  3  per  cent,  of  its  peculiar  alkaloids,  as  determined  by  assay  accord¬ 
ing  to  a  prescribed  rule. 

Cinchona  Flava ,  Yellow  Cinchona,  Calisaya  Bark, — is  the  bark  of  Cinchona  Calisaya , 
containing  at  least  2  per  cent,  of  quinine.  Occurs  in  tawny-yellow  flat  pieces  or  quills, 
ridged  exteriorly,  finely  striated  on  inner  surface,  breaking  with  a  transverse  fracture 
showing  numerous  rigid  fibres  in  bundles  or  radial  rows. 

Cinchona  Rubra ,  Red  Cinchona, — the  bark  of  C.  succirnba ,  containing  at  least  2  per 
cent,  of  Quinine.  Occurs  in  brown-red  quills  and  flat  pieces  of  various  sizes,  with  ridges 
and  warts  on  outer  surface,  coarsely  striated  on  inner  surface. 

Bark  may  be  administered  in  doses  of  gr.  x-^j,  but  it  is  never  used  now  in  substance, 
being  too  bulky  and  disagreeable. 


CINCHONA. 


1 77 


Composition  of  Cinchona. 

The  bark  contains  21  natural  alkaloids  (of  which  4  are  official),  8  arti¬ 
ficial  alkaloids,  2  simple  acids,  2  tannic  acids,  a  resinoid  and  coloring- 
matter,  as  follows : — 

* 

Quinine ,  C20H24N2O2, — a  strong  base,  fluorescent,  the  most  valuable  of  all  the  alka¬ 
loids;  heated  with  glycerin  to  3740  F.,  it  is  converted  into  the  isomeric  base  Qianicine. 

Quinidine ,  C20H24N2O2, — isomeric  with  Quinine,  fluorescent,  probably  the  most 
powerful  as  an  antiperiodic,  but  existing  in  very  small  quantity. 

Cinchonine ,  C20H24NzO, — the  least  active  of  the  official  four,  having  about  half  the 
therapeutic  power  of  Quinine.  Not  fluorescent. 

Cinchonidine ,  C20H24N2O, — isomeric  with  Cinchonine,  not  fluorescent,  one  of  the 
most  powerful  of  the  alkaloids. 

Kinic  and  Kinovic  Acids , — are  combined  in  the  bark  with  the  alkaloids.  The  former 
is  used  to  make  a  Kinate  of  Quinine,  and  the  latter  occurs  in  non-official  pharmacy  as 
Kinovate  of  Lime,  an  ingredient  in  Deloudre’s  Extract,  which  is  used  in  Europe  and 
India  for  dysentery. 

Kino-tannic  and  Kinovo-tannic  Acids, — give  to  bark  its  peculiar  and  powerful  astrin¬ 
gent  qualities.  They  have  not  been  fully  studied. 

Kinovin , — is  a  bitter,  amorphous  resinoid,  which  is  resolvable  into  Kinovic  Acid  and 
sugar.  It  is  soluble  in  alcohol,  but  not  in  water. 

Cinchona  Red, — a  reddish-brown,  insipid,  inodorous  substance. 

[The  other  alkaloids  are  of  no  interest  medicinally.] 

Preparations  of  the  Bark. 

Extradum  Cinchonce, — made  from  Yellow  Cinchona.  Dose,  gr.  j-v. 

Extr actum  Cinchonce  Fluidum , — from  Yellow  Cinchona,  Dose,  TT^x-  %  j . 

Tindura  Cinchonce , — Yellow  Cinchona,  strength  20  per  cent.  Dose,  ^ss-ij. 

Tinctura  Cinchonce  Composita , — made  from  Red  Cinchona,  strength  10  per  cent. 
Contains  Bitter  Orange-peel  8,  and  Serpentaria  2  per  cent.  Dose,  ^j-^ss. 

Infusum  Cinchonce , — made  from  any  official  bark.  Cinchona  6,  Aromatic  Sulphuric 
Acid  1,  Water  93  parts.  Is  the  only  official  infusion  containing  this  acid.  Dose,  gj-^  j  or 
more. 

Huxham' s  Tincture  of  Bark,  1788  (Unofficial), — is  still  used.  Red  Cinchona  5  iv, 
Orange  peel  ^  iij,  Serpentaria  gr.  lxxx,  Spanish  Saffron  gr.  clx,  Cochineal  gr.  lxxx,  Brandy 
3x1,  digested  for  4  days,  expressed  and  filtered.  Dose,  gss-ij. 

Quinine  and  its  Salts. 

Quinina,  Qjuinine,  C20H24N2O2.3H2O, — a  white,  amorphous  or  minutely  crystalline 
powder,  of  alkaline  reaction  and  very  bitter  taste,  soluble  in  1600  of  water  and  6  of  alcohol 
at  590  F.,  in  25  of  ether,  5  of  chloroform,  and  readily  in  dilute  acids.  Dose,  gr.  j-xx,  or 
xl  in  special  cases.  Is  insoluble  in  saliva. 

Quinines  Sulphas ,  Sulphate  of  Quinine  (C20H24N2O2)2.H2SO4.7H2O, — very  light, 
snow-white,  fragile  crystals,  of  very  bitter,  persistent  taste,  soluble  in  700  of  water  and  65 
of  alcohol  at  590  F.,  in  30  of  boiling  water,  3  of  boiling  alcohol,  also  in  acidulated  water. 
Dose,  gr.  j-xx,  or  even  gr.  xl  in  special  cases. 

Quinines  Bisulphas,  Bisulphate  of  Quinine,  C20H24N2O2.H2SO47lI2O, — clear,  color¬ 
less,  efflorescent  crystals  or  small  needles,  of  very  bitter  taste  and  strongly  acid  reaction, 
soluble  in  10  of  water  with  blue  efflorescence,  and  in  32  of  alcohol,  at  590  F.  Dose,  gr. 
j-xxx,  or  even  gr.  lx  in  special  cases. 

Quinines  Hydrobromas,  Hydrobromate  of  Quinine,  C20II24N2O2IIBr.2H2O, — color¬ 
less  needles,  of  very  bitter  taste,  soluble  in  16  of  water  and  in  3  of  alcohol  at  590  F.,  and  in 
I  of  boiling  water  or  alcohol.  Is  the  best  salt  for  hypodermic  use,  gj  of  water  dissolving 
gr.  iv,  which  may  be  injected  every  4  hours  without  causing  irritation.  Dose,  gr.  j-xx. 

Quinines  Hydrochloras,  Muriate  of  Quinine,  C2(jH24N„04HC1.2li20, — white  needles 
in  tufts,  of  very  bitter  taste,  soluble  in  34  of  water  and  3  of  alcohol  at  590  F.,  in  I  of  boil¬ 
ing  water  or  alcohol.  Is  used  hypodermically.  Dose,  gr.  j-xx.  An  excellent  salt  which 
should  be  more  generally  used;  5  to  10  gr.  doses  are  antipyretic. 

Quinines  Valerianas,  Valerianate  of  Quinine,  C20H24N2O2C5II 4  0O2.H2O, — white, 
pearly  crystals,  of  valerianic  odor  and  bitter  taste,  soluble  in  100  of  water  and  in  5  of 


12 


i7« 


CINCHONA. 


alcohol  at  590  F.  Dose,  gr.  j-iij.  It  is  the  only  salt  of  Quinine  supposed  to  be  affected 
by  the  constituent  acid. 

Quinince  Hydrochloras  Carbamidata ,  Carbamide  Hydrochlorate  of  Quinine  (Unofficial), 
— is  a  new  compound  salt  of  Quinine  and  Urea,  soluble  in  equal  parts  of  water  and  there¬ 
fore  admirably  adapted  for  hypodermic  administration  in  a  50  per  cent,  solution.  It  is 
almost  unirritating  to  the  tissues,  and  is  given  subcutaneously  in  doses  of  gr.  j-iij. 

Chininum  Amorphum  Boricum,  Amorphous  Borate  of  Quinine  (Unofficial), — is  a  new 
preparation,  soluble  in  an  equal  quantity  of  water,  and  claimed  by  its  introducers  to  be 
equally  as  satisfactory  as  any  other  Quinine  salt,  and  much  better  borne  by  the  stomach 
than  any  other  one.  It  is  also  said  to  cause  little  or  no  congestion  of  the  membrana  tym- 
pani. 

Tinctura  Pyrexialis,  Warburg’s  Tincture  (Unofficial), — is  a  celebrated  preparation, 
formerly  secret,  but  published  in  1875  by  the  originator,  whose  formula  is  as  follows: — 
fit  .  Aloes  soc.  ft  j  ;  Rad.  rhei  (chinens),  Sem.  angelicae,  Confec.  Damocratis,*  aa  3  iv  ; 
Rad.  helenii  (s.  enulae),  Croci  sativi,Sem.  foeniculi,  Cretae,  prep.,  aa  3  ij ;  Rad.  gentianae, 
Rad  zedoariae,  Pip.  cubebae,  Myrrhae  elect.,  Camphoroe,  Bolet.  laricis,  aa  3  j.  Digest  the 
whole  with  500  oz.  of  proof  spirit  in  a  water-bath  for  12  hours,  express,  add  sj  x  Bisul¬ 
phate  of  Quinine,  dissolve  by  aid  of  a  water-bath,  cool  and  filter.  Dose,  %j,  in  two 
doses  3  hours  apart.  Hager’s  modification  of  the  original  formula  is — fit.  Quininae  sulph. 
part,  j,  Spt.  camphorae  part,  ij,  Elix.  proprietatis  (Tinct.  aloes  et  myrrhae)  part,  xxij,  Alco- 
holis  part.  xvj.  The  evidence  published  in  favor  of  this  preparation  goes  to  show  that  its 
power  does  not  wholly  lie  in  the  quinine,  camphor,  aloes  or  rhubarb,  but  in  some  of  the 
aromatic  plants  contained  in  it. 

Other  Official  Alkaloids  and  their  Preparations. 

Cinchonina,  Cinchonine,  C20H24N2O, — white,  lustrous  prisms  or  needles,  of  bitter 
after-taste,  almost  insoluble  in  water,  readily  so  in  dilute  acids  and  no  of  alcohol  at  590 
F.  Dose,  gr.  j-xxx  or  more. 

Cinchonince  Sulphas,  Suphate  of  Cinchonine  (C2  0H2  4N20)  2H2S04.2H20, — white, 
shining  prisms,  of  very  bitter  taste,  soluble  in  70  of  water  and  in  6  of  alcohol  at  590  F., 
and  readily  soluble  in  dilute  acids.  Dose,  gr.  v-xxx  or  more. 

Cinchonidince  Sulphas ,  Sulphate  of  Cinchonidine  (C20H24N2O)2H2SO4.3H2O, — 
white,  silky  crystals,  of  bitter  taste,  soluble  in  100  of  water  and  in  71  of  alcohol  at  590 F., 
freely  soluble  in  acidulated  water.  Dose,  gr.  j-xx  or  more. 

Quinidince  Sulphas,  Sulphate  of  Quinidine  (C20H24N2O2)2H2SO4.2H2O, — white, 
silky  needles,  of  bitter  taste,  soluble  in  100  of  water  and  in  8  of  alcohol,  readily  in  acidu¬ 
lated  water,  at  59°F.  Dose,  gr.  j-xx  or  more.  It  is  not  so  bitter  as  Quinine,  is  less 
expensive,  and  is  a  valuable  antipyretic  and  antiperiodic. 

Chinoidinum,  Chinoidin,  Quinoidin, — a  mixture  of  alkaloids,  mostly  amorphous, 
obtained  as  a  by-product  in  the  manufacture  of  the  crystallizable  alkaloids  from  Cinchona. 
A  black  solid  when  cold,  plastic  when  warmed,  of  bitter  taste,  almost  insoluble  in  water, 
freely  soluble  in  alcohol  and  in  dilute  acids.  It  contains  the  4  alkaloids  in  amorphous 
condition,  and  has  about  x/2  the  therapeutic  power  of  Quinine.  Dose,  gr.  v-xxx  or  more. 

Non-  Official  Preparations. 

Quinquinina,  or  Quinetum , — is  an  Indian  preparation  containing  the  total  alkaloids 
extracted  from  bark  by  acidulated  water,  then  precipitated  by  soda  and  dried.  In  India 
it  is  called  “  febrifuge.” 

Cinchonidince  Salicylas,  Salicylate  of  Cinchonidine, — has  anti-malarial  power  only 
inferior  to  the  salts  of  Quinine. 

Substitutes  for  Quinine. 

The  synthetical  production  of  Quinine  has  been  the  “  philosopher’s 
stone”  of  the  modern  chemists,  who  have  prosecuted  with  untiring  energy 
the  search  for  an  artificial  product  possessing  all  its  properties.  Though 
in  this  they  have  as  yet  been  unsuccessful,  they  have  discovered  several 

*  For  the  formula  for  this  ingredient  see  the  article  on  Confections  in  the  section  on 
Extemporaneous  Pharmacy,  Part  II. 


CINCHONA. 


179 


organic  bodies,  which  closely  resemble  each  other  and  also  quinine,  both 
in  chemical  constitution  and  physiological  action.  These  substances 
belong  to  the  aromatic  series  of  carbon  compounds,  all  of  which  are  de¬ 
rivatives  of  Benzene  or  Benzol ,  C6H6,  the  Hydride  of  the  organic  radical 
Phenyl,  C6H5.  The  distinctive  action  of  the  lower  members  of  this  series 
is  their  antiseptic  and  antipyretic  powers,  — as  that  of  the  fatty  series  of 
carbon  compounds  is  stimulant  and  ancesthetic  (Brunton).  Many  of  these 
agents  are  obtained  from  coal-tar  oil  (petroleum)  by  fractional  distilla¬ 
tion,  etc., — and  they  are  all  derivatives  of  Benzene  (Benzol),  either 
directly  or  from  some  of  the  products  formed  therefrom,  by  substitution  ; 
various  radicals  replacing  the  different  constituent  atoms  of  H  and  C. 

Thus,  by  the  ring-arrangement  of  atoms  peculiar  to  this  series,  there  are  formed  from 
Benzene  (C6H6),  the  following  substances,  viz. — 

Phenol ,  or  Carbolic  Acid ,  C6H5OH — by  replacing  H  by  OH,  (hydroxyl). 

Pyrocatechin ,  or  Ortho-  )  C6H4(OH)2. 

Rescorcin ,  or  Meta-  1-  di-hydroxy-benzene , — by  replacing  2H  by  2OH. 

Hydroquinone,  or  Para-  J  C6H4(OII)2. 

Pyrogallol,  Pyrogallic  Acid,  Tri-hydroxybenzene,  C6H3(OH)3, — 3H  by  3OH. 

Amido-benzene,  or  Anilin,  C6H5.NH2 — by  replacing  H  by  NH2  (amidogen.) 

Nitro-benzene ,  C6H5.N02 — by  replacing  H  by  N02  (nitroxyl). 

Benzoic  Acid,  C6H5CO.OH — by  replacing  H  by  CO. OH  (carboxyl). 

Salicylic  Acid,  HC7H503 — by  replacing  2H  by  OH  and  CO. OH. 

Naphthaline,  C10Hg — by  uniting  two  Benzines  in  an  over-lapping  ring. 

Pyridine ,  C5H5N — by  replacing  tetrad  C  by  triad  N. 

Chinoline,  C9H7N — uniting  Benzene  (C6H6)  and  Pyridine  (C5H5N). 

Derived  from  Chinoline  is  the  hypothetical  base. 

Chinicine  or  Quinicine,  C9H9N2, — represented  in  Antipyrine. 

Also  Kairine ,  Thalline,  and  other  compounds. 


The  most  important  of  these  are  Antipyrine,  Acetanilide,  Resorcin, 
Chinoline  and  Naphthaline,  which  are  respectively  described  in  separate 
articles.  Others  of  the  same  class  are  the  following,  viz. — 

Some  Unofficial  Antipyretics. 

Kairina,  Kairine  (Hydrochlorate  of  Oxy-ethyl-chinoline-hydride),  Cx 0HX  3NO.HCl. 
H20, — is  an  artificial  alkaloid  prepared  from  Chinoline,  belonging  to  the  phenol  group 
of  carbon  compounds,  and  a  powerful  antipyretic  in  8-grain  doses  hourly.  It  stains  the 
urine  a  deep  green,  and  has  not  proven  fatal  though  220  doses  have  been  administered  in 
one  case.  In  some  cases  of  typhus  it  has  caused  cyanosis  and  collapse.  It  produces 
profuse  sweating  and  vomiting,  and  the  subsequent  rise  of  temperature  after  its  antipyretic 
influence  has  worn  off  is  generally  ushered  in  by  a  severe  rigor.  It  is  by  many  authorities 
considered  to  be  the  most  certain,  most  powerful  and  most  rapid  antipyretic  drug  we 
possess,  though  this  claim  is  now  disputed  by  the  advocates  of  Antipyrine.  It  occurs  in 
white  crystals,  which  are  freely  soluble  in  water,  but  is  best  given  in  wafer-paper  or  cap¬ 
sules.  Dose,  gr.  iij-xxx. 

Kairolina,  Kairoline  (Sulphate  of  Tetra-hydromethyl-chinoline), — is  antipyretic,  but 
much  less  efficient  than  Kairine. 

Thalline  (Parachinanisols), — is  a  synthetically  prepared  alkaloid,  having  the  chemical 
name  Tetra-hydro-paramethyl-oxy-chinoline.  It  occurs  as  a  colorless  powder,  which  is 
soluble  in  water,  and  enters  into  combination  with  acids,  forming  salts,  of  which  the 
tartrate  and  sulphate  are  the  most  eligible,  especially  the  latter.  The  dose  of  Thalline  or 
its  Sulphate  ranges  from  gr.  ij  to  gr.  xv,  a  mean  average  dose  being  about  5  grains,  given 
in  the  form  of  compressed  tablets.  Thalline  is  an  antipyretic  of  very  great  power,  doses 
of  5  to  12  grains  lowering  the  temperature  in  typhoid  fever  40  to  50,  in  2  hours’  time,  the 
effect  lasting  nearly  3  hours.  In  tuberculosis  similar  results  were  obtained.  Large  doses, 


i8o 


CINCHONA. 


however,  produce  very  profuse  sweating  and  a  dangerous  degree  of  depression  ;  so  that 
this  agent  is  not  a  favorite  remedy  for  hyperpyrexia. 

Hydroquinone  (Para-di-hydroxy-benzene)  C6H4(OH)2, — is  isomeric  with  Resorcin 
(see  ante ,  page  179).  It  crystallizes  in  rhombic,  colorless  prisms  which  are  slightly 
soluble  in  water,  readily  so  in  alcohol  and  in  ether,  and  is  obtained  from  Arbutin ,  a  glu- 
coside  constituent  of  Uva  Ursi  and  other  Ericaceae.  It  is  an  efficient  antipyretic,  without 
injurious  effects  so  far  as  observed,  but  its  influence  is  only  temporary.  The  action  of 
this  drug  on  animals  is  summarized  in  the  N.  Y.  Medical  Record  for  August  15th,  1885, 
and  its  influence  on  pyrexia  elucidated  in  the  same  journal  for  May  30th,  1885.  Dose,  as 
an  antipyretic,  gr.  xv-xx,  best  given  in  alcohol.  Gr.  xl  have  been  given  without  disagree¬ 
able  effects. 

Pyrocatechin ,  Catechol  (Ortho-di  hydroxy-benzene),  C6H4(OH)2, — is  also  isomeric 
with  Resorcin,  and  is  one  of  the  acid  constituents  of  coal-tar,  also  obtained  from  wood-tar 
and  from  kinic  acid.  It  is  a  good  antipyretic,  but  much  inferior  to  Quinine  or  Rescorcin. 

Phenacetine  (Para-Acetphenetidine), — a  white  and  glossy,  crystalline  powder,  in  chem¬ 
ical  constituent  analogous  to  Acetanilide.  It  is  tasteless,  and  but  slightly  soluble  in 
water,  more  so  in  glycerin,  and  still  more  so  in  alcohol  and  in  lactic  acid.  It  is  a  very 
efficient  antipyretic  and  antineuralgic,  with  no  disagreeable  after  effects.  The  dose  is 
about  one-half  that  of  Antipyrine,  or  gr.  x-xx. 

Pheno-resorcin , — is  a  mixture  of  Carbolic  Acid  67  with  Resorcin  33  and  Water  10, 
forming  a  liquid  which  mixes  readily  with  water.  It  is  supposed  to  combine  the  virtues 
of  both  its  ingredients. 

Physiological  Action. 

The  action  of  Cinchona  in  sufficient  dose  is  generally  that  of  its  alka¬ 
loid  Quinine,  except  that  bark  is  decidedly  astringent,  more  of  a  gastric 
irritant,  and  by  reason  of  its  bulk  its  active  principles  are  more  slowly 
absorbed.  In  large  doses  (oij)  the  powdered  bark  has  produced  flatu¬ 
lence  and  eructation,  and  in  many  well-authenticated  instances  has  pro¬ 
duced  a  well-marked  febrile  paroxysm,  beginning  with  chill,  then  fever 
and  headache,  which  gradually  subsided  in  slight  perspiration.  So  also, 
Quinine,  while  incapable  of  producing  intermittent  fever  in  a  healthy 
person,  will,  if  taken  in  large  doses  unnecessarily,  throw  the  nervous 
system  into  high  commotion,  and  if  untimely  used  by  a  malarial  subject 
may  reproduce  the  paroxysm  with  greater  or  less  severity. 

Cinchona  is  an  astringent  bitter  and  a  stomachic  tonic.  At  first  it 
promotes  appetite,  digestion,  the  flow  of  saliva  and  of  gastric  juice ;  long- 
continued  it  sets  up  a  gastric  catarrh,  impeding  digestion  and  causing 
constipation. 

Quinine  is  a  bitter  tonic,  antiseptic,  antiperiodic,  antimiasmatic  and 
antipyretic,  a  diminisher  of  reflex  action,  a  protoplasmic  poison,  a  cardiac 
depressant  and  perhaps  an  oxytocic.  It  is  rapidly  diffused  and  slowly  ex¬ 
creted,  being  found  in  the  urine  in  15  minutes  after  its  administration  and 
for  two  or  three  days  afterwards.  Its  action  on  the  stomach  is  similar  to 
that  of  cinchona.  It  arrests  the  movements  of  the  white  blood-corpus¬ 
cles  though  increasing  their  number,  and  prevents  acetification  and  decay 
of  the  blood.  It  is  actively  destructive  of  lowly  organized  life,  a  solution 
of  1  to  500  being  fatal  to  infusoria  and  fungi,  while  one  of  double  this 
strength  prevents  alcoholic  fermentation  and  checks  putrefactive  decom¬ 
position.  The  heart  and  arterial  tension  are  somewhat  stimulated  by 
small  doses,  but  depressed  by  large  ones  (gr.  xl-lxxx),  which  slow  and 


CINCHONA. 


1 8 1 


enfeeble  the  pulse  by  direct  action  on  the  cardiac  ganglia.  The  brain  is 
rendered  hypersemic  and  exhilarated  by  small  or  moderate  doses,  but 
large  ones  produce  a  sense  of  fulness  and  constriction  in  the  head,  cere¬ 
bral  anaemia,  pallor,  tinnitus  aurium,  vertigo,  staggering  gait,  amaurosis 
and  deafness,  great  headache,  dilated  pupils,  delirium,  coma,  and  in  ani¬ 
mals  convulsions.  The  eyes  and  ears  are  very  rarely  injured  permanently. 
These  symptoms  collectively  are  termed  Cinchonism.  It  reduces  the  size 
of  the  spleen  when  enlarged,  and  lowers  the  temperature  of  pyrexia, 
though  it  does  not  depress  the  body  temperature  in  health.  Large  doses 
lower  the  reflex  function  of  the  spinal  cord.  In  some  subjects  it  produces 
sexual  excitement,  in  others  cutaneous  eruptions  sometimes  followed  by 
desquamation.  It  lessens  the  excretion  of  uric  acid,  but  not  that  of  urea, 
and  is  a  uterine  stimulant  in  labor,  but  its  power  to  initiate  uterine  con¬ 
tractions  is  a  much  debated  question. 

Quinidine  and  Cinchonidine  correspond  in  action  with  Quinine  both 
qualitatively  and  quantitatively,  the  latter  however  producing  less  severe 
head  symptoms. 

Cinchonine  also  corresponds  in  effect,  but  is  much  the  least  active  of 
the  four  alkaloids.  It  is  said  to  produce  greater  headache,  and  much  pre¬ 
cordial  pain  and  muscular  weakness,  but  to  have  little  effect  on  sight  or 
hearing. 

Antagonists  and  Incompatibles. 

Horpiiin>e  antagonizes  its  cerebral  action.  Atropine  its  nervous,  cardiac  and  antipyretic 
powers.  Free  Tannic  Acid  is  incompatible  with  the  Infusion  of  Cinchona.  Iodine 
preparations,  Alkalies,  Alkaline  Carbonates  and  Earths,  are  incompatible  with  solutions  of 
the  alkaloids,  the  first-named  forming  insoluble  compounds,  the  latter  precipitating  them. 

Therapeutics. 

Cinchona  is  used  as  a  tonic  and  has  many  applications.  The  Infusion 
or  Compound  Tincture  with  a  mineral  acid  is  extremely  serviceable  in 
atonic  dyspepsia,  gastric  catarrh  of  alcoholics,  adynamia,  convalescence, 
asthma,  chronic  bronchitis,  and  generally  in  weak  subjects  of  flabby  flesh 
and  perspiring  skin. 

Quinine  finds  its  principal  field  of  action  in  the  malarial  diseases,  over 
which  its  power  is  that  of  a  specific.  In  intermittents,  a  ten-grain  dose 
of  the  sulphate  should  be  given  in  the  sweating  stage  and  again  5  hours 
before  the  expected  time  of  the  next  paroxysm.  In  the  intervals  Arsenic 
is  better  used,  as  Quinine  will  cause  a  daily  exacerbation  of  temperature 
if  long  continued.  In  remittents  20-  to  30-grain  doses  should  be  admin¬ 
istered  once  or  twice  a  day  until  the  temperature  is  reduced  to  the  normal 
point.  In  pernicious  remittents  large  doses  (gr.  xxx  to  lx)  are  necessary 
to  the  safety  of  the  patient.  In  chronic  malarial  poisoning  Quinine  has 
considerable  power,  but  Chinoidin  is  more  effective.  Small  doses  of 
Quinine  (gr.  ij-iij  per  diem)  are  efficient  as  a  prophylactic  against 
malaria. 


182 


CINNAMOMUM. 


As  an  antipyretic  Quinine  is  used  with  the  best  results,  especially  in 
typhus,  typhoid,  variola,  pneumonia  and  acute  rheumatism.  Inflamma¬ 
tions  may,  at  their  inception,  be  aborted  by  15-  or  20-grain  doses,  com¬ 
bined  with  Morphine,  which  in  this  respect  is  synergistic  to  Quinine. 
Acute  tonsillitis  and  acute  catarrh  may  sometimes  be  aborted  by  a  full 
dose.  In  surgical  fevers,  pyaemia  and  exhausting  suppurative  conditions, 
also  in  septicaemia,  hectic  fever,  and  before  surgical  operations,  Quinine 
is  much  employed.  Neuralgias  of  malarial  origin  are  amenable  to  it,  as 
also  neuralgia  of  the  ophthalmic  division  of  the  fifth  nerve.  In  eruptive 
fevers,  especially  scarlet  fevers,  erysipelas  and  measles,  it  is  advantageously 
administered  throughout  their  course.  In  some  skin  diseases,  particularly 
erythema  nodosum,  it  is  quite  efficient,  also  in  whooping-cough  and  hay- 
fever.  In  the  latter  affection  a  solution  of  gr.  vj  to  the  S  of  the  neutral 
hydrochlorate  is  a  very  useful  local  application. 

Antipyresis  has  of  late  received  considerable  attention,  particularly  in 
the  German  hospitals.  The  most  certain  and  safe  of  all  antipyretics  is 
undoubtedly  the  cold  bath,  but  it  is  not  always  the  most  practicable, 
especially  in  private  practice.  Internal  antipyretics  are  therefore  of  great 
value,  and  of  these  the  safest  and  best  is  Quinine,  next  in  order  being 
Antipyrine. 

Warburg’s  Tincture  has  obtained  a  very  high  reputation  in  the 
hands  of  Indian  army-surgeons  in  the  treatment  of  remittent  and  other 
malarial  fevers  of  the  most  malignant  types,  in  malarial  neuralgiae,  acute 
nervous  exhaustion  and  sudden  collapse  without  organic  disease.  The 
most  pronounced  testimony  to  its  value  is  that  of  Dr.  Maclean  (. Med .  Ti?nes 
and  Gazette ,  Nov.,  1875),  whose  authority  will  not  be  questioned  by  the 
most  captious.  He  affirms  that  the  influence  of  this  combination  to  arrest 
an  exacerbation  of  remittent  fever  is  far  more  powerful  than  that  of  Qui¬ 
nine  alone.  The  remedy  has  become  much  less  of  a  favorite  since  its 
originator  was  induced  to  make  public  the  secret  of  its  composition. 


A  dministration. 

The  persistently  bitter  taste  of  Quinine  and  its  salts  is  best  obviated  by  administering 
them  in  pill  form,  made  with  glycerin  as  an  excipient,  or  by  using  Liquorice,  Eriodyction 
or  Chocolate  to  cover  the  taste  if  given  in  solution  or  powder.  The  taste  is  extremely 
well  covered  by  using  as  a  vehicle  a  combination  of  Glycyrrhizin  and  Fluid  Extract  of 
Eriodyction,  named  “  Veloutine but  the  Quinine  must  be  suspended  therein  by  the  aid 
of  mucilage,  as  when  an  acid  is  used  to  dissolve  it  the  bitter  taste  cannot  be  disguised. 

For  hypodermic  use  the  best  salt  is  the  Hydrobromate,  it  being  the  most  soluble, — 
gr.  xij  in  of  distilled  water  gives  gr.  j  in  Ttpv.  The  Carbamide  Hydrochlorate  is 
coming  into  favor  for  hypodermic  administration  by  reason  of  its  solubility  and  freedom 
from  irritating  qualities. 


CINNAMOMUM,  Cinnamon,  — is  the  inner  bark  of  the  shoots 
of  Cinnamomum  Zeylanicum  (Ceylon),  or  the  bark  of  the  shoots  of  sev¬ 
eral  species  of  Cinnamomum  (nat.  ord.  Lauraceae)  grown  in  China 


coccus. 


183 


(Cassia  Bark).  The  former  occurs  in  light,  yellowish-brown  quills,  con¬ 
sisting  of  several  pieces  rolled  together,  each  very  thin,  while  the  Chinese 
variety  comes  in  single  quills  of  irregular  form  and  rougher  texture.  The 
taste  is  warm  and  aromatic,  and  the  odor  very  fragrant.  The  active  prin¬ 
ciple  is  a  Volatile  Oil ,  and  it  also  contains  a  resin,  tannic  and  cinnamic 
acids.  Dose,  gr.  x-xx. 

Preparations. 

Oleum  Cinnamomi , — is  the  volatile  oil,  a  yellowish-colored  liquid  of  sp.  gr.  1. 040  to 
I.060,  becomes  dark  by  age,  of  slightly  acid  reaction.  The  oil  of  Chinese  Cinnamon  is 
not  so  agreeable  in  odor  or  taste.  Dose,  gtt.  j-v. 

Aqua  Cinnamomi,  Cinnamon-Water, — has  of  the  oil  2  parts  in  1000,  percolated  through 
cotton.  Dose,  indefinite. 

Spiritus  Cinnamomi , — contains  10  per  cent,  of  the  oil.  Dose,  npv-xxx. 

Tinctura  Cinnamomi ,  contains  10  per  cent,  of  the  powdered  bark.  Dose,  gss-ij. 

Pulvis  Arojnaticus,  Aromatic  Powder, — Cinnamon  35,  Ginger  35,  Cardamom  15, 
Nutmeg  15,  rubbed  together  in  fine  powder.  Dose,  gr.  x-xxx. 

Extraction  Aromaticum  Fluidum , — has  of  Aromatic  Powder  100  grammes,  Alcohol 
q.  s.  ad  100  cubic  centimeters.  Dose,  rtqx-xxx. 

Cinnamon  is  an  agreeable  carminative,  somewhat  astringent  and  stimu¬ 
lant,  also  highly  aromatic  and  antiseptic.  The  oil  is  not  astringent  but 
is  a  pleasant  stimulant  to  the  nervous  and  vascular  systems,  and  is  by  some 
believed  to  exercise  a  specific  action  on  the  uterus,  particularly  as  a 
hemostatic. 

The  various  preparations  are  in  general  use  as  flavoring  excipients,  and 
the  aqua  is  a  pleasant  vehicle  for  extemporaneous  prescriptions.  The 
bark  and  its  preparations  are  used  to  check  diarrhoea  in  combination  with 
opium,  chalk,  or  some  vegetable  infusion.  The  oil  is  a  good  stimulant 
in  flatulence,  paralysis  of  the  tongue,  cramp  of  the  stomach,  enteralgia, 
etc.,  and  is  sometimes  used  to  check  nausea  and  vomiting.  Cinnamon 
was  formerly  used  with  success  in  uterine  hemorrhage,  generally  in  com¬ 
bination  with  sulphuric  acid,  which  of  itself  is  an  efficient  uterine  hemo¬ 
static.  It  has  lately  been  employed  in  France  as  an  internal  germicide, 
with  great  satisfaction;  and  has  given  particularly  good  results  in  the 
treatment  of  typhoid  fever,  against  the  supposed  bacillus  of  which  disease 
it  is  believed,  by  its  advocates,  to  have  specific  and  destructive  powers. 

COCCUS,  Cochineal  , — is  the  dried  female  of  Coccus  cacti ,  an 
insect  of  the  order  Hemiptera,  which  feeds  on  the  cactus  plants  of  Mexico 
and  Central  America.  Occurs  in  ovate,  plano-convex  form,  of  a  purple- 
gray  or  purple-black  color,  yielding  when  crushed  a  dark-red  powder, 
which  contains  Carminic  Acid ,  or  Carmine ,  the  red  coloring-matter, 
which  is  soluble  in  water  and  alcohol,  but  not  in  oils.  Cochineal  is  an 
ingredient  of  Tinctura  Cardamomi  Composita,  and  is  used  in  pharmacy 
solely  as  a  coloring  material. 

The  only  therapeutic  use  of  Cochineal  is  in  whooping-cough  and  neu¬ 
ralgia,  in  which  affections  it  is  supposed  to  have  considerable  influence, 
especially  in  the  former.  Its  dose  to  an  infant  is  about  gr.  thrice  d  /. 


184 


COLCHICUM. 


COLCHICUM,  Meadow  Saffron, — is  the  corm  and  seed  of  the 
Colchicum  autumnale ,  a  European  plant  of  the  nat.  ord.  Melanthaceae. 
It  contains  an  intensely  bitter,  poisonous  alkaloid,  Colchicine ,  Ci7H19N05, 
which  by  the  action  of  acetic  and  mineral  acids  is  converted  into  Col- 
chiceme  and  a  resin, — also  tannic  and  gallic  acids,  resin,  starch,  sugar, 
etc.  It  is  official  in  two  forms,  namely — 

Colchici  Radix,  Colchicum  Root, — the  corm,  about  1  inch  long, 
white  internally,  grooved  on  one  side,  inodorous,  taste  sweetish,  bitter 
and  acrid.  Is  less  active  than  the  seed.  Dose,  gr.  ij-viij.  Contains  of 
Colchicine,  0.45  per  1000. 

Colchici  Semen,  Colchicum  Seed, — about  inch  thick,  sub-globular, 
resembling  black  mustard  seed  but  larger,  very  hard  and  tough,  inodor¬ 
ous,  of  bitter  and  acrid  taste.  Dose,  gr.  j-v.  Contains  of  Colchicine, 
3.35  per  1000. 

Preparations. 

Extractum  Colchici  Radicis, — made  with  Acetic  Acid  35  parts  to  100  of  the  root,  and 
sufficient  water.  Dose,  gr.  *^-ij. 

Extractum  Colchici  Radicis  Fluidum , — Dose,  ITLij— x. 

Extractum  Colchici  Seminis  Fluidum , — Dose,  1T\j-v. 

Vinu?n  Colchici  Radicis, — strength  40  per  cent.  Dose,  rtpv-xv. 

Vinui?i  Colchici  Seminis, — strength  1 5  per  cent.  Dose,  Tryx-xxx. 

Tindura  Colchici. — from  the  seed,  strength  15  per  cent.  Dose,  rrpx-xxx. 

Colchicina,  Colchicine,  CnH19N05  (Unofficial), — a  white  or  yellowish,  amorphous 
powder,  of  saffron-like  odor  and  bitter  taste,  soluble  in  water  and  in  alcohol.  Dose,  gr. 

Is  suitable  for  hypodermic  injection. 

Laborde  and  Houde  condemn  all  preparations  made  with  acetic  acid,  also  those  made 
from  the  tubers  and  all  wines.  The  best  preparation  is  Colchicine,  in  granules  or  in  a 
wine ;  or  a  strong  tincture  made  from  fresh  seed  with  the  shell  on,  the  latter  containing  a 
very  volatile  but  active  oil.  Of  this  seed  to  ]/2  pint  of  highest  proof  alcohol,  standing 
for  2  weeks.  Of  this  3  v  to  water  q.  s.  ad  Ox/2,  of  which  the  dose  is  3  ss  every  4  hours 
night  and  day,  avoiding  acids,  until  nausea,  vomiting  and  purging  set  in. 


Physiological  Action. 

Colchicum  is  emetic,  diuretic  and  diaphoretic,  a  drastic  purgative,  a 
gastro-intestinal  irritant  and  a  cardiac  depressant.  In  small  doses  it  in¬ 
creases  secretion,  especially  the  urine  and  the  sweat.  In  full  doses  its 
action  is  emeto-cathartic,  producing  profuse  watery  discharges,  great 
nausea  and  extreme  muscular  feebleness.  In  large  doses  it  is  a  powerful 
irritant  of  the  gastro-intestinal  tract,  causing  severe  griping,  choleraic  dis¬ 
charges,  lowered  arterial  tension  and  depression  of  the  heart  by  reflex 
action  over  the  distribution  of  the  pneumogastric, — then  great  prostration, 
convulsions  and  collapse,  death  occurring  from  exhaustion,  with  con¬ 
sciousness  preserved  until  carbonic  acid  narcosis  sets  in.  On  the  excretion 
of  uric  acid  and  urea  its  influence  is  very  much  disputed,  but  it  probably 
increases  the  flow  of  bile,  and  certainly  unloads  the  portal  circulation. 

Antagonists  and  Incompatibles. 

Tannic  Acid  to  retard  absorption.  Emetics  and  cathartics,  also  warm  demulcent  drinks 
freely.  Morphine  hypodermically  to  antagonize  the  cardiac  depression,  also  Alcohol. 


COLOCYNTHIS. 


185 


Therapeutics. 

Colchicum  is  a  specific  palliative  in  gout  of  acute  form,  in  which  it 
should  be  given  with  an  alkali,  and  kept  short  of  emeto-catharsis.  It  does 
not  prevent  relapses,  and  its  power  in  this  disorder  is  weakened  by  repe¬ 
tition.  In  ascites  from  obstructive  disease  of  the  liver  it  is  most  effective, 
given  in  full  doses  to  establish  a  profuse  drain,  with  opium  to  sustain  the 
heart.  In  acute  cerebral  congestion  and  in  portal  congestions  it  is  well 
given  as  a  drastic  purgative.  It  is  often  used  with  marked  success  in 
acute  rheumatism,  but  frequently  fails,  and  in  no  case  should  it  be  con- 
tinued  long  in  this  affection.  It  has  been  used  with  good  results  in  the 
treatment  of  gonorrhoea  and  chordee.  The  alkaloid  is  probably  the  best 
preparation  for  general  use,  and  is  admittedly  superior  to  the  other  pre¬ 
parations  in  acute  gout. 


COLOCYNTHIS,  Colocynth,— is  the  fruit  of  Citrullus  Colccyn- 
this,  deprived  of  its  rind.  The  plant  is  a  native  of  Spain  and  Asiatic 
Turkey  and  belongs  to  the  nat.  ord.  Cucurbitacese,  the  fruit  being  of  the 
size  of  a  small  orange,  white,  light,  spongy,  inodorous,  very  bitter,  con¬ 
taining  many  flat,  brown  seeds  which  should  be  rejected  before  the  pulp 
is  used.  Its  active  principle  is  Colocynthin ,  C56H81023,  an  amorphous  but 
crystallizable  bitter  glucoside,  readily  soluble  in  water.  It  also  contains 
Colocynthein,  a  resin,  and  Colocynthitin ,  which  is  a  tasteless,  crystalline 
powder,  soluble  in  ether  but  not  in  water,  and  devoid  of  purgative 
action. 

Preparations. 

Extradum  Colocynthidis , — alcoholic.  Dose,  gr.  jj-ij. 

Extractum  Colocynthidis  Composition, — contains  of  the  preceding  16  parts,  Aloes  50, 
Cardamom  6,  Resin  of  Scammony  14,  Soap  14,  Alcohol  10.  Dose,  gr.  v-xx. 

Pilulce  Catharticce  Composite e,  Compound  Cathartic  Pills, — each  has  of  the  preceding 
gr.  1.3,  Abstract  of  Jalap  gr.  j,  Calomel  gr.  j,  Gamboge  gr.  Dose,  j-iij  pills. 

Laville"1  s  Anti- Goat  Remedy , — is  a  proprietary  medicine  prepared  in  France  and  pur¬ 
porting  to  be  “  a  mixture  of  prepared  Kino-colocynthine.”  The  published  formula  is  as 
follows:  Active  principle  of  Colocynth  2]/z,  Quinine  and  Cinchonine  5,  Spanish  Wine 
800,  Alcohol  100,  Water  to  1000  parts;  but  there  is  good  reason  for  believing  that  it 
contains  Colchicine  instead  of  Colocynthin. 


Physiological  Action. 

Colocynth  is  classed  among  the  tonic-astringent  and  resin-bearing 
purgatives.  In  moderate  doses  it  increases  peristalsis  and  the  intestinal 
glandular  secretions,  producing  bilious,  watery  evacuations  with  much 
colicky  griping  pain.  Its  purgative  action  is  specific,  and  may  be  ob¬ 
tained  by  its  application  to  the  skin  over  the  abdomen.  In  large  doses  it 
is  a  violent  irritant  of  the  gastro-intestinal  tract,  and  has  frequently  pro¬ 
duced  fatal  gastro-enteritis.  It  is  popularly  supposed  to  be  abortifacient, 
but  this  is  only  true  of  quantities  sufficient  to  endanger  life.  It  is  an  in¬ 
direct  diuretic. 


CONIUM. 


1 86 


Therapeutics. 

Colocynth  is  too  severe  an  agent  to  be  administered  alone  for  constipa¬ 
tion,  but  it  makes  a  useful  factor  in  compound  purgatives,  as  the  com¬ 
pound  cathartic  pill.  In  cerebral  congestion  it  may  be  used  to  produce 
rapid  derivation,  and  in  ascites  to  set  up  a  profuse  drain  from  the  intes¬ 
tinal  canal.  In  certain  cases  of  chlorotic  amenorrhoea  it  stimulates  the 
pelvic  nerves  and  vessels  with  excellent  results.  There  seems  to  be  abun¬ 
dant  evidence  that  in  very  small  doses  to  a  tincture)  colocynth 

is  an  efficient  remedy  in  colic,  sciatica,  ovarian  and  other  neuralgiae,  as 
well  as  in  the  pain  of  glaucoma.  These  actions  may  be  due  to  its  two 
non-purgative  principles,  which  may  prove  to  possess  powers  not  hereto¬ 
fore  suspected,  an  example  of  which  is  seen  in  the  recently-discovered 
cardiac  influence  of  Convallaria,  a  drug  until  recently  only  known  as  a 
purgative  and  a  diuretic. 


CONIUM,  Hemlock  , — is  the  full-grown  fruit,  gathered  while  green, 
of  Conium  maculatum ,  the  spotted  hemlock  (nat.  ord.  Umbelliferae).  It 
is  smaller  than  anise-fruit,  of  a  gray-green  color,  slight  odor  and  taste, 
and  contains  3  alkaloids,  namely, — Coniine,  C8H15N,  liquid  and  volatile, 
Methyl-coniine,  C8HUNCH3,  and  Conhydrine,  C8HnNO,  solid  and  vola- 
tilizable  ; — also  Coniic  acid  and  a  volatile  oil.  Paraconiine ,  is  an  artificial 
substance  produced  by  the  reaction  between  Butyric  Aldehyd  and  an 
alcoholic  solution  of  Ammonia,  and  isomeric  with  Coniine  but  not  iden¬ 
tical  with  it.  The  leaves  of  Conium  are  no  longer  official. 

Preparations. 

Abstraction  Conii , — made  from  200  parts  of  Conium,  6  of  Dilute  HC1  acid,  Sugar  of 
Milk  and  Alcohol  to  make  100  parts;  each  grain  representing  2  grains  of  the  powdered 
drug.  Dose,  gr.  ss-iij. 

Extraction  Conii  Alcoholicum , — each  grain  represents  a  grain  of  the  crude  drug. 
Dose,  gr.  ij-v-xl. 

Extraction  Conii  Fluidum , — of  the  same  strength  as  the  alcoholic  extract.  Dose, 
Ttpij-v-xl. 

Tinctura  Conii , — strength  15  per  cent.  Dose,  rtpx-gj,  beginning  with  the  10-minim 
dose  and  gradually  increasing  until  physiological  effects  are  manifest. 

Coniina  Coni'ine,  C8Ii15N  (Unofficial), — an  oily,  limpid,  volatile  liquid,  of  acrid  taste, 
alkaline  reaction,  and  an  odor  compared  to  that  of  the  urine  of  mice.  It  is  quickly 
decomposed  by  heat,  and  if  exposed  to  the  air  soon  becomes  inert.  Dose,  gr.  do~T$’  or 
in  minim-doses,  Iff, to-*)-  to°  irritant  for  hypodermic  use,  unless  carefully  neutralized 
by  acetic  acid.  The  Ilydrobromate  in  watery  solution  of  gr.  viij  to  the  3 ,  of  this  rtpx-i, 
is  a  good  form  for  subcutaneous  or  stomachal  administration,  and  may  be  given  in  doses 
of  gr.  t!z  to  gr.  j,  as  it  is  not  actively  toxic. 

All  the  preparations  of  Conium  are  uncertain  in  action,  particularly  the  extract  and 
abstract,  as  the  active  principle  is  very  volatile.  Any  specimen  must  be  carefully  tested 
before  deciding  on  its  dosage,  and  if  the  powerful  mouse-like  odor  of  the  drug  be  absent, 
it  is  probably  worthless. 

Physiological  Action. 

The  special  action  of  Conium  and  Coniine  is  the  production  of  motor 
paralysis  without  loss  of  consciousness  or  sensation.  It  paralyzes  the 


CONVALLARIA  MAJALIS. 


187 


motor  nerves,  the  action  commencing  at  the  peripheral  end-organs  and 
extending  upwards,  involving  the  nerve-trunks  and  finally  the  centres, 
but  the  muscular  irritability  remains  unaffected.  Methyl-Coniine  acts 
similarly  but  reversely,  affecting  first  the  motor  columns  of  the  cord. 
The  sensory  nerves  are  not  affected,  but  the  general  sensibility  is,  a  feel¬ 
ing  of  numbness  being  experienced  in  the  extremities. 

Gastric  irritation  is  usually  the  first  sensation  produced  by  a  full  dose  of 
Conium,  nausea  and  vomiting  being  its  symptoms.  Then  weakness  of 
the  legs,  numbness  and  fatigue,  drooping  eyelids,  diplopia,  slightly 
dilated  pupils,  vertigo,  impaired  utterance,  slow  and  labored  breathing, 
and  if  the  dose  be  a  lethal  one,  paralysis  of  the  voluntary  muscles,  those 
of  the  lower  limbs  being  first  affected,  speech  and  vision  are  lost,  and 
finally  death  occurs  from  paralysis  of  the  muscles  of  respiration.  The 
heart  is  not  affected  and  the  mind  remains  clear,  but  torpid  and  indiffer¬ 
ent,  until  carbonic  acid  narcosis  sets  in. 

Muscular  movement  counteracts  the  effects  of  the  drug  to  a  very  great 
extent. 

Conium  is  believed  to  have  been  the  state  poison  of  the  Athenians,  by 
the  juice  of  which  Socrates  and  Phocion  died. 

Antagonists  and  Incompatibles. 

Nux  Vomica  and  its  alkaloids,  Picrotoxin  and  other  tetanizers  are  antagonistic. 
Tannic  acid  and  caustic  alkalies  are  chemically  incompatible. 

Therapeutics. 

Conium  is  especially  indicated  in  diseases  characterized  by  excessive 
motor  activity.  Large  doses  are  required  as  some  physiological  action  is 
necessary.  Children  bear  it  well,  their  constant  activity  preventing  its 
full  action.  In  chorea  it  palliates  by  depressing  the  motor  nervous  sys¬ 
tem.  In  acute  mania  and  delirium  tremens  to  quiet  motor  excitement 
and  prevent  exhaustion,  it  is  remarkably  efficient,  especially  when  given 
conjointly  with  Morphine.  When  pain  and  spasm  are  present,  it  will 
prove  a  useful  agent ;  and  in  tetanus,  blepharospasm,  asthma,  whooping- 
cough,  and  other  spasmodic  affections  it  is  frequently  used  with  great 
benefit.  The  pain  of  cancer  seems  to  be  especially  amenable  to  its  influ¬ 
ence  when  locally  applied,  and  Coniine-vapor  is  an  admirable  palliative 
of  the  tickling  cough  of  phthisis  and  the  irritability  of  the  air-passages 
in  acute  bronchitis.  In  pneumonia  and  pleurisy  the  hypodermic  use  of 
Coniine  to  afford  the  organs  rest  by  inducing  a  paretic  state  of  the  respira¬ 
tory  muscles  has  been  followed  by  a  marked  decrease  in  the  temperature 
and  pulse-rate. 

CONVALLARIA  MAJALIS,  Lily  of  the  Valley  (Unofficial), 
—  is  a  stemless  perennial  of  the  nat.  ord.  Liliacese,  indigenous  to  Europe, 


1 88 


CONVALLARIA  MAJALIS. 


Northern  Asia  and  the  Southeastern  portion  of  the  United  States.  All 
parts  of  the  plant  are  used,  but  the  preparations  vary  in  action  according 
to  the  quantity  of  the  Resin  present,  it  being  emeto-cathartic.  Convalla- 
ria  contains  two  glucosides,  namely,  Convallamarin ,  on  which  the  cardiac 
action  depends,  and  Convallarin ,  a  crystalline,  purgative  principle,  insol¬ 
uble  in  water; — also  an  acrid  Resin  which  probably  contains  the  latter 
glucoside. 

Preparations. 

Extraction  Convallarice  (Unofficial),  prepared  from  the  flowers  and  stalks  with  yl  of 
the  leaves  and  root  ;  is  a  black  solid,  freely  soluble  in  water  and  alcohol.  Dose,  gr.  ij-x. 

Extraction  Convallarice  Fluidum  (Unofficial), — as  found  in  the  shops  is  an  alcoholic 
preparation  of  the  whole  plant,  and  is  likely  to  contain  Convallarin,  which  is  not  present 
in  aqueous  preparations,  being  insoluble  in  water.  Dose,  rrpij-x. 

Infusion  Convallarice  (Unofficial), — prepared  from  the  flowers,  leaves  and  stems  25,  in 
water  75.  Dose,  ^ss-ij. 

Convallamarinum ,  Convallamarin,  C23H44012  (Unofficial), — an  amorphous,  white, 
bitter  powder,  freely  soluble  in  water  and  in  alcohol,  but  insoluble  in  ether.  Dose,  gr. 

X-ffi 

Physiological  Action. 

Con vall aria  has  long  been  known  as  a  decided  cathartic  and  a  prompt 
and  powerful  diuretic,  but  its  cardiac  action  has  only  lately  excited  atten¬ 
tion,  and  it  is  now  considered  a  close  analogue  of  Digitalis,  while  free 
from  the  cumulative  action  which  makes  the  latter  drug  so  frequently  a 
dangerous  remedy. 

Preparations  of  the  root  have  a  powerful  emeto-cathartic  action,  prob¬ 
ably  due  to  a  preponderance  of  the  resin.  Those  freed  from  this  ingre¬ 
dient  correspond  in  action  with  Convallamarin,  stimulate  the  appetite 
without  impairing  digestion,  increase  peristalsis  without  producing  cathar¬ 
sis,  slow  the  heart  and  raise  the  arterial  tension,  also  slowing  and  deepen¬ 
ing  respiration.  Lethal  doses  at  first  produce  irregularity  of  the  cardiac 
action  and  spasm  of  the  respiratory  muscles,  high  arterial  tension  and  a 
very  rapid  pulse, — followed  by  lowered  blood-pressure,  very  slow  and 
deep  breathing,  and  finally  arrest  of  the  heart  in  systole.  Its  mode  of 
action  is  by  direct  stimulation  of  the  pneumogastric,  the  motor  and 
sensory  nerves  retain  their  irritability,  the  muscles  preserve  their  contrac¬ 
tility,  and  the  cerebral  functions  and  the  pupil  are  unaffected. 

Convallarin  is  a  drastic  purgative  in  3 -grain  doses.  Convalla¬ 
marin  is  an  emetic  even  in  small  quantity,  and  the  powdered  root  is 
sternutatory. 

Therapeutics. 

Convallaria  is  a  heart-tonic  like  Digitalis,  and  is  indicated  in  the  same 
class  of  cases  as  is  that  drug,  with  the  advantage  that  having  no  cumula¬ 
tive  action  it  is  not  dangerous  to  the  heart  in  medicinal  doses,  and  does 
not  disturb  the  stomach  or  the  functions  of  the  cerebro-spinal  axis.  In 
doses  of  gr.  xv-xxv  of  the  extract  it  slows  the  action  of  the  heart  and 
increases  the  force  of  its  contractions,  raises  arterial  tension,  augments 


COPAIBA. 


189 


the  force  and  volume  of  the  respiration,  and  produces  prompt  diuresis 
without  altering  the  composition  of  the  urine.  It  is  a  most  valuable 
remedy  in  mitral  stenosis  or  insufficiency  with  venous  stasis,  dilatation  of 
the  heart,  palpitation,  vehement  cardiac  action  or  disordered  rhythm, 
and  in  all  valvular  affections  accompanied  by  dropsy  and  a  weak  heart. 
It  has  also  been  used  with  benefit  in  pneumonia,  typhoid  fever  and  renal 
dropsy.  Its  action  is  maintained  for  several  days  after  its  use  has  been 
suspended. 


COPAIBA,  Balsam  of  Copaiba, — is  the  oleoresin,  of  Copaifera 
Langs  do  rffii,  and  other  species  of  Copaifera ,  a  S.  American  tree  of  the 
nat.  ord.  Leguminosse,  growing  chiefly  in  the  valley  of  the  Amazon.  It 
is  a  translucent,  viscid  liquid,  of  yellow  color,  aromatic  odor,  acrid  and 
bitter  taste,  not  fluorescent,  soluble  in  alcohol  and  benzol.  Is  not  a  bal¬ 
sam  as  it  contains  no  cinnamic  acid.  Its  constituents  are  a  Volatile  Oil 
and  a  Resin  in  about  equal  proportions,  the  latter  containing  nearly  99 
per  cent,  of  Copaibic  Acid.  Dose,  hbx-oj. 


Preparations. 

Oleum  Copaibce,  C10II16, — the  volatile  oil,  a  pale  yellow  liquid,  of  sp.  gr.  0.890,0! 
bitter  taste  and  neutral  reaction,  soluble  in  an  equal  weight  of  alcohol.  Dose,  ripx-xv. 

Resina  Copaibce , — is  the  residue  left  after  distilling  off  the  volatile  oil  from  Copaiba,  a 
yellowish,  brittle  body,  of  acid  reaction,  soluble  in  alcohol,  benzol  or  amylic  alcohol. 
Consists  mainly  of  Copaibic  Acid,  which  is  crystallizable,  also  1^  per  cent,  of  a  viscid 
resin.  Dose,  gr.  j-v. 

Massa  Copaibce , — consists  of  Copaiba  94,  fresh  Magnesia  6  parts,  mixed  and  set  aside 
to  concrete  into  a  pilular  mass.  Dose,  npx-^j. 

Mistura  Copaibce  Composila,  Lafayette’s  Mixture  (Unofficial), — R.  Copaibse  £vij,01. 
Cubebse  3  j,  Glyceriti  Vitelli  3  vij.  Triturate  and  add  gradually  while  triturating  Syrupi 
Aq.  Menth.  Piperitoe  ^  ijss.  Then  add  with  constant  stirring  Liq.  Potasste  ss,  Tr. 
Cardamomi  Co.  gij,  Spt.  Etheris  Nitrosi  ^  ss,  Aq.  Menthae  Pip.  q.  s.  ad  ^  viij.  Dose, 

3j"3ss- 

Physiological  Action. 

Copaiba  is  a  stimulant  diuretic,  diaphoretic,  expectorant,  and  a  gastro¬ 
intestinal  irritant.  Its  taste  is  bitter  and  nauseous.  In  the  stomach  it 
causes  heat,  unpleasant  eructations,  heaviness,  frequently  anorexia  and 
diarrhoea,  and  if  continued  for  any  length  of  time  gastro-intestinal  catarrh 
and  desquamative  nephritis  may  result.  The  oil  and  resin  diffuse  into  the 
blood  and  are  excreted  by  the  bronchial  mucous  membrane,  skin  and 
kidneys,  producing  increased  secretion  at  the  points  of  elimination. 
The  various  secretions  have  the  odor  of  the  drug,  especially  the  urine. 
In  medium  doses  it  increases  the  quantity  of  urine  and  its  solid  con¬ 
stituents,  but  large  doses  will  cause  scanty  urine,  containing  albumen, 
casts  and  blood,  with  pain  in  the  loins  and  other  signs  of  renal  con¬ 
gestion.  On  the  skin  it  often  produces  itching  and  several  forms  of 
eruption. 


190 


CORIANDRUM - CORNUS. 


Therapeutics. 

Copaiba  has  been  largely  used  in  gonorrhoea  after  the  acute  symptoms 
have  subsided,  also  in  chronic  cystitis,  acute  and  chronic  bronchitis,  and 
in  dropsies,  particularly  ascites.  In  all  these  affections  is  a  useful  rem¬ 
edy,  but  its  nauseous  taste  and  irritant  effects  on  the  stomach  are  driving 
it  out  of  fashion,  especially  in  private  practice.  One  eminent  surgeon  de¬ 
clares  that  not  only  is  it  useless  in  gonorrhoea  but  that  it  does  more  harm 
than  good,  often  prolonging  the  disease  beyond  its  natural  limit.  In 
psoriasis  and  urticaria,  and  in  cutaneous  affections  characterized  by  torpid 
peripheral  circulation,  this  drug  has  been  administered  internally  with 
excellent  results.  In  long-standing  cystitis  in  the  female  Copaiba  has 
been  injected  into  the  bladder  with  great  benefit.  The  resin  is  the  most 
active  ingredient,  especially  for  diuretic  purposes. 


CORIANDRUM,  Coriander,  — is  the  fruit  of  Coriandrum  sativum , 
a  European  plant  of  the  nat.  ord.  Umbelliferse.  It  is  a  minute,  globular, 
brownish-yellow  body  finely  ribbed,  of  aromatic  odor  and  taste,  and  con¬ 
tains  a  volatile  and  a  fixed  oil.  Dose,  gr.  x-xx. 

Preparation. 

Oleum  Coriandri, — the  volatile  oil.  Dose,  rtpij-v. 

Physiological  Action  and  Therapeutics. 

Coriander  is  stimulant,  aromatic  and  carminative.  It  is  used  almost 
wholly  as  a  flavoring  to  other  remedies,  or  as  a  corrective  against  the 
griping  effects  of  certain  purgatives.  Its  flavor  covers  the  taste  of  Senna 
and  Rhubarb,  and  it  is  an  ingredient  of  the  official  Confectio  Sennae. 


CORNUS,  Dog-wood, — is  the  bark  of  the  root  of  Cornus  florida , 
a  small  tree  of  the  nat.  ord.  Cornaceae,  indigenous  in  the  U.  S.  Occurs 
in  reddish-brown,  curved  pieces,  of  astringent,  bitter  taste,  and  contains 
a  bitter  principle  named  Cornin ,  which  is  crystallizable  and  soluble  in 
water  and  alcohol  ;  also  a  resin  and  tannic  acid. 

Preparation. 

Extraction  Cornus  Fluidum , — Dose,  npx—  "Z  j . 

Physiological  Action  and  Therapeutics. 

Cornus  is  a  simple  bitter,  having  stomachic  and  other  qualities  similar 
to  those  of  Calumba  (which  see).  In  addition  it  is  possessed  of  con¬ 
siderable  antiperiodic  power,  and  has  a  good  deal  of  reputation  in  the 
Southern  States  as  a  remedy  in  malarial  fever,  the  physicians  of  that  sec¬ 
tion  considering  it  as  next  to  Quinine  in  efficiency.  Heat  destroys  its 
active  principle,  consequently  a  decoction  is  a  useless  preparation. 


COTO — CREASOTUM. 


I9I 

COTO,  Coto  Bark  (Unofficial), — is  the  bark  of  some  unknown  tree 
growing  in  Bolivia,  from  whence  it  comes  in  brownish  pieces  of  aromatic 
odor  and  acrid,  bitter  taste.  It  contains  an  acrid,  bitter  principle,  of 
yellow  color,  crystalline  and  soluble  in  hot  water  and  alcohol,  named 
Cotoin ,  C22H1806 ;  also  Piperonylic  Acid ,  C8H604,  and  a  volatile  oil,  resin, 
etc.,  but  no  tannin.  Dose,  gr.  j-xv. 

Paracoto  Bark,  or  False  Coto, — is  thicker  than  the  true  bark,  has  a 
fainter  odor  and  taste,  and  is  marked  by  whitish  furrows  on  its  surface. 
Its  principle,  Paracotoin ,  C19H1206,  has  a  strong  similarity  to  Cotoin  thera¬ 
peutically,  but  is  less  active. 

A  fluid  extract  of  the  official  strength  is  prepared,  also  a  tincture  (10  per  cent.),  which 
may  be  administered  in  doses  of  from  rqj-xx.  Cotoin  is  used  in  doses  of  gr.  j-iv,  and 
Paracotoin  in  somewhat  larger  quantities. 

The  physiological  action  of  Coto  has  not  been  studied,  all  that  is  known 
about  it  being  that  it  is  decidedly  irritant  to  the  skin  and  mucous  mem¬ 
branes.  After  its  internal  administration  the  urine  takes  a  dark-red  color 
with  Nitric  Acid.  Ferric  Chloride  blackens  a  dilute  solution  of  Cotoin, 
but  has  no  reaction  with  Paracotoin. 

The  bark  and  both  principles  are  highly  recommended  in  diarrhoeas  of 
various  forms,  especially  those  of  phthisis,  typhoid  fever,  and  cholera.  In 
Asiatic  cholera  Paracotoin  has  been  used  hypodermically  in  3-grain  doses 
with  success.  Where  there  is  any  tendency  to  acute  inflammation  of  the 
gastro-intestinal  tract  this  agent  must  be  used  with  caution.  Small  doses 
of  the  tincture  (rrp j— v)  are  said  to  be  very  effective  in  the  diarrhoea  of 
children. 


CREASOTUM,  Creasote, — is  a  product  of  the  distillation  of 
wood-tar,  chiefly  consisting  of  the  four  phenols,  Guiacol Creasol,  Methyl- 
creasol  and  Phlorol ,  in  varying  proportions.  It  is  a  nearly  colorless, 
inflammable,  oily  liquid,  of  smoky  odor,  caustic  taste  and  neutral  reaction, 
soluble  in  80  of  water  at  590  F.,  in  12  of  boiling  water,  and  in  all  pro¬ 
portions  in  alcohol,  ether,  chloroform  and  acetic  acid.  It  does  not 
coagulate  albumen  (?)  or  collodion,  Carbolic  Acid  does.  It  was  named 
from  its  remarkably  preservative  power  over  meat  creas ,  flesh,  and  sohzoh , 
preserve.  Much  of  the  commercial  Creasote  is  an  impure  Carbolic 
Acid,  or  a  heavy  oil  distilled  from  coal-tar  and  containing  Carbolic  and 
Cresylic  Acids.  Dose,  iqj-iij,  well  diluted. 

Aqua  Creasoti , — a  I  per  cent,  solution,  containing  TTyvT^  in  each  fluidounce.  Dose, 

3D1V- 

Morson's  Beechwood  Creasote, — is  best  for  internal  use.  Dose,  try  every  3  hours,  in 
wine  or  whiskey,  well  diluted. 

Creasote  is  expectorant,  astringent,  antiseptic,  styptic,  escharotic,  an¬ 
aesthetic  and  narcotic.  Its  action  is  practically  the  same  as  that  of  Car- 


192 


CREOLIN - CROCUS. 


bolic  Acid  (see  ante ,  page  60),  especially  upon  the  heart,  respiration  and 
nervous  system,  but  differs  from  that  of  the  latter  in  not  causing  convul¬ 
sions,  and  in  increasing  the  coagulability  of  the  blood.  It  is  eliminated 
by  the  kidneys  and  bronchial  mucous  membrane,  which  it  stimulates, 
being  quite  a  good  expectorant.  In  small  doses  it  seems  to  have  a  selec¬ 
tive  sedative  influence  on  the  terminal  nerve-filaments  in  the  gastric 
mucous  membrane.  In  large  doses  it  is  a  powerful  poison,  resembling 
Carbolic  Acid  in  its  symptoms,  except  that  its  nervous  effects  are  even 
more  marked.  It  explodes  when  combined  with  Oxide  of  Silver  in  pill, 
unless  previously  diluted  with  an  inert  powder. 

Being  a  very  complex  substance  of  varying  composition  Creasote  as  a 
therapeutic  agent  has  been  almost  entirely  supplanted  by  Carbolic  Acid. 
It  is  used  internally  with  success  in  reflex  nausea  and  vomiting,  as  from 
sea-sickness,  pregnancy,  cholera,  etc.,  also  as  an  aseptic  and  expectorant 
in  chronic  basilar  cavity,  in  which  it  seems  to  have  greater  efficacy  than 
any  other  remedy.  As  an  astringent  it  has  been  employed  in  intestinal 
hemorrhage,  gonorrhoea  and  gleet,  and  generally  in  the  same  affections  as 
Carbolic  Acid.  Externally  it  is  a  good  application  in  eczema,  pruritus, 
ulcers  and  scaly  skin  diseases,  and  it  effectually  relieves  the  pain  of  an 
exposed  dental  nerve  if  applied  thereto.  It  is  a  good  agent  by  inhalation 
in  chronic  bronchitis  and  gangrene  of  the  lung,  and  it  has  lately  been 
administered  internally  in  phthisis  with  decided  benefit. 

CREOLIN,  (Unofficial) — is  a  coal-tar  product  of  uncertain  compo¬ 
sition,  occurring  as  a  semi-fluid,  black  substance,  of  the  consistence  of 
honey.  It  forms  a  white  cloud  when  added  to  water,  with  which,  how¬ 
ever,  it  is  miscible,  as  an  emulsion,  up  to  about  10  or  12  per  cent, 
strength.  The  Solutions  in  general  use  vary  from  ^  to  2  per  cent. ;  the 
Ointments  to  5  per  cent.,  and  Creolin  Gauze  is  prepared  of  10  per  cent, 
strength  of  the  drug. 

Creolin  was  highly  vaunted,  by  Professor  v.  Esmarch  and  other  authorities,  as  the 
ideal  antiseptic  for  external  use,  being  possessed  of  great  germicidal  power,  and  a  most 
efficient  deodorant  and  disinfectant,  while  its  absorption  caused  no  toxic  results  whatever. 
Experience  has  justified  these  claims  in  the  main,  but  the  drug  has,  however,  given  rise  to 
serious  symptoms,  when  used  to  excess.  As  a  vaginal  wash,  in  puerperal  cases,  the  2  per 
cent,  solution  is  reported  as  fully  equal  to  sublimate  solutions,  while  better  as  a  deodorant, 
and  free  from  danger  by  absorption.  The  weaker  solutions  have  given  satisfaction  as  local 
applications  in  the  treatment  of  otorrhoea,  nasal  ulcers,  rhinitis  (1  to  1000),  blepharitis, 
keratitis,  etc. ;  and  in  female  cystitis  a  I  per  cent,  solution  as  a  vesical  wash,  gradually 
increased  to  2  per  cent,  is  highly  praised  by  Parvin.  The  Ointments  and  Gauze  are  used 
for  wounds  and  other  solutions  of  continuity,  in  the  same  manner  as  carbolized  prepara¬ 
tions,  and  with  better  satisfaction,  Creolin  being  less  volatile  than  Carbolic  Acid,  and  of 
a  more  agreeable,  though  powerful,  odor. 


CROCUS,  Saffron, — the  stigmas  of  Crocus  sativus,  a  plant  of  the 
nat.  ord.  Iridacese,  cultivated  in  Europe,  containing  a  volatile  oil  and 
coloring  matter.  Occurs  as  separate  stigmas  or  three  attached  to  the  style, 


CUBEBA. 


193 


of  orange-brown  color,  peculiar,  aromatic  odor,  and  bitter  taste.  So- 
called  American  Saffron  is  not  Crocus  but  the  flowers  of  Carthamus  tinc- 
torius.  True  Saffron  is  expensive,  as  it  requires  about  60,000  flowers  to 
furnish  one  pound  of  the  stigmas.  Dose,  gr.  v-xx,  in  infusion. 

Tinctura  Croci, — 10  per  cent.  Dose,  3  j-ij. 

Saffron  Tea ,  so  much  used  in  domestic  practice,  is  an  infusion  of  Carthamus  tinc- 
orius ,  or  Safflower. 

Crocus  is  a  stimulant  aromatic,  having  some  antispasmodic  and  anodyne 
qualities.  The  hot  infusion  produces  diaphoresis,  probably  by  virtue  of 
the  hot  water  alone.  It  is  said  to  have  caused  death  with  narcotic  symp¬ 
toms.  On  the  continent  of  Europe  it  is  employed  as  a  stimulant  and 
emmenagogue,  but  in  this  country  its  only  use  is  as  a  coloring  agent.  The 
miscalled  Saffron  Tea  noted  above  is  used  in  domestic  practice  for  measles 
and  other  exanthemata. 


CUBEBA,  Cubeb  , — is  the  unripe  fruit  of  Cubeba  officinalis ,  a  plant 
of  the  nat.  ord.  Piperacese,  cultivated  in  Java.  Occurs  as  a  blackish-gray, 
wrinkled,  globular  body,  about  the  size  and  shape  of  black  pepper,  of 
strong,  spicy  odor,  and  aromatic,  pungent  taste.  Contains  a  Volatile  Oil , 
which  is  official,  an  acrid  resin  composed  in  part  of  Cubebic  Acid,  also  a 
fatty  oil,  gum,  and  Cubebin ,  which  is  an  insoluble,  neutral,  odorless  and 
tasteless  body.  The  volatile  oil  may  be  separated  into  Cubebene  a  cam¬ 
phor,  and  Cubeben  a  liquid  portion.  The  active  principles  are  the  volatile 
oil  and  the  cubebic  acid,  both  of  which  are  contained  in  the  oleoresin. 
Cubeb  should  be  kept  whole  and  not  pulverized  until  wanted  for  use. 
Dose  of  the  powdered  drug,  gr.  x—  3 i j - 

Extractum  Cubebce  Fluidum, — alcoholic.  Dose,  rtqv-xxx. 

Tinctura  Cubebce , — 10  per  cent.  Dose,  npx-^iij. 

Oleoresina  Cubebce , — extracted  by  ether.  Dose,  nqv-xxx. 

Trochisci  Cubebce , — each  contains  of  the  Oleoresin  gr.  Oil  of  Sassafras  gr.  0.15, 
Extract  of  Glycyrrhiza  gr.  iv,  Acacia  gr.  ij,  and  Syrup  of  Tolu  q.  s.  to  form  a  mass. 
Dose,  j-iij. 

Oleum  Cubebce ,  C15H24, — is  the  volatile  oil,  a  colorless  or  pale  greenish-yellow  liquid, 
of  sp.  gr.  0.920,  warm,  aromatic  taste,  odor  of  cubeb  and  a  neutral  reaction.  Is  soluble 
in  an  equal  weight  of  alcohol.  Dose,  up  v-xx. 

Cubeb  belongs  to  the  pepper  family,  and  like  black  pepper  is  an 
aromatic  stomachic  and  a  stimulant  diuretic  in  small  or  medium  doses, 
but  large  doses  derange  digestion  and  may  act  as  a  gastro-intestinal  irri¬ 
tant.  Its  constitutents  are  eliminated  by  the  bronchial  mucous  membrane, 
the  skin  and  the  kidneys,  stimulating  and  disinfecting  the  genito-urinary 
passages,  increasing  the  bronchial  mucus,  sweat  and  urine,  and  frequently 
causing  an  urticarial  or  vesicular  eruption.  It  increases  the  action  of  the 
heart  and  of  the  vascular  system,  stimulates  the  venereal  appetite,  and 
promotes  the  menstrual  discharge. 

Cubeb  is  particularly  useful  in  affections  of  the  bladder  and  urethra. 

13 


194 


CUPRUM. 


It  is  used  in  the  acute  stage  of  gonorrhoea,  chronic  cystitis,  prostator- 
rhcea  and  chronic  bronchitis  with  excellent  results.  The  powder  is  a 
good  application  in  hay-fever,  chronic  nasal  catarrh  and  follicular  pharyn¬ 
gitis,  blown  on  to  the'  mucous  membrane  by  an  insufflator.  It  may  also 
be  smoked  in  cigarettes  with  temporary  relief  in  cases  of  acute  nasal 
catarrh  with  “  stuffed  ”  nasal  passages.  In  some  subjects  the  continued 
use  of  cubeb  produces  nausea,  hemorrhoids,  hematuria  and  severe  head¬ 
ache.  The  troches  are  a  useful  preparation  in  chronic  irritability  of  the 
fauces,  pharynx  and  air-passages,  and  are  much  employed  by  singers  and 
public  speakers  for  their  tonic  effect  on  these  parts  and  for  the  relief  or 
prevention  of  hoarseness. 

CUPRUM,  Copper,  Cu, — is  not  official,  but  two  of  its  salts  are, 
namely  the  Acetate  and  the  Sulphate.  The  metal  itself  is  inert,  but  in 
combination  it  is  actively  poisonous.  Copper  has  been  found  in  the 
normal  human  blood  in  very  minute  quantity. 

Saifs  and  Preparations  of  Copper. 

Cupri  Acetas ,  Acetate  of  Copper,  Cu(C2H302)2.H20, — forms  green,  prismatic  crys¬ 
tals,  efflorescent,  of  nauseous,  metallic  taste  and  acid  reaction,  soluble  in  15  of  water  and 
135  of  alcohol  at  590  F.  Its  aqueous  solution  is  of  a  blue  color.  Dose,  gr.  • 

Cupri  Sulphas ,  Sulphate  of  Copper,  CuS04.5H20, — blue,  translucent  crystals,  efflor¬ 
escent,  of  nauseous,  metallic  taste  and  acid  reaction,  very  soluble  in  water,  insoluble  in 
alcohol.  Its  solution  is  blue  by  transmitted  light,  green  by  reflected  light.  Dose,  as  an 
emetic,  gr.  ij-v,  every  10  or  15  minutes, — as  a  tonic,  gr.  ]/(,—%• 

Solution  of  Potassio-Cupric  Tartrate ,  Fehling’s  Solution  (Unofficial),  used  as  a  reagent  for 
glucose,  may  be  made  as  follows, — Dissolve  70  grains  of  Sulphate  of  Copper  in  400  minims 
of  Distilled  Water.  Also  Dissolve  488  grains  of  Rochelle  Salt  (Pot.  et  Sodti  Tart.)  in 
1600  minims  Solution  of  Soda  (Liq.  Sodae),  sp.  gr.  1.12.  When  required  for  use  pour 
the  copper  solution  into  the  other,  and  add  distilled  water  to  make  2720  minims  ( 3  5^3). 

Ctiprum  Ammoniatum ,  Ammoniated  Copper  (Unofficial), — is  made  by  triturating  3 
parts  of  Ammonium  Carbonate  with  4  of  Cupric  Sulphate  until  effervescence  has  ceased, 
then  drying.  A  deep-azure  blue  powder,  of  ammoniacal  odor,  a  styptic,  metallic  taste, 
and  alkaline  reaction,  soluble  in  water.  Dose,  gr.  l/e-)- 

Cupri  Arsenis,  Arsenite  of  Copper,  See  ante,  page  1 1 7 . 

Physiological  Action. 

The  salts  of  Copper  are  gastro-intestinal  irritants,  producing  a  metallic 
taste,  nausea  with  greenish  vomited  matter,  purging  of  blood  and  mucus, 
constricted  fauces,  depressed  heart-action,  hurried  respiration  and  fever. 
Or,  as  with  Arsenic,  gastro-enteritis  may  not  occur,  but  instead  profound 
nervous  symptoms,  as  headache,  defective  coordination,  coma  and  con¬ 
vulsions.  The  symptoms  of  chronic  poisoning  are  bronchial  irritation 
.  and  catarrh,  gastro-intestinal  catarrh,  colic  with  diarrhoea  [Lead  produces 
colic  with  constipation],  dysentery,  nausea,  emaciation,  anaemia,  saliva¬ 
tion,  and  a  green  line  (sulphide)  along  the  margin  of  the  gums  in  those 
who  do  not  clean  their  teeth.  The  nervous  symptoms  above  mentioned 
are  also  usually  well  marked.  The  liver  becomes  atrophied  from  irrita¬ 
tion  of  its  connective  tissue  and  fatty  degeneration  of  the  hepatic  cells. 
The  lungs  are  congested,  even  pneumonic  consolidation  may  be  set  up, 


CUPRUM. 


195 


the  metal  seeming  to  have  a  selective  affinity  for  the  parenchyma  of  these 
organs.  These  effects  are  often  produced  by  the  inhalation  of  cuprous 
fumes,  and  by  eating  acid  fruits  cooked  in  a  copper  vessel. 

Sulphate  of  Copper  is  a  simple,  irritant  emetic,  producing  prompt 
and  continued  vomiting  with  but  little  nausea  or  depression.  In  small 
doses  it  is  a  nerve-tonic  and  astringent  to  the  gastro-intestinal  tract. 
Externally  applied  in  solution  it  is  a  useful  stimulant  and  astringent  to 
diseased  mucous  surfaces,  and  is  mildly  caustic  if  used  in  substance.  The 
Acetate  is  possessed  of  the  same  general  action  as  above  described.  Its 
local  action  is  stimulant  and  escharotic.  The  impure  acetate  (verdigris) 
is  a  violent  irritant  poison.  Ammoniated  Copper  has  no  special  action 
other  than  above  noted 

Antagonists  and  Antidotes. 

Ferro-cyanide  of  Potassium  is  the  antidote  to  Copper  salts,  but  albumen  or  magnesia 
may  be  used.  Any  chemical  antidote  should  be  followed  by  prompt  evacuation  of  the 
stomach,  then  Opium  and  demulcents  for  gastro  enteritis,  and  Potassium  Iodide  even  to 
saturation  of  the  system.  Alkalies  and  their  carbonates,  lime  water,  iodides,  mineral 
salts  except  the  sulphates,  are  all  incompatible. 

Therapeutics. 

The  Sulphate  is  a  prompt  and  efficient  emetic,  and  is  so  used  in  croup 
and  narcotic  poisoning.  In  phosphorus  poisoning  it  forms  a  comparatively 
insoluble  phosphide  of  copper  besides  producing  emesis.  Fifteen  or 
twenty  grains  may  be  dissolved  in  5 iv  of  water,  and  a  teaspoonful  or 
more,  according  to  age,  given  every  ten  minutes  until  vomiting  is  pro¬ 
duced.  In  acute  diarrhoea  and  chronic  dysentery  it  is  the  best  metallic 
astringent  in  doses  of  gr.  y1^  to  y1^  with  Opium,  and  in  gastro-intestinal 
catarrh  it  is  equally  efficient.  Locally,  it  is  used  with  benefit  in  throat 
affections,  gonorrhoea,  granular  lids  and  corneal  ulcers,  indolent  granula¬ 
tions  and  chronic  inflammations  of  mucous  membranes.  In  most  of  these 
affections  weak  solutions  (gr.  ^  to  ^  to  the  5)  are  best,  but  in  granular 
conjunctivitis  the  smooth  crystal  may  be  rubbed  quickly  over  the  surface 
once  daily. 

In  various  nervous  diseases,  as  epilepsy,  chorea,  hysteria,  etc.,  the  salts 
of  copper  are  sometimes  beneficial,  the  Ammoniated  Copper  being  con¬ 
sidered  the  most  efficient  preparation  in  these  cases.  In  Germany  a  tinc¬ 
ture  of  the  Acetate  was  official  and  has  been  used  successfully  in  the 
treatment  of  pneumonia.  Ammoniated  Copper  has  lately  been  highly 
recommended  for  facial  neuralgia,  but  requires  pushing  to  the  production 
of  some  physiological  action. 

Ointments  or  lotions  of  the  Acetate  are  useful  applications  in  eczema, 
herpes,  tinea  sycosis,  mentagra  and  herpes  circinatus. 

Villate' s  Solution  has  been  successfully  used  as  a  local  injection  for  the 
cure  of  caries.  It  is  composed  of  Sulphate  of  Copper,  Sulphate  of  Zinc 
of  each  15  parts,  Liquor  Plumbi  Subacetatis  30,  Vinegar  200.  The  solu¬ 
tion  is  thoroughly  injected  into  the  sinuses  leading  to  the  carious  bone. 


196 


CURARE. 


CURARE,  Woorara  (Unofficial), — is  a  vegetable  extract  obtained 
from  various  members  of  the  Strychnos  family  and  from  Paulinia  curare 
and  other  plants.  It  is  used  in  S.  America  as  an  arrow-poison  under 
various  names,  as  Caroval ,  Vao ,  etc.  Its  active  principle  is  the  crystal- 
lizable  alkaloid  Curariue ,  which  contains  no  oxygen. 

The  dose  of  Curare  is  gr.  hypodermically, — of  Curarine,  gr.  hypoder¬ 
mically,  or  gr.  by  the  stomach,  but  as  the  samples  vary  greatly  in  activity  they 

should  first  be  tried  on  some  inferior  animal  before  being  administered  to  man. 

Physiological  Action. 

Curare  is  a  paralyzer  of  the  voluntary  muscles,  affecting  them  through 
the  end-organs  of  the  motor  nerves.  It  does  not  at  first  act  upon  the 
brain  or  spinal  cord,  but  if  life  be  prolonged  by  artificial  respiration  the 
cord,  sensory  nerves  and  even  the  muscular  tissue  all  become  affected. 
The  heart,  at  first  quickened,  becomes  depressed,  and  the  blood-pressure 
is  lowered,  the  eyelids  droop,  the  eye-balls  protrude,  vision  is  disordered, 
intestinal  peristalsis  and  sensibility  to  stimuli  are  greatly  increased,  and 
an  artificial  glycosuria  (curare-diabetes)  is  set  up.  The  limbs  are  paralyzed 
first,  death  occurring  by  paralysis  of  respiration.  The  absorption  of  the 
drug  by  the  stomach  is  very  slow,  as  its  active  principle  passes  with  diffi¬ 
culty  through  animal  membranes,  and  its  elimination,  which  takes  place 
by  the  kidneys,  being  more  rapid  and  complete  than  that  of  any  other 
agent,  no  marked  effect  may  be  produced  when  administered  internally. 
When  hypodermically  injected  its  action  is  very  prompt.  The  urine  of  a 
curarized  animal  will  poison  another,  and  that  of  the  second  will  paralyze 
a  third. 

As  compared  with  other  motor  depressants  Curarine  and  Coniine  para¬ 
lyze  the  end-organs  of  the  motor  nerves,  Gelsemine  and  Methyl-coniine 
paralyze  the  motor  centres. 

Antagonists  and  Incompatibles. 

Strychnine ,  though  from  a  member  of  the  same  family,  is  antagonistic  as  to  the  action 
on  the  heart  and  respiration.  So  also  is  Atropine.  Artificial  respiration  is  the  most 
efficient  antagonist,  maintaining  life  until  elimination  occurs.  Evacuation  of  the  bladder 
repeatedly  is  important  to  prevent  reabsorption.  The  caustic  alkalies  destroy  Curarine  as 
they  do  all  other  alkaloids. 

Therapeutics. 

Curare  is  chiefly  used  for  experimental  purposes  on  the  lower  animals. 
It  has  an  historical  interest  from  its  having  been  the  means  by  which  Ber¬ 
nard  demonstrated  the  existence  of  muscular  contractility  as  an  essential 
endowment  of  that  tissue.  It  has  been  used  with  some  success  in  spas¬ 
modic  nervous  affections,  particularly  in  tetanus,  both  idiopathic  and 
traumatic,  in  hydrophobia,  chorea  and  epilepsy.  It  does  not  promise 
well  as  a  therapeutic  agent,  but  two  undoubted  cases  of  hydrophobia  are 
reported  by  high  authority  as  cured  by  this  drug. 


CYDONIUM - CYPRIPEDIUM - DA  MI  ANA. 


I97 


CYDONIUM,  Quince  Seed, — is  the  seed  of  Cydonia  vulgaris ,  a 
tree  of  the  nat.  ord.  Rosaceae,  native  in  Crete  and  Austria,  and  cultivated 
elsewhere.  The  seeds  are  about  inch  long,  triangularly  compressed, 
covered  with  a  whitish  epithelium,  and  in  water  they  swell  up  forming  a 
mucilaginous  mass.  The  mucilage  is  the  only  constituent  of  importance 
and  is  contained  in  the  epithelial  cells.  It  has  been  named  Cydonin,  and 
considered  to  be  a  compound  of  gum  and  cellulose. 

Preparation . 

Mucilago  Cydonii , — prepared  by  macerating  2  parts  of  Cydonium  in  100  of  Distilled 
Water.  Dose,  indefinite. 

Physiological  Action  and  Therapeutics. 

Cydonium  is  of  value  for  its  mucilage,  which  is  used  as  a  bland,  de¬ 
mulcent  application  in  conjunctivitis,  abrasions  of  the  skin,  fissures  of  the 
mucous  membranes,  and  as  a  vehicle  for  injections  in  gonorrhoea.  In¬ 
ternally  it  may  be  used  as  a  soothing  remedy  for  the  throat,  stomach,  or 
intestines.  The  preparation  known  as  Bandolitie ,  used  as  a  hair-dressing, 
is  identical  with  the  mucilage  of  Cydonium. 

CYPRIPEDIUM,  Ladies’  Slipper  , — is  the  rhizome  and  rootlets 
of  Cypripedium  pubescens ,  and  of  C.  parvifiorum ,  the  Moccasin-plant,  or 
American  Valerian  (nat.  ord.  Orchidaceae).  Is  dark  or  orange-brown  in 
color,  of  strong,  heavy  odor,  and  bitter,  pungent  taste.  It  contains  a 
volatile  oil,  a  volatile  acid,  resins  and  tannin. 

Preparations. 

Extractum  Cypripedii  Fluidum , — Dose,  rtpx-xxx. 

Cypripedin  (Unofficial), — is  an  impure  alcoholic  extract.  Dose,  gr.  ss-iij. 

Physiological  Action  and  Therapeutics. 

Cypripedium  is  antispasmodic,  tonic,  stimulant  and  diaphoretic,  pos¬ 
sessing  the  same  general  properties  as  Valerian,  whence  one  of  its  common 
names. 

It  is  a  popular  remedy  in  some  parts  of  the  U.  S.  for  nervous  hyper- 
sesthesia  unaccompanied  by  organic  lesion,  especially  morbid  sensibility 
of  the  eye.  It  is  reported  to  have  even  cured  epilepsy,  and  to  be  highly 
useful  in  neuralgia,  hysteria,  nervous  headache  and  insomnia. 


DAMIAN  A  (Unofficial)  , — the  leaves  of  Turnera  aphrodisiaca ,  a 
plant  of  the  nat.  ord.  Turneraceae,  growing  in  Mexico  and  Lower  Cali¬ 
fornia.  Several  varieties  of  so-called  Damiana  are  in  the  market,  but  the 
true  leaf  is  of  a  light-green  color,  small,  lanceolate,  and  dentate  along  the 
margin.  It  contains  a  volatile  oil  and  a  resin.  Dose,  5]  daily. 


198 


DATURA  TATULA - DIGITALIS. 


Preparations. 

Extraction  Damiance  (Unofficial), — Dose,  gr.  ij-x. 

Extractum  Damiance  Fluidum  (Unofficial), — Dose,  Ttyx- ^  j . 

Physiological  Action  and  Therapeutics. 

Damiana  is  said  to  be  a  powerful  aphrodisiac  in  cases  of  sexual  atony, 
but  the  published  reports  of  its  use  since  its  introduction  vary  greatly  as 
to  its  efficacy.  It  is  probably  a  stimulant  diuretic,  a  bitter  tonic,  and  a 
purgative  in  sufficient  doses. 

Besides  its  use  as  an  aphrodisiac  Damiana  has  been  administered  with 
benefit  in  some  forms  of  cerebral  exhaustion  and  general  atony  of  the 
nervous  system,  also  in  sick  headaches  and  in  some  few  cases  of  paralysis. 
It  forms  the  chief  stock  in  trade  of  the  numerous  charlatans  who  fill  the 
daily  papers  with  advertisements  of  11  manhood-restorers.” 

DATURA  TATULA  (Unofficial), — is  an  indigenous  plant  of  the 
nat.  ord.  Solanaceae,  resembling  Stramonium  very  closely,  with  which  it 
generally  agrees  in  its  physiological  action  and  therapeutics.  It  is  distin¬ 
guished  by  its  purple  stem,  purple  flowers  and  anthers,  and  the  darker 
green  of  its  leaves.  It  probably  contains  the  alkaloid  Daturine  (see 
Stramonium), — and  has  been  smoked  in  asthma,  in  a  few  cases  giving 
continued  relief  when  Stramonium  had  failed  to  render  any  service. 


DIGITALIS,  Fox-glove, — Digitalis  consists  of  the  leaves,  col¬ 
lected  from  plants  of  the  second  year’s  growth,  of  Digitalis  purpurea , 
the  Purple  Foxglove,  a  plant  of  the  nat.  ord.  Scrophulariaceae,  which 
grows  wild  in  Europe,  and  is  cultivated  in  this  country,  often  in  private 
gardens  for  its  beautiful  spike  of  purple  flowers,  and  largely  by  the  Shakers 
for  the  drug  market. 

The  British  Phar.  directs  that  the  official  drug  shall  consist  of  “  the  dried  leaf,  collected 
from  the  wild,  indigenous  plant,  when  about  two-thirds  of  the  flowers  are  expanded.” 
Much  of  the  leaf  found  in  our  shops  is  of  very  poor  quality,  a  large  proportion  being 
inert ;  but  whether  this  is  due  to  our  Phar.  not  restricting  the  official  drug  to  the  wild 
plant,  or  to  careless  treatment  in  gathering  and  drying,  is  not  definitely  known.  When, 
however,  the  leaves  are  imperfectly  dried,  a  process  of  decomposition  sets  in,  which 
destroys  the  active  principles,  and  may  produce  new  and  poisonous  ones.  A  similar 
decomposition  is  said  to  occur  whenever  the  tincture  of  Digitalis  is  mixed  with  watery 
or  syrupy  solutions.  Certain  it  is,  at  any  rate,  that  Digitalis  is  one  of  the  most  unreliable 
drugs,  in  respect  of  the  physiological  activity  of  any  particular  sample  or  preparation. 
The  seeds  are  known  to  contain  the  active  principle  in  much  greater  proportion  than  the 
leaves,  but  they  are  never  used. 

The  active  principle  of  Digitalis  has  been  designated  by  the  term  Digi¬ 
talin,  (Digitalinum),  under  which  name  a  substance  was  official  in  the 
U.  S.  and  Br.  Phar.  and  a  process  was  given  therein  for  its  extraction,  until 
their  last  revision,  when  it  was  struck  from  both  lists.  It  was  an  amorphous 
product,  of  complex  composition,  and  did  not  represent  Digitalis. 


DIGITALIS. 


I99 


In  1871  Nativelle  received  the  Orfila  prize  from  the  French  Academy  for  the  discovery 
of  a  crystalline  principle  in  Digitalis,  which  he  named  Digitaline.  This  was  supposed 
to  be  the  active  principle  of  the  plant,  until  Roucher,  (1872)  and  Schmiedeberg,  (1875) 
found  it  to  be  a  complex  body,  consisting  of  a  mixture  of  Digitoxin  and  Digitalin. 
Schmiedeberg’s  latest  analysis  is  now  accepted  as  the  most  accurate  determination  yet 
obtained  of  this  vexed  question.  He  enumerates  five  principles  at  least  as  contained  in 
Digitalis,  viz.  : — (i)  Digitalin ,  amorphous,  insoluble  in  water,  but  readily  soluble  in 
alcohol  ;  the  active  ingredient  of  Homolle’s  French  Digitaline  and  the  Digitalin  of  the 
U.  S.  and  Br.  Pharmacopoeias; — (2)  Digitoxin ,  insoluble  in  water  and  sparingly  soluble 
in  alcohol ;  the  most  active  of  all,  and  the  principal  constituent  of  Nativelle’s  prize  Digi¬ 
taline  ;  —  (3)  Digitalein ,  soluble  in  both  water  and  alcohol ; — (4)  Digitonin,  readily  soluble 
in  water,  sparingly  so  in  alcohol ; — active,  but  acts  like  Saponin,  forming  a  solution  which 
froths  easily  and  antagonizes  the  other  three; — (5)  Digitin,  which  seems  to  be  entirely 
inert.  The  first  three  are  cardiac  poisons,  the  fourth  antagonizes  them ;  and  all  five  are 
non-nitrogenous,  and  except  Digitoxin,  are  glucosides. 


Preparations. 

These  vary  greatly  in  results,  by  reason  of  the  different  solubilities  and  actions  of  the 
active  principles. 

Digitalis ,  Folia  Digitalis,  Digitalis  Leaves.  Dose,  gr.  ss-iij. 

Abstraction  Digitalis ,  Abstract  of  Digitalis.  Dose,  gr.  j^-ij. 

Extraction  Digitalis ,  Extract  of  Digitalis, — Al.  2,  Aq.  1.  Dose,  Ye-fz- 

Extr.  Digitalis  Eluidnm,  FI.  Ext.  of  Digitalis, — Al.  3,  Aq.  I.  Dose,  Trpj-iij. 

Tinctura  Digitalis,  Tincture  of  Digitalis, — 15  per  cent.  Dose,  rrpv-^j. 

Infusum  Digitalis,  Infusion  of  Digitalis, — 1^  per  cent.  Dose,  ^ss-j.  Is  flavored 
with  Cinnamon,  and  has  7 per  cent,  of  Alcohol. 

Digitalinum,  Digitalin, — the  complex  product  of  the  process  in  the  U.  S.  and  Br. 
Phar.,  but  no  longer  official.  Dose,  gr.  -%^-jo" 

Note  on  the  Preparations. — Of  the  above,  the  Tincture  and  Eluid  Extract,  being 
alcoholic  preparations,  contain  a  large  proportion  of  Digitalin  and  Digitalein,  with  a  small 
proportion  of  Digitonin ;  the  Digitoxin  going  to  the  bottom  as  an  insoluble  precipitate. 
The  Infusion  contains  a  larger  proportion  of  Digitonin  than  of  the  others,  some  Digitalein, 
and  little  or  no  Digitoxin  or  Digitalin.  It  is  the  best  for  diuretic  action,  the  Tincture  for 
acting  upon  the  heart ;  but  to  obtain  the  action  of  the  plant  itself,  the  powdered  leaves 
must  be  used  in  pill  or  capsule. 


Physiological  Action. 

Digitalis  is  a  cardiac  tonic  and  a  vascular  stimulant,  an  excito-motor, 
also  emetic,  diuretic,  hemostatic,  anaphrodisiac,  and  paralyzant.  In  over¬ 
doses  it  irritates  the  mucous  membranes,  causing  sneezing,  severe  gastric 
disturbances,  nausea,  vomiting,  colic  and  purging,  the  discharges  being 
of  a  grass-green  color.  It  lowers  temperature,  probably  by  lessening  the 
blood-supply  to  the  tissues,  produces  headache,  irregularity  of  the  heart’s 
action,  vertigo  and  an  appearance  of  vibratory  fringes  of  color  around 
objects. 

The  Heart  is  slowed  by  Digitalis,  but  its  force  is  at  the  same  time 
increased.  The  drug  stimulates  the  cardiac  motor  ganglia,  the  inhibitory 
apparatus,  and  the  vaso-motor  centres,  contracting  the  arterioles ;  and 
thereby  greatly  raising  the  arterial  tension.  Full  doses  continued  exhaust 
the  irritability  of  the  motor  ganglia  and  paralyze  the  cardiac  muscle  itself. 
The  recumbent  posture  must  be  maintained  when  Digitalis  is  given  for  its 
full  cardiac  effects.  Its  general  effect  on  striped  muscular  tissue  is  to 
lessen  the  contractile  power,  causing  great  weakness  and  languor.  Under 


200 


DIGITALIS. 


it,  the  excretion  of  urea  is  at  first  increased,  but  soon  decidedly  dimin¬ 
ished.  It  lessens  the  sexual  appetite  and  impairs  the  venereal  function. 

The  Diuretic  Action  of  Digitalis  is  due  to  its  peculiar  influence  upon 
the  general  and  renal  circulation,  it  increasing  the  force  of  the  ventricular 
contractions,  while  at  the  same  time  one  of  its  constituents,  Digitalin , 
contracts  the  blood  vessels  of  the  body,  and  two  others,  Digitoxin  and 
Digitale'in ,  dilate  the  renal  arteries.  The  effect  of  this  combined  action 
is  to  greatly  raise  the  arterial  tension  and  the  blood-pressure  in  the 
glomeruli,  their  afferent  vessels  being  contracted  ; — while  the  rapidity  of 
the  renal  circulation  is  increased  and  its  volume  augmented  by  the  greater 
force  of  the  heart-beat  and  the  dilatation  of  the  afferent  vessels.  No  other 
drug  known  has  this  double  power,  and  therefore,  so  far  as  vascular  action 
is  concerned,  Digitalis  is  the  ideal  diuretic.  Still,  while  its  power  to  pro¬ 
duce  diuresis  in  cardiac  disease  is  unquestioned,  most  observers  deny  that 
it  has  any  such  power  in  health. 

Lethal  Doses  lessen  the  reflexes  by  stimulation  of  Setschenow’s  centre, 
and  paralyze  the  muscles  and  the  peripheral  nerves,  motor  and  sensory. 
Respiration,  at  first  slowed,  becomes  rapid  and  feeble ;  cyanosis,  coma 
and  convulsions  follow,  and  death  by  sudden  paralysis  of  the  heart,  which 
is  arrested  in  systole. 

Compared  with  Aconite,  both  it  and  Digitalis  slow  the  heart,  but  other¬ 
wise  their  actions  are  antagonistic.  Aconite  relaxes  inhibition  and 
depresses  the  cardiac  motor  ganglia, — Digitalis  increases  inhibition  and 
stimulates  the  motor  apparatus.  Both  drugs  finally  paralyze  the  cardiac 
ganglia,  Aconite  by  direct  depression,  Digitalis  by  over-stimulation. 
Both  depress  the  cardiac  muscle.  Under  Aconite  the  heart  is  arrested  in 
diastole,  under  Digitalis  in  systole.  The  arterial  tension  is  lowered  by 
Aconite,  raised  by  Digitalis.  Aconite  acts  quickly,  Digitalis  very  slowly, 
— a  fact  which  makes  the  latter  drug  of  little  value  in  poisoning  by  the 
former. 

During  the  use  of  this  drug  for  any  length  of  time  the  motor  apparatus 
of  the  heart  is  so  nearly  paralyzed  by  over-stimulation  that  on  suddenly 
assuming  the  erect  position  the  cardiac  energy  may  fail,  more  especially 
if  the  doses  used  are  administered  too  closely  together  to  admit  of  the 
elimination  of  one  before  the  ingestion  of  the  next.  This  is  the  expla¬ 
nation  of  the  so-called  cumulative  action  of  Digitalis,  which  is  not  now 
recognized  in  the  sense  in  which  the  term  was  formerly  applied. 


Antidotes ,  Antagonists  and  Incompatibles . 

Tannic  Acid  is  the  chemical  antidote,  but  as  the  tannate  is  not  inert  the  stomach 
should  be  evacuated.  Aconite  is  the  best  antagonist  to  the  effects  of  large  doses,  Opium 
to  those  of  its  long-continued  use.  Saponin  and  Senegin  are  considered  to  be  its  most 
complete  physiological  antagonists.  Incompatibles  are  Cinchona,  Sulphate  of  Iron,  Tinc¬ 
ture  of  the  Chloride  of  Iron,  and  Acetate  of  Lead,  also  syrupy  and  watery  solutions 
which  may  decompose  the  active  principles  of  the  plant. 


DIOSCOREA. 


201 


Therapeutics. 

The  chief  use  of  Digitalis  in  disease  is  based  on  its  property  as  a  heart 
tonic.  Its  great  sphere  is  in  mitral  disease,  when  the  heart  is  rapid  and 
feeble,  it  moderating  pulmonary  hypersemia  and  engorgement  by  giving 
the  auricle  time  to  empty  itself  through  the  obstructed  orifice.  In  aortic 
disease  it  gives  relief  when  the  compensatory  hypertrophy  has  not  set  in, 
otherwise  it  is  contraindicated.  It  is  particularly  useful  in  dilatation  of 
the  right  side  of  the  heart  with  incompetence  of  the  tricuspid.  The 
rational  symptoms  which  indicate  its  use  are — rapid  and  feeble  cardiac 
action,  low  arterial  tension,  cough,  dyspnoea,  pulsating  jugulars,  a  dusky 
face,  scanty  and  high-colored  urine  and  general  dropsy.  In  the  irritable 
heart  of  soldiers  Digitalis  is  frequently  curative,  and  palpitation,  cardiac 
failure,  and  venous  engorgement  are  well  treated  by  it.  It  should  not  be 
used  in  simple  hypertrophy  when  compensatory,  aortic  stenosis  with  com¬ 
pensatory  hypertrophy,  pericarditis  or  fatty  heart,  except  temporarily  for 
some  special  indication.  It  is  a  useful  remedy  in  dropsy,  both  cardiac 
and  renal,  in  the  first  stage  of  pneumonia  and  other  inflammations,  in  the 
early  stage  of  scarlet  fever  and  when  the  kidneys  strike  work  in  that 
disease,  in  exophthalmic  goitre,  congestive  headaches,  and  hemicrania,  in 
mania,  delirium  tremens  and  other  congestive  conditions  of  the  brain. 
As  a  hemostatic  it  may  be  used  in  hemorrhage  from  a  large  surface,  in  the 
hemorrhagic  diathesis,  hemoptysis,  and  menorrhagia.  As  an  antipyretic 
it  has  been  much  used  in  fevers,  but  a  reaction  is  setting  in  against  this 
employment  of  so  powerful  a  heart-depressant.  In  rheumatic  fever  it 
lowers  the  temperature,  shortens  the  duration  of  the  disease,  and  is  par¬ 
ticularly  indicated  for  any  cardiac  complications.  In  spermatorrhoea  of 
the  plethoric  it  may  be  well  combined  with  Potassium  Bromide,  and  when 
this  affection  is  complicated  with  an  atonic  condition,  shown  by  feeble 
erections,  frequent  emissions  and  cold  feet  and  hands,  it  is  a  serviceable 
anaphrodisiac.  Finally,  Digitalis  is  said  by  high  authority  to  be  particularly 
adapted  to  blondes  and  persons  of  sanguine  and  indolent  temperament. 

DIOSCOREA,  Wild  Yam,  Colic-root  (Unofficial), — is  the  rhi¬ 
zome  of  Dioscorea  villosa ,  a  creeping  plant  of  the  nat.  ord.  Dioscoraceae, 
indigenous  to  the  eastern  U.  S.  It  contains  an  acrid  resin,  and  is  re¬ 
ported  to  be  expectorant  and  diaphoretic  in  action,  as  well  as  stimulating 
to  the  intestinal  canal,  and  in  large  doses  to  cause  general  neuralgic  pains 
with  erotic  excitement.  It  is  used  with  great  success  in  bilious  colic ; 
and  in  the  cramps  of  cholera  morbus,  spasmodic  hiccough,  dysmenorrhoea 
and  nocturnal  emissions  of  sthenic  type  it  is  said  to  be  very  efficient.  A 
powdered  extract  named  Dioscorein  is  on  the  market,  of  which  the  dose 
is  gr.  j-iv.  A  fluid  extract  made  according  to  the  pharmacopoeial  rule 
may  be  administered  in  doses  of  rrLxv-xxx. 


202 


DITA  BARK - DROSERA - DUBOISIA. 


DITA  BARK  (Unofficial)  , — is  the  bark  of  Alstonia  scho/aris ,  a  tree 
of  the  nat.  ord.  Apocynaceae,  growing  in  the  Philippine  Islands.  It  con¬ 
tains  two  active  alkaloids,  Ditaine  and  Ditamine ,  the  former  of  which 
has  an  action  identical  with  that  of  Curare.  The  bark  is  considered  tonic 
and  antiperiodic,  and  is  used  in  the  East  as  a  remedy  for  intermittents. 
It  may  be  given  in  doses  of  3j~iv,  in  powder  or  as  fluid  extract. 

DROSERA,  Sundew  (Unofficial). — A  fluid  extract  of  Drosera 
rotundifolia ,  the  round-leaved  Sundew,  is  said  to  have  been  successfully 
used  in  phthisis  pulmonalis.  It  is  certainly  a  most  useful  agent  in  whoop¬ 
ing-cough  and  other  spasmodic  coughs ;  especially  when  marked  by  vio¬ 
lent  paroxysms,  the  cough  being  loud  and  harsh,  and  followed  by  bleed¬ 
ing  from  the  nose  or  mouth,  and  perhaps  by  vomiting  of  the  contents  of 
the  stomach.  The  expressed  juice  has  been  applied  to  warts  and  corns, 
for  the  purpose  of  curing  them.  Dose  of  the  fluid  extract,  ffpv-xx. 

DUBOISIA  (Unofficial), — is  the  leaf  of  Duboisia  myoporoides ,  an 
Australian  tree  of  the  order  Solanaceae.  It  contains  a  poisonous  alkaloid, 
Duboisine ,  which  is  believed  to  be  identical  with  Hyoscyamine,  and 
strongly  resembles  Atropine. 

Preparations. 

Extractum  Duboisia  (Unofficial), — Dose,  gr.  -g- X* 

Tinctura  Duboisia  (Unofficial), — Dose,  rtpv-xx. 

Duboisina  Sulphas  (Langenberg’s),  Unofficial, — Dose,  gr.  t£o~6V 

Physiological  Action. 

The  actions  of  Duboisia  are  in  all  respects  similar  to  those  of  its  con¬ 
gener,  Belladonna,  except  that  Duboisine  is  more  soluble  in  water  than 
Atropine,  is  less  irritating  to  mucous  membranes,  and  more  prompt  in 
mydriatic  action,  but  its  effects  are  of  shorter  duration.  It  is  also  less  of 
a  cerebral  excitant  and  more  of  a  calmative  and  hypnotic.  On  man  its 
action  is  said  by  some  authorities  to  be  more  powerful  than  that  of  Atro¬ 
pine,  but  less  powerful  on  frogs. 

Antagonists  and  Incompatibles. 

These  are  the  same  as  for  Belladonna,  for  which  see  ante ,  p.  127. 

Therapeutics. 

Duboisine  has  not  been  much  used  except  by  ophthalmologists  who 
employ  it  as  a  mild  mydriatic.  Its  advantages  over  Atropine  in  ocular 
therapeutics  are  its  more  rapid  action  in  paralyzing  accommodation  and 
effecting  mydriasis,  the  shorter  duration  of  its  effects  and  its  slight  irrita¬ 
tion  of  the  conjunctiva.  It  has  been  well  employed  in  puerperal  mania, 
and  may  be  used  in  place  of  Atropine  in  many  conditions,  especially  the 
night-sweats  of  phthisis,  respiratory  neuroses  and  cardiac  failure.  It  is  an 
efficient  antagonist  to  Morphine. 


DULCAMARA - ELATERINUM. 


203 


DULCAMARA,  Bittersweet, — the  young  branches  of  Solatium 
Dulcamara ,  or  Woody  Night-shade,  a  shrub  of  the  nat.  ord.  Solanaceae, 
growing  in  Europe  and  N.  America.  Occurs  in  short  sections  inch 
thick,  covered  with  a  pale  green  bark,  of  slight  odor,  and  taste  at  first 
bitter,  afterwards  sweet.  It  contains  the  glucoside  Dulcamarin,  a  pecu¬ 
liar  principle  named  Plcroglyclon,  and  the  alkaloid  Solanlne,  which  exists 
in  the  stems  of  other  species  of  Solanum,  viz. — S.  tuberosum  (potato),  S. 
Lycopersicum  (tomato),  and  S.  nigrum  (black  nightshade).  Solanine  is 
of  bitter  taste,  alkaline  reaction,  crystalline  in  minute  prisms  soluble  in 
125  of  boiling  alcohol  but  very  insoluble  in  water.  It  is  a  narcotic 
poison,  but  exists  in  very  small  quantity  in  the  plant. 

Preparations. 

Extradum  Dulcamarce  Fluidum , — Dose,  3  j. 

Decodum  Dulcamarce  (Unofficial), — may  be  made  of  the  official  10  per  cent,  strength 
and  given  in  doses  of  ^j-ij. 

Physiological  Action. 

Dulcamara  is  but  imperfectly  understood.  In  overdoses  it  has  pro¬ 
duced  nausea  and  vomiting,  vertigo,  convulsive  muscular  movements, 
pruritus  and  erythematous  eruptions  on  the  skin,  languid  circulation  with 
a  dusky  color  of  the  face  and  hands.  In  children  who  have  eaten  the 
berries  there  have  been  observed  signs  of  severe  enteralgia,  abdominal 
tenderness,  nausea,  thirst,  heat  in  the  throat  and  chest,  great  prostration, 
rapid  pulse,  quick  and  painful  respiration.  In  very  large  doses  it  is  a 
narcotic  poison,  causing  paralysis  by  depression  of  the  central  nervous 
system,  with  lowered  activity  of  the  heart  and  respiration.  It  is  believed 
by  some  authorities  to  be  anaphrodisiac,  diaphoretic  and  diuretic. 

Therapeutics. 

Dulcamara  was  formerly  used  in  a  variety  of  affections,  as  herpetic 
diseases,  chronic  rheumatism,  gout,  jaundice,  etc.  It  is  now  chiefly 
employed  in  obstinate  scaly  skin  diseases,  as  psoriasis  and  pityriasis,  in 
which  it  is  unquestionably  serviceable.  It  is  also  serviceable  in  the  diar¬ 
rhoea  of  children  when  produced  by  exposure  to  cold  and  damp,  in 
mania  with  strong  venereal  propensities,  chronic  bronchitis  and  whooping- 
cough.  As  a  diaphoretic  it  has  been  used  with  benefit  in  rheumatic  and 
venereal  disorders,  and  is  often  beneficial  in  nasal,  pulmonary  and  vesical 
catarrhs.  It  is  said  to  be  particularly  useful  in  affections  of  a  rheumatic 
or  catarrhal  nature  when  caused  by  exposure  to  damp  weather. 


ELATERINUM,  Elaterin,  C20H28O3, — is  a  neutral  principle  ex¬ 
tracted  from  Elaterium ,  a  substance  deposited  by  the  juice  of  the  fruit  of 
Ecballium  Elaterium ,  or  Squirting  Cucumber,  a  cultivated  European 


204 


ERGOTA. 


plant  of  the  nat.  ord.  Cucurbitaceae.  Elaterium  is  no  longer  official  by 
reason  of  its  variable  quality.  Elaterin  occurs  in  small,  colorless  scales 
or  prisms,  of  bitter  taste  and  neutral  reaction,  insoluble  in  water,  soluble 
in  125  of  alcohol  and  in  solutions  of  the  alkalies.  Dose,  gr.  — rV 

Preparation. 

Trituratio  Elaterini, — Elaterin  10,  Sugar  of  Milk  90  parts,  thoroughly  mixed  by  tritu¬ 
ration.  Dose,  gr.  ss-j. 

Physiological  Action  and  Therapeutics. 

Elaterin  is  the  most  powerful  of  the  hydragogue  cathartics,  causing 
profuse,  watery  stools,  and  when  given  in  large  doses  great  prostration 
and  gastro-intestinal  irritation,  nausea  and  vomiting.  On  the  lower  ani¬ 
mals  it  does  not  produce  purgation,  but  profoundly  impresses  the  nervous 
system,  causing  irregular  breathing,  convulsions  and  death. 

Its  chief  use  is  to  produce  free  watery  discharges  in  ascites,  anasarca, 
uraemia  and  cerebral  disorders,  but  while  the  most  efficient  agent  we 
possess  for  this  purpose  it  must  be  used  with  great  caution  in  the  aged  and 
feeble,  as  it  is  very  depressant. 


ERGOTA,  Ergot,  Ergot  of  Rye, — is  the  sclerotium  (compact 
mycelium  or  spawn,  intermediate  fibrous  stage)  of  Claviceps  purpurea 
(nat.  ord.  Fungi),  growing  within  the  flower  and  replacing  the  grain  of 
Secale  cereale ,  Rye  (nat.  ord.  Graminaceae).  It  occurs  in  fusiform, 
curved,  grain-like  bodies,  about  an  inch  long,  three-furrowed,  obtuse  at 
the  ends,  of  purplish-black  color,  peculiar  and  heavy  odor,  and  oily,  dis¬ 
agreeable  taste.  It  should  be  preserved  in  a  dry  place,  and  should  not 
be  kept  longer  than  a  year.  Dose,  gr.  x-5j- 

Composition  of  Ergot. 

The  composition  of  Ergot  and  the  nomenclature  of  its  supposed  con¬ 
stituents  is  a  subject  upon  which  there  exists  a  great  diversity  of  opinion, 
and  about  which  there  is  nothing  settled.  The  following  synopsis  gives 
the  views  of  the  different  persons  who  have  examined  into  the  matter. 

Wenzell  (1864)  named  two  alkaloids,  Ecboline  and  Ergotine,  which  he  claimed  to  be 
the  active  principles,  and  to  be  combined  with  Ergotic  Acid,  a  volatile  body  yielding 
crystallizable  salts.  He  also  claimed  the  presence  of  Trimethylamine  as  a  Phosphate. 

Tanret  (1877)  isolated  a  crystallized  alkaloid,  which  he  named  Ergotinine, 
C35H40N4O6  (dose,  gr.  ^L—jL),  also  a  volatile  camphoraceous  substance. 

Dragendorff  and  his  pupils  (1875-1879)  stated  the  active  principles  to  be  two  in 
number,  Sclerotinic  Acid ,  a  very  powerful  body,  yellow-brown,  amorphous,  tasteless  and 
well  adapted  for  hypodermic  use  in  doses  of  gr.  and  Scleromucui ,  a  colloid  sub¬ 

stance,  also  quite  active.  Besides  these  they  held  that  Ergot  contained  various  coloring 
matters  (Sclererythrin,  Scleroxanthin,  etc.),  also  a  non-drying  Oil,  a  peculiar  sugar 
(Mykose),  a  number  of  alkaloids  (Trimethylamine,  etc.),  and  other  principles,  all  inert. 

Robert  (1885)  announces  that  Ergot  contains  three  active  principles,  viz.,  Ergotinic 
Acid,  the  chief  constituent  of  Sclerotinic  Acid,  having  no  ecbolic  action,  but  affecting  the 
nervous  system,  the  heart  and  the  respiration  ; — Sphace/inic  Acid,  which  is  non-nitrogen- 


ERGOTA. 


205 


ous  and  soluble  in  alcohol,  stimulates  the  vaso-motor  centre  and  is  the  active  agent  in 
producing  gangrenous  ergotism  ; — Cornytine ,  an  alkaloid,  produces  convulsions  and  peri¬ 
staltic  contractions  of  the  uterus,  and  is  the  active  agent  in  causing  convulsive  ergotism. 

Tanret’s  Ergotinine  has  been  proven  to  have  no  action  on  the  uterus. 
The  Ergotin  of  Bonjean,  Wiggers  and  Tanret  is  not  a  fixed  compound, 
but  a  mixture.  The  Ecboline  of  Wiggers  is  also  a  mixture.  Sclerotinic 
Acid  is  said  by  many  authorities  to  act  on  the  uterus,  but  this  is  positively 
denied  by  many  others.  It  is  probably  a  very  uncertain  preparation. 
For  the  Ergotin  of  commerce  see  below. 

Preparations. 

Extractum  Ergotce  Fluidum, — prepared  with  diluted  Hydrochloric  Acid,  Alcohol  and 
Water.  Dose,  ^ss-ij. 

Extractum  Ergotce ,  Extract  of  Ergot,  commonly  called  Ergotin , — is  prepared  by 
evaporating  5  parts  of  the  fluid  extract  at  a  temperature  not  above  1220  F.  until  reduced 
to  I  part.  Dose,  gr.  ij-xx. 

Vinum  Ergotce , — strength  15  per  cent.  Dose,  3 j- ^ j.  Is  made  by  an  improved 
method  and  is  more  reliable  than  that  formerly  official. 

Ergotin  (Unofficial), — is  the  name  of  several  watery  extracts  found  on  the  market, 
and  varying  much  in  action  both  from  each  other  and  from  the  parent  drug.  That  made 
by  Squibb  is  about  the  same  strength  as  the  official  extract,  and  represents  the  general 
powers  of  Ergot.  It  may  be  used  hypodermically  in  doses  of  gr.  %-gr.  v.  The  Ergotin 
of  Bonjean  is  also  an  aqueous  extract,  but  is  very  variable  in  quality  and  frequently  inert. 
Wiggers’  Ergotin  is  insoluble  in  the  ordinary  menstrua,  and  inert  on  the  vascular  appa¬ 
ratus,  but  causes  colic  and  gastro-enteritis. 

Physiological  Action. 

Ergot  is  an  excito-motor  and  a  hemostatic,  chiefly  affecting  the  spinal 
cord,  circulation,  respiration,  intestinal  and  uterine  muscular  fibres.  Its 
principal  actions  are  the  production  of  an  artificial  anaemia,  and  tetanic 
contraction  of  unstriped  muscular  fibre.  Its  phenomena  are  divided  into 
two  sets,  named  respectively  Acute  and  Chronic  Ergotism ,  according  as 
the  drug  is  administered  in  large  doses,  or  in  small  quantity  for  a  consid¬ 
erable  length  of  time. 

Acute  Ergotism.  In  large  doses  Ergot  acts  as  a  gastro-intestinal 
irritant,  causing  nausea  and  vomiting,  gastralgia,  colic,  thirst,  difficult 
micturition  and  purging.  It  slows  the  heart,  raises  the  arterial  tension 
greatly,  dilates  the  pupils  and  produces  pallor,  vertigo  and  frontal  head¬ 
ache.  Its  action  on  the  circulation  is  due  to  its  inducing  arterial  anaemia, 
but  whether  this  is  done  by  contraction  of  the  arterioles  through  direct 
action  on  their  muscular  fibres  or  by  central  stimulation  of  the  vaso-motor 
system,  or  by  producing  active  venous  dilatation,  thus  draining  the  arte¬ 
rial  system,  is  a  much  disputed  question.  It  certainly  stimulates  the  con¬ 
traction  of  unstriped  muscular  fibre,  especially  affecting  the  sphincters 
and  the  uterus,  causing  continuous  labor  pains  and  tonic  contraction  of 
the  sphincter  vesicae,  making  micturition  difficult  if  not  impossible.  It 
also  produces  cerebral  and  spinal  anaemia,  coldness  of  the  surface,  tetanic 
spasms  and  violent  convulsions,  but  very  large  doses  (several  ounces)  are 


206 


ERGOTA. 


necessary  to  such  results.  As  much  as  3 iij  of  the  fluid  extract  has  been 
given  daily  for  a  week  or  more,  without  producing  any  marked  effect. 

Chronic  Ergotism  occurs  in  two  forms,  (i)  the  Convulsive ,  (2)  the 
Gangrenous , — either  usually  excluding  the  other.  The  convulsions  are 
tetanoid  spasms  of  the  flexor  muscles,  the  uterus,  the  intestinal  fibres,  and 
the  muscles  of  respiration,  ending  in  coma  and  death  by  asphyxia.  The 
gangrenous  form  begins  with  coldness  and  numbness  of  the  limbs,  formi¬ 
cation  of  the  skin  all  over  the  body,  loss  of  sensibility  and  abolishment 
of  the  special  senses,  bullae  of  blood  and  ichor,  followed  by  dry  or  moist 
gangrene  of  the  lower  extremities,  buttocks  and  other  parts,  epileptiform 
convulsions,  coma  and  death.  Autopsies  show  changes  in  the  posterior 
columns  of  the  cord,  resulting  probably  from  the  spinal  anaemia. 

Experiments  with  the  various  derivatives  of  Ergot  show  that  no  one 
of  its  constituents  represents  the  power  of  the  drug  itself.  Those  which 
come  nearest  to  it  in  action  are  the  Ergotinine  of  Tanret  and  Sclerotinic 
Acid. 

Antagonists  and  Incompatibles. 

Amyl  Nitrite,  Aconite,  Veratrum  Viride,  Tobacco  and  Lobelia  antagonize  its  action 
on  the  circulation.  Caustic  alkalies  and  metallic  salts  are  chemically  incompatible. 

Therapeutics. 

Ergot  has  a  wide  field  of  application.  Its  most  familiar  use  is  to  pro¬ 
mote  uterine  contraction  in  labor,  but  as  the  contractions  produced  by  it 
are  continuous  instead  of  the  natural  intermittent  ones,  it  is  highly  dan¬ 
gerous  when  there  is  any  obstacle  in  front  of  the  child,  the  probable 
results  being  rupture  of  the  uterus,  paralysis  of  the  foetal  heart,  and  severe 
laceration  of  the  perineum.  At  the  end  of  the  second  stage,  when  the 
head  is  born,  is  the  best  time  for  its  use  (if  employed  in  labor  at  all),  in 
order  to  promote  firm  uterine  contraction,  thereby  guarding  against  post¬ 
partum  hemorrhage,  and  promoting  the  expulsion  of  the  placenta.  The 
tendency,  however,  of  obstetrical  teaching,  is  against  its  employment  at 
all  in  labor ;  while,  in  practice,  the  teaspoonful  of  Ergot  is  almost  in¬ 
variably  administered  as  soon  as  possible  after  the  child  is  born.  In 
many  uterine  affections,  as  chronic  metritis,  subinvolution,  congestive 
dysmenorrhoea,  menorrhagia,  fibroids  and  polypi,  Ergot  is  well  em¬ 
ployed,  producing  firm  contraction  of  the  womb  and  promoting  absorp¬ 
tion  of  inflammatory  products.  It  is  extremely  useful  in  amenorrhoea 
due  to  plethora,  and  in  the  atonic  form  of  spermatorrhoea.  In  con¬ 
junctivitis,  gonorrhoea,  and  inflammations  of  mucous  membranes  gen¬ 
erally,  it  is  of  striking  benefit,  if  used  both  locally  and  internally.  It 
is  also  an  excellent  remedy  in  acute  and  chronic  dysentery,  chronic  diar¬ 
rhoea,  atonic  hemorrhages  of  arterial  type,  mania  due  to  cerebral  hyper- 
temia,  headache  and  migraine  of  congestive  form,  myelitis,  spinal  con¬ 
gestion,  cerebro-spinal  meningitis,  splenic  enlargement,  lax  sphincters  of 


ERIGERON - ERIODYCTION. 


207 

rectum  and  bladder,  and  in  incontinence  of  urine  from  paralysis  of  the 
sphincter  vesicse.  Hemorrhoids  are  well  treated  by  its  local  application, 
but  here  it  should  not  be  used  internally  as  it  promotes  venous  congestion. 
In  aneurism  it  aids  coagulation  by  slowing  the  blood-current,  and  in  car¬ 
diac  hypertrophy  without  valvular  lesion  it  acts  well  by  slowing  the  heart. 
In  diabetes  insipidus  full  doses  of  Ergot  are  often  curative,  and  it  has 
been  used  with  benefit  in  diabetes  mellitus. 

Hypodermically,  the  aqueous  extract  dissolved  in  water  and  free  from 
alcohol  or  any  other  irritating  substance,  is  in  many  cases  much  more 
prompt  in  action  than  when  given  per  orem,  especially  if  injected  near  to 
the  seat  of  the  affection.  This  is  particularly  true  in  post-partum  and 
other  hemorrhages,  prolapse  of  the  rectum,  chronic  metritis  and  subinvo¬ 
lution  of  the  womb,  uterine  fibroids,  varicocele  and  varicose  veins.  When 
so  administered  it  will  frequently  so  contract  the  sphincter  of  the  bladder 
as  to  produce  retention  of  urine,  and  require  the  use  of  the  catheter. 

ERIGERON,  Fleabane  (Unofficial), — is  the  flowering  plant  Eri¬ 
geron  canadense ,  a  weed  of  the  nat.  ord.  Compositae,  growing  in  N. 
America.  It  contains  a  Volatile  Oil,  which  is  official,  also  tannic  acid 
and  a  bitter  extractive. 

Oleum  Erigerontis ,  Oil  of  Fleabane, — a  pale  yellow  liquid,  of  sp.  gr.  about  0.850, 
becoming  darker  by  age  and  exposure  to  air,  of  peculiar  and  persistent  odor,  pungent 
taste  and  neutral  reaction,  readily  soluble  in  alcohol.  Dose,  rtpx-^ss. 

Oil  of  Erigeron  has  the  same  action  as  Oil  of  Turpentine  but  is  less 
irritant  and  less  efficient.  It  has  considerable  reputation  as  a  hemostatic, 
especially  in  menorrhagia  and  intestinal  hemorrhage  of  passive  form,  as 
in  typhoid  fever.  It  is  also  used  with  benefit  in  diarrhoea  and  dysentery, 
and  in  hemoptysis  without  fever  or  other  evidence  of  irritation  it  is  a  very 
valuable  remedy. 

ERIODYCTION,  Yerba  Santa  (Unofficial), — the  leaves  of  Erio- 
dyction  glutinosum ,  a  Californian  shrub  of  the  nat.  ord.  Hydrophyllacese. 
They  are  from  2  to  4  inches  long,  shining  green  as  if  varnished  on  the 
upper  surface,  white  and  hairy  beneath,  of  fragrant  odor,  aromatic  taste, 
and  contain  an  acrid  Resin  and  an  aromatic  Volatile  Oil. 

Extractum  Eriodyctii  Fluidum  (Unofficial), — Dose,  rtyxv-^j. 

Extractum  Eriodyctii  (Unofficial), — Dose,  gr.  ij-x. 

Eriodyction  is  expectorant,  and  covers  the  taste  of  Quinine  in  a  re¬ 
markable  manner,  for  which  purpose  it  is  combined  in  mixture  with  Gly- 
cyrrhizin,  under  the  title  11  Veloutine"  as  a  proprietary  preparation  (see 
ante ,  page  182).  It  is  used  with  fair  success  in  bronchial  and  laryngeal 
affections,  also  in  asthma.  Combined  in  syrup  with  Grindelia  it  is  very 
efficient  for  coughs. 


208 


ERYTHROXYLON. 


ERYTHROXYLON,  Coca,  Cuca, — the  leaves  of  Erythroxylon 
Coca ,  a  small  shrub  of  the  nat.  ord.  Erythroxylaceae,  indigenous  to  the 
mountains  of  Peru  and  Bolivia,  and  extensively  cultivated  in  those  and 
other  S.  American  states.  It  has  numerous  purplish-brown  branches ; 
small,  yellowish,  5-petalous  flowers,  and  a  scarlet-red,  oblong  fruit,  con¬ 
taining  a  single  seed.  The  leaf  resembles  a  large  tea-leaf,  being  2  to  3 
inches  long,  oval-shaped,  obtuse  at  the  apex,  reticulate  on  both  sides, 
with  a  prominent  midrib,  on  either  side  of  which  is  seen  a  curved  line  on 
the  leaf  from  base  to  apex ;  odor  tea-like,  taste  slightly  bitter  and  aro¬ 
matic.  It  contains  a  crystalline  alkaloid  Cocaine ,  C17H21N04,  which  when 
heated  with  HC1  is  split  up  into  Benzoic  Acid,  Methylic  Alcohol  and 
another  alkaloid  Ecgoni?ie.  Other  constituents  are  a  volatile,  liquid 
alkaloid  of  herring-brine  odor,  alkaline  reaction  and  burning  taste,  named 
Hygrine ,  an  aromatic  Oil,  and  Coca-tannic  Acid.  Coca  should  not  be 
confounded  with  Cocoa,  the  seed  of  the  chocolate-tree,  Theobroma  Cacao. 
Dose  of  the  leaves,  5j-iv. 

Preparations. 

Extractum  Erythroxyli  Fluid um, — Dose,  3  ss-ij.  Leaves  of  good  quality  are  so 
difficult  to  be  obtained  that  Dr.  Squibb,  the  well-known  pharmaceutist,  recently  omitted 
the  fluid  extract  from  his  trade-list,  with  the  explanation  that  “it  is  impossible  to  get  Coca 
of  proper  quality  for  medical  use.” 

Cocaina,  Cocaine,  C17H21N04  (Unofficial), — crystalline,  colorless  and  of  bitter  taste, 
very  soluble  in  ether,  almost  insoluble  in  water  or  alcohol,  and  of  decided  basic  proper¬ 
ties,  combining  with  acids  to  form  salts.  It  exists  in  the  leaves  in  very  small  quantity, 
viz. — from  0.02  to  0.04  per  cent.  Dose,  gr.  y%- ij. 

Cocaines  Hydrochloras ,  Hydrochlorate  of  Cocaine,  C17H21N04C1  (Unofficial), — more 
properly  Chloride  of  Cocaine. — is  used  in  aqueous  solutions  of  2  to  5  per  cent,  as  a  local 
anaesthetic  to  mucous  surfaces  or  by  subcutaneous  injection.  Dose,  internally,  gr.  ij. 

Cocaince  Oleas ,  Oleate  of  Cocaine  (Unofficial), — a  10  per  cent,  solution  of  the  alka¬ 
loid  in  Oleic  Acid,  for  external  use. 

Wines,  Lozenges,  Elixirs,  Glyceroles,  Pastes,  etc.,  of  Coca  are  being  manufactured  and 
marketed  in  great  variety.  The  Citrate  and  Salicylate  of  Cocaine  are  recent  products  of 
the  laboratory  and  may  be  obtained  in  the  shops. 


Physiological  Action. 

Coca  is  an  aromatic  bitter  tonic,  a  diuretic  and  a  cerebral  and  nervous 
stimulant,  though  locally  used  one  of  the  most  efficient  nerve  sedatives. 
Small  doses  improve  digestion,  stimulate  respiration,  increase  the  heart’s 
action  after  a  brief  depression,  raise  the  arterial  tension,  and  increase  the 
excitability  of  the  sensory  nerves.  It  stimulates  the  brain  by  increasing 
its  blood-supply,  producing  wakefulness,  a  sense  of  well-being,  and  a 
marked  diminution  of  the  senses  of  fatigue,  hunger  and  thirst.  Under 
its  daily  use  a  considerable  amount  of  labor  and  want  of  sleep  can  be 
borne  without  suffering.  Though  diuretic,  it  lessens  the  quantity  of  urea 
eliminated  by  checking  the  processes  of  waste.  Very  large  doses  produce 
impaired  coordination,  hallucinations  and  delirium. 

Cocaine  acts  upon  the  lower  animals  similarly  to  Caffeine.  It  tetanizes 
frogs,  and  in  large  doses  paralyzes  their  sensory  nerves  and  the'  posterior 


ERYTHROXYLON. 


209 


columns  of  the  spinal  cord.  It  kills  rabbits  and  dogs  by  paralysis  of  the 
respiratory  centre.  In  proper  doses  it  raises  arterial  tension  by  stimulating 
the  vaso-motor  centres  and  the  cardiac  motor  system. 

On  man,  in  small  doses  Cocaine  is  a  cerebral,  cardiac,  respiratory  and 
nervous  stimulant,  and  a  diuretic.  It  improves  digestion,  stimulates  res¬ 
piration,  increases  the  heart’s  action,  raises  the  arterial  tension,  and  exalts 
the  irritability  of  the  sensory  nerves.  It  stimulates  the  brain  by  increasing 
its  blood-supply,  producing  wakefulness  and  marked  diminution  of  the 
senses  of  fatigue  and  hunger.  Though  decidedly  diuretic,  it  lessens  the 
quantity  of  urea,  by  checking  the  processes  of  waste,  thus  acting  as  an 
indirect  nutrient,  and  enabling  the  body  to  maintain  its  energy  on  a 
lessened  supply  of  food.  It  increases  the  cutaneous  circulation,  flushing  the 
surface,  exciting  perspiration,  and  a  sense  of  heat,  and  does  actually  raise 
the  body-temperature.  It  dilates  the  pupil,  both  when  locally  applied 
and  when  taken  systemically, — and  stimulates  intestinal  peristalsis  as  well 
as  the  evacuation  of  the  bladder  in  a  few  minutes  after  its  ingestion. 

A?i  Overdose  produces  symptoms  of  cardiac  and  respiratory  embarrass¬ 
ment  in  a  very  short  time.  The  pulse,  at  first  quick  and  forcible,  becomes 
small,  rapid  and  intermitting  ; — the  heart  apparently  standing  still  in 
systole  once  in  every  10  or  12  beats.  Respiration  is  slow  and  shallow, 
and  a  sense  of  “  tightness”  about  the  chest  is  very  marked; — the  skin 
grows  cold  and  clammy,  and  the  subject  is  seized  with  a  sense  of  impend¬ 
ing  dissolution.  Death  occurs  in  animals  by  paralysis  of  respiration, — 
but  in  man  there  seems  to  be  a  tetanoid  spasm  of  the  cardiac  muscle,  which 
is  equally  dangerous  to  life.  Other  symptoms  are  impairment  of  coordi¬ 
nation,  hallucinations  and  delirium.  Lethal  Doses  paralyze  the  intra¬ 
cardiac  motor  ganglia,  the  posterior  columns  of  the  cord  and  the  sensory 
nerves,  and  the  respiratory  centre. 

As  a  Local  Ancesthetic  the  power  of  Cocaine  is  very  great  over  a  limited 
area.  Applied  to  such  structures  as  the  Schneiderian  membrane,  mucous 
covering  of  the  glans  penis  ;  or  injected  hypodermically  in  other  locations, 
it  blanches  the  structures  and  causes  a  profound  but  temporary  anaesthesia 
throughout  a  small  space.  Applied  to  the  tongue  it  temporarily  destroys 
both  taste  and  tactile  sensibility; — to  the  ocular  conjunctiva,  it  produces 
profound  anaesthesia  of  that  membrane,  together  with  dilatation  of  the 
pupil,  partial  paralysis  of  accommodation,  enlargement  of  the  palpebral 
fissure,  slight  lachrymation,  and  sometimes  temporary  ptosis.  This  pro¬ 
found  degree  of  anaesthesia  is  thought  by  some  to  be  caused  by  its  para¬ 
lyzing  the  terminal  twigs  of  the  sensory  nerves, — by  others  to  be  due  to 
vaso-motor  action  rendering  the  nerves  bloodless  and  therefore  unable  to 
transmit  sensory  impressions.  It  produces  mydriasis  by  stimulation  of  the 
ends  of  the  sympathetic  in  the  iris,  and  does  not  affect  the  third  nerve  or 
the  sympathetic  centre. 

14 


210 


ERYTHR0XYL0N. 


In  general  action,  Cocaine  resembles  Atropine  very  closely,  especially 
in  its  influence  upon  the  pulse  and  blood-pressure,  the  respiration,  pupils, 
salivary-  and  sweat-glands  and  intestinal  peristalsis.  In  its  symptoms, 
both  from  large  and  small  doses,  it  exactly  parallels  Sparteine ,  another 
cardio-inhibitory  depressant. 

Antagonists. 

Amyl  Nitrite  combats  the  earliest  symptoms  of  cardiac  depression, — then  Alcohol  and 
Opium  as  stimulants  to  the  heart,  also  Artificial  Respiration.  The  most  direct  antago¬ 
nist  is  Chloral ,  so  also  are  Chloroform  and  Ether.  Morphine  is  also  directly  antagonistic 
at  almost  all  points. 

The  Cocaine-Habit. 

Cocainism,  or  the  Cocaine-habit,  is  now  presenting  itself  to  observation,  numerous 
instances  of  persons  addicted  to  its  excessive  use  being  met  with.  Loss  of  digestive  power, 
absolute  insomnia,  enfeeblement  of  the  intellect,  great  emaciation,  ascites,  general  maras¬ 
mus,  nausea,  decay  of  the  teeth,  an  excessively  fetid  breath,  amblyopia,  visual  hallucina¬ 
tions  and  complete  anorexia  form  a  consensus  of  symptoms  which  rival  the  worst  effects 
of  the  opium  habit.  Some  observers  report  the  most  extraordinary  mental  changes  result¬ 
ing  from  Cocainism,  and  exceeding  those  produced  by  any  other  drug.  The  most  intense 
selfishness,  utter  disregard  of  all  social  and  domestic  duties,  the  most  debasing  habits, 
complete  destruction  of  all  noble  qualities,  and  a  general  condition  of  depravity,  are  some 
of  the  results  which  are  being  charged  to  this  drug.  The  habit  is  acquired,  in  almost  all 
cases,  by  persons  previously  addicted  to  the  use  of  Morphine,  who  go  to  Cocaine  in  the 
hope  of  finding  help  in  their  struggle  against*  the  tyranny  of  the  former  drug.  In  this 
hope,  however,  they  are  always  disappointed,  especially  when  the  drugs  are  in  their  own 
hands.  The  victim  soon  finds  that  one  of  these  agents  antagonizes  the  other  to  a  great 
extent,  while,  at  the  same  time,  it  sets  up  peculiar  troubles  of  its  own  :  and  that  there  is  a 
constant  need  of  more  Morphine  to  counteract  the  Cocaine-symptoms,  and  of  more  Cocaine 
to  antagonize  the  increased  amount  of  Morphine.  The  result  of  any  such  attempt  will  be 
that  one  who  is  only  using  a  moderate  daily  amount  of  Morphine,  will,  if  Cocaine  be 
added,  soon  be  using  a  very  great  amount  of  Morphine,  as  well  as  of  Cocaine,  and  “the 
last  state  of  that  man  is  worse  than  the  first.” 


Therapeutics. 

Coca-leaves  are  chewed  by  the  Peruvians  for  the  purpose  of  sustaining 
them  during  arduous  labors  and  long  journeys,  and  were  so  highly 
esteemed  as  to  have  been  represented  on  the  coat-of-arms  of  that  nation, 
by  whom  they  are  used  much  as  we  do  tea,  coffee  or  tobacco.  This 
example  was  imitated  by  Weston  the  pedestrian,  who  is  said  to  have  been 
detected  chewing  the  coca-leaf  during  one  of  his  protracted  walks. 
Cocaine  is  a  useful  stimulant  to  the  brain  and  the  nervous  system  in 
many  morbid  conditions,  particularly  cerebral  and  spinal  anaemia,  neuras¬ 
thenia,  melancholia,  hysterical  and  hypochondriacal  insanity,  and  in 
protracted  mental  depression  with  suicidal  tendency.  It  maybe  employed 
with  benefit  in  wasting  diseases  to  retard  waste  and  to  stimulate  digestion, 
in  convalescence  from  fevers  and  other  acute  maladies,  and  in  migraine 
and  neuralgia  due  to  depression  of  the  nervous  system.  It  is  very  beneficial 
in  some  cases  of  the  vomiting  of  pregnancy,  in  stomatitis  and  gastralgia, 
and  in  functional  impotence  due  to  general  atony  of  the  system. 

A  wine  of  the  leaves  is  thought  by  singers  and  speakers  to  relieve  hoarse¬ 
ness,  to  tense  the  vocal  cords  and  improve  the  timbre  of  the  voice.  Coca- 


ERYTHROXYLON. 


21  I 


leaves  may  be  smoked  in  cigars  or  cigarettes  to  obtain  the  exhilarating 
effects  of  the  drug,  and  for  the  relief  of  asthma,  hay-fever  and  many 
irritable  throat  affections.  The  Oleate  of  Cocaine  is  an  efficient  palliative 
application  to  painful  hemorrhoids,  fissures  of  the  anus,  burns,  boils,  and 
irritable  ulcers  ;  also  in  pruritus  pudendi  et  ani  and  skin  diseases  attended 
with  intolerable  itching. 

Hydrochlorate  of  Cocaine  has  achieved  notoriety  as  a  local  anaes¬ 
thetic,  and  promises  to  be  of  the  greatest  value  in  many  operations  on  the 
eye  and  ear,  nasal  passages,  uterus  and  urethra.  A  2  to  4  per  cent,  solu¬ 
tion  is  brushed  lightly  over  the  mucous  surface  or  injected  into  the  ure¬ 
thral  canal,  the  application  being  repeated  within  5  or  10  minutes  if 
profound  local  anaesthesia  is  required.  After  about  fifteen  minutes  any 
superficial  operation  may  be  performed  without  giving  the  slightest  pain. 
Its  anaesthetic  action  is  so  entirely  local  and  generally  free  from  unpleas¬ 
ant  after-effects  that  it  is  considered  the  most  efficient  and  desirable  agent 
of  the  kind  which  is  known.  It  has  been  used  in  the  same  manner  with 
decided  benefit  in  congestion  of  the  nasal  passages  from  acute  catarrh 
and  hay-fever ;  and  has  been  applied  to  the  cervix  uteri  to  relieve  the  first 
pains  of  labor,  to  the  ear  for  tinnitus  aurium,  and  by  inhalation  to 
strengthen  the  vocal  cords,  relieve  hoarseness  and  cough,  and  to  improve 
the  quality  of  the  voice.  It  is  injected  hypodermically  around  the  pre¬ 
puce  to  prevent  pain  during  circumcision,  into  the  vicinity  of  the  supra¬ 
orbital  and  infra-orbital  foramina  to  cut  short  neuralgia  of  those  nerves, 
and  into  hemorrhoids  previous  to  their  ligation.  It  may  be  injected  into 
the  bladder  before  lithotrity,  into  the  urethra  before  the  passage  of  sounds 
or  catheters  or  to  relieve  chordee,  and  it  is  an  excellent  application  to  the 
gums  of  teething  infants.  To  be  efficient  it  must  reach  the  terminal  fila¬ 
ments  of  the  sensory  nerves  in  sufficient  concentration.  Rhus  poisoning, 
by  either  the  oak  or  ivy,  is  promptly  controlled  by  the  application  of  a  5 
per  cent,  solution  of  oleate,  freely  over  the  affected  surface.  It  gives 
instant  relief  from  the  burning  and  itching,  and  speedily  reduces  the 
dermatitis. 

As  a  Mydriatic  for  ophthalmological  use,  Cocaine  has  peculiar  qualities 
which  make  it  the  most  serviceable  of  the  class.  The  dilatation  produced 
by  it  is  great,  is  quickly  attained,  lasts  only  12  to  20  hours,  is  promptly 
overcome  by  the  application  of  Eserine,  and  is  not  accompanied  by  much 
photophobia.  The  latter  is  due  to  the  fact  that  the  cocainized  pupil  is 
not  rigidly  dilated  (as  with  Atropine),  but  reacts  to  light.  The  accom¬ 
modation,  moreover,  is  greatly  reduced,  but  not  entirely  paralyzed,  and 
is  quickly  regained. 

As  an  Antagonist  Cocaine  is  of  especial  value  in  narcotic  poisoning  by 
Chloral  or  Opiates,  where  depression  of  the  cardiac  and  respiratory  cen¬ 
tres  exists.  It  is  also  indicated  in  chronic  depressant  poisoning  from  the 


212 


EUCALYPTUS. 


Bromides,  and  in  spinal  paralyses.  In  these  cases  it  has  all  the  advantages 
of  Strychnine  without  its  poisonous  character.  It  has  no  value  in  the 
proper  treatment  of  Morphinism  except  to  antagonize  certain  heart 
symptoms,  for  which  purpose  it  should  be  administered  only  by  the  phy¬ 
sician  in  charge  of  the  case ;  and  never,  by  him,  as  a  regular  remedy,  at 
regular  intervals  of  time. 

EUCALYPTUS, — the  leaves  collected  from  rather  old  trees,  of 
Eucalyptus  globulus,  or  Blue  Gum-tree  (nat.  ord.  Myrtacese),  a  native  of 
Australia,  now  grown  in  California,  Italy,  etc.  The  leaves  are  6  to  12 
inches  long,  gray-green,  lanceolately  scythe-shaped,  studded  with  oil- 
glands;  of  camphoraceous  odor  and  bitter,  aromatic  taste.  They  contain 
tannic  acid,  a  resin,  a  fatty  acid  and  a  Volatile  Oil.  The  latter  consists 
of  three  different  oils  which  distil  over  at  different  temperatures,  the  first 
product  being  named  Eucalyptol,  C12H20O,  which  by  the  action  of  Phos¬ 
phoric  Acid  is  converted  into  Eucalyptene,  a  substance  allied  to  Cymene, 
and  Eucalyptoleti. 

Preparations. 

Extraction  Eucalypti  Fluidum , — alcoholic.  Dose,  npx-^j. 

Oleum  Eucalypti , — the  volatile  oil,  distilled  from  various  species  of  Eucalyptus,  that 
from  E.  amygdalina  being  considered  wanting  in  Eucalyptol.  Dose,  rtpv-xxx  in  capsules 
or  emulsion. 

Tinctura  Eucalypti  (Unofficial), — Dose,  g  ss-ij . 

Physiological  Action. 

The  taste  of  Eucalyptus  is  warm,  aromatic,  bitter  and  camphoraceous. 
It  increases  the  flow  of  saliva,  the  gastric  juice  and  the  intestinal  secre¬ 
tions,  and  in  small  doses  promotes  appetite  and  digestion,  increases  the 
heart’s  action  and  lowers  arterial  tension.  In  large  doses  it  produces 
eructations,  indigestion,  diarrhoea,  nausea  and  vomiting,  lowered  tempera¬ 
ture,  great  muscular  weakness,  and  if  continued  will  irritate  and  congest 
the  kidneys,  and  induce  a  feverish  state  with  symptoms  of  cerebral  con¬ 
gestion,  and  great  constitutional  disturbance.  Toxic  doses  are  fatal  by 
paralysis  of  respiration  through  direct  action  on  the  spinal  cord. 

It  is  powerfully  antiseptic,  and  destructive  to  low  forms  of  life,  a  stimu¬ 
lating  expectorant  and  an  efficient  diaphoretic.  By  some  authorities  it  is 
believed  to  reduce  the  size  of  an  enlarged  spleen,  and  to  possess  anti- 
malarial  properties  by  absorbing  noxious  germs  as  well  as  by  draining  the 
soil  of  its  water,  and  by  its  aseptic  emanations  purifying  the  atmosphere 
in  its  vicinity.  It  is  largely  cultivated  in  malarial  districts  for  these 
properties,  and  is  reported  to  have  rendered  habitable  a  portion  of  the 
deadly  Roman  Campagna. 

Eucalyptus  is  eliminated  by  the  skin,  bronchial  mucous  membrane 
and  the  kidneys,  imparts  its  odor  to  the  breath  and  the  urine,  and  is  more 
or  less  irritant  at  the  points  of  its  elimination. 


EUONYMUS - EUPATORIUM. 


213 


Therapeutics. 

Eucalyptus  is  an  efficient  stomachic  in  atonic  dyspepsia,  chronic  gastric 
and  intestinal  catarrh,  and  in  conditions  of  the  intestinal  canal  which 
favor  the  development  of  worms.  In  chronic  catarrhal  conditions  of  the 
genito-urinary  organs,  the  broncho-pulmonary  mucous  membrane,  and 
especially  the  bladder,  it  is  very  useful,  acting  as  a  stimulant  and  disinfec¬ 
tant  to  the  mucous  membranes.  It  is  equally  beneficial  in  chronic  bron¬ 
chitis  and  bronchorrhoea,  in  cachectic  states  generally,  and  in  convales¬ 
cence  from  acute  diseases.  In  hysteria,  chorea  and  asthma  it  is  beneficial, 
in  the  latter  affection  being  advantageously  smoked  in  cigarettes  with 
Stramonium  or  Belladonna  Leaves.  In  malaria  as  a  reconstructant  it  is 
better  than  Quinine,  and  it  has  considerable  utility  in  obstinate  intermit- 
tents  where  it  is  desirable  to  stop  the  use  of  Cinchona  preparations.  As 
an  antiseptic  it  is  highly  valued  in  dilute  solution  for  application  to  ulcers, 
and  as  a  substitute  for  Carbolic  Acid  on  gauze  in  the  antiseptic  treatment 
of  wounds.  It  is  also  used  in  dilute  solution  locally  as  a  stimulating  dis¬ 
infectant  in  stomatitis  and  in  the  subacute  stages  of  pharyngitis  and  ton¬ 
sillitis.  An  aqueous  preparation  is  highly  recommended  as  a  vehicle  for 
alkaloids  in  solutions  for  hypodermic  use,  to  prevent  the  development  of 
the  penicillium  which  rapidly  destroys  the  alkaloid  present. 


EUONYMUS,  Wahoo  , — is  the  bark  of  Euotiymus  atropurpureus , 
a  shrub  of  the  nat.  ord.  Celastraceae,  growing  in  the  U.  S.  Occurs  in 
quills  or  curved  pieces,  about  inch  thick,  of  ashy-gray  color  and  acrid, 
sweetish  taste.  It  contains  an  amorphous,  bitter  principle  named  Euony - 
min ,  also  Resins,  Euonic  Acid,  and  Asparagin ,  fixed  oil,  etc. 

Extraction  Euonvnii, — Dose,  gr.  j-v. 

Euonymin  (Unofficial), — the  eclectic  preparation,  consists  of  the  fixed  oil  and  resin, 
and  is  given  in  doses  of  gr.  ss-v. 

Euonymus  is  classed  with  Rhubarb,  Jalap,  Aloes,  etc.,  as  a  tonic-astrin¬ 
gent  and  resin-bearing  purgative.  It  is  said  to  be  also  diuretic  and  expec¬ 
torant,  and  a  very  efficient  cholagogue.  Its  cathartic  action  is  similar  to 
that  of  Rhubarb  but  milder.  It  has  been  employed  with  benefit  in  some 
cases  of  dropsy,  also  in  habitual  constipation,  torpid  liver,  and  pulmonary 
affections.  In  overdoses  it  will  set  up  considerable  gastro-intestinal  irri¬ 
tation. 


EUPATORIUM,  Thorough-wort,  Boneset, — the  leaves  and 
flowering  tops  of  Eupatorium  perfoliaium ,  an  American  plant  of  the  nat. 
ord.  Compositae,  having  lanceolate  leaves,  two  united  at  the  base,  each  4 
to  6  inches  long,  of  weak,  aromatic  odor  and  bitter,  astringent  taste.  It 


214 


EUPHRASIA - FEL  BOVIS. 


contains  a  neutral,  bitter  principle,  named  Eupatorin ,  tannic  acid,  a  vola¬ 
tile  oil,  etc. 

Extract i  Eupatorii  Fluidum , — Dose,  tiyx-^j. 

Boneset  is  a  bitter  tonic  and  efficient  diaphoretic,  also  in  full  doses 
emetic  and  aperient.  It  has  been  supposed  to  have  antiperiodic  and 
taeniafuge  powers.  A  warm  infusion  (Boneset  tea)  is  a  popular  diapho¬ 
retic  in  remittent  and  typhoid  fevers,  and  at  the  onset  of  an  attack  of 
acute  catarrh  or  general  cold.  As  a  bitter  tonic  it  may  be  used  with  ad¬ 
vantage  in  dyspepsia  and  general  debility.  Its  common  name  is  derived 
from  its  supposed  power  to  relieve  the  bone  pains  of  dengue  or  the  “  break- 
bone  fever.” 

Another  variety  of  Eupatorium,  E.  puipureum ,  or  Gravel-root,  is 
reputed  to  have  decided  power  over  the  uric  acid  diathesis. 


EUPHRASIA,  Eye-bright  , — is  a  small  annual  plant  of  the  nat. 
ord.  Strophulariaceae,  growing  in  Europe  and  the  U.  S.,  odorless,  of 
astringent  taste,  and  containing  Euphrastic  Acid ,  tannin,  etc.  It  was 
formerly  of  great  repute  in  various  eye-affections,  and  may  be  of  utility  as 
a  mild  astringent  in  catarrhal  conjunctivitis.  Its  chief  value,  however,  is 
to  abort  an  attack  of  acute  nasal  catarrh  with  lachrymation,  for  which 
purpose  a  few  drops  of  the  tincture  every  two  hours  is  remarkably  effi¬ 
cient.  In  hay-fever  also  it  is  of  decided  utility  in  mitigating  the  catarrhal 
symptoms,  and  in  the  acute  coryza  of  measles  it  will  be  found  an  excel¬ 
lent  remedy.  A  tincture  (i  to  9)  of  the  fresh  plant  should  be  used,  and 
given  in  doses  of  Rlj-v. 


FEL  BOVIS,  Ox-gall, — the  fresh  gall  or  bile  of  Bos  Taurus ,  is  a 
dark-green,  viscid  liquid,  of  peculiar  odor,  bitter  taste,  and  neutral  or 
faintly  alkaline  reaction.  Sp.  gr.  1.018  to  1.028.  It  contains  Glyco- 
cholate  of  Sodium,  Taurocholate  of  Sodium,  Cholesterin  and  coloring 
matter. 

Preparations. 

Eel  Bovis  Inspissatum,  Inspissated  Ox-gall, — 100  parts  of  fresh  Ox-gall  evaporated  to 
15  parts,  after  straining.  Dose,  gr.  v-xv. 

Eel  Bovis  Purificatu?n ,  Purified  Ox-gall, — 3  of  Ox-gall  and  I  of  Alcohol  evaporated 
to  pilular  consistence,  after  standing  24  hours,  decanting,  filtering,  etc.  Dose,  gr.  v-xv. 


Physiological  Action  and  Therapeutics. 

Bile  is  tonic,  antiseptic  and  purgative.  It  assists  in  the  emulsification  of 
fats,  and  stimulates  the  absorbent  powers  of  the  mucous  membrane.  In 
the  stomach  it  neutralizes  the  gastric  juice,  precipitating  the  pepsin,  and 
is  apt  to  cause  nausea  and  vomiting.  Recently  it  is  found  to  act  well  in 
stimulating  the  resolution  of  hypertrophies  when  locally  applied  to  the 


FERRUM. 


215 


part,  as  the  mammae,  tonsils,  pannus,  etc.  It  is  used  as  a  laxative  in  con¬ 
stipation  when  the  natural  secretion  of  bile  is  deficient,  but  has  no  advan¬ 
tage  over  other  purgatives. 


FERRUM,  Iron,  Fe, — is  metallic  Iron  in  the  form  of  fine,  bright 
and  non-elastic  wire. 

Ferrum  Reductum,  Reduced  Iron, — consists  of  metallic  Iron  in  fine 
powder,  obtained  by  reducing  the  Sesquioxide  by  hydrogen  at  a  dull  red 
heat.  It  is  a  very  fine,  gray-black,  lustreless  powder,  odorless,  tasteless, 
and  insoluble  in  water  and  alcohol,  but  soluble  in  dilute  sulphuric  acid 
with  the  evolution  of  nearly  odorless  hydrogen  gas.  Dose,  gr.  j-v,  after 
meals. 

Iron  Compounds  and  their  Preparations. 

Liquor  Ferri  Acetatis, — is  an  aqueous  solution  of  Ferric  Acetate,  containing  33  per 
cent,  of  the  anhydrous  salt.  A  dark  red -brown  transparent  liquid  of  acetous  odor,  sweet 
ish  and  faintly  styptic  taste,  reaction  slightly  acid.  Action, — stimulant,  ferruginous,  little 
if  any  astringency.  Used  to  prepare  the  following  tincture. 

Tinctura  Ferri  Acetatis, — has  of  the  preceding  50  parts,  Alcohol  30,  Acetic  Ether  20. 
A  clear,  dark  red-brown  liquid,  of  acetous  odor,  acidulous  and  slightly  astringent  taste, 
and  slight  acid  reaction.  Miscible  with  water  in  all  proportions.  Dose,  rqx-spj. 

Svrupi  Ferri  Bromidi , — is  a  syrupy  liquid  containing  10  per  cent,  of  Ferrous  Bro¬ 
mide,  FeBr2.  A  pale  green,  odorless  liquid,  of  sweet  ferruginous  taste  and  neutral  reac¬ 
tion.  Action, — a  sedative  chalybeate  tonic,  especially  recommended  in  nervous  disorders, 
and  by  Da  Costa  in  chorea.  Irritant  in  large  doses.  Dose,  npv-xxx. 

Ferri  Carbonas  Saccharatus, — has  at  least  15  per  cent,  of  ferrous  carbonate.  A  green¬ 
ish-gray  powder,  of  sweetish  taste  at  first,  changing  to  ferruginous.  Partially  soluble  in 
water,  but  soluble  in  dilute  hydrochloric  acid  with  evolution  of  C02.  Action, — slightly 
stimulant  to  digestive  tract.  Dose,  gr.  ij-x  with  food. 

Massa  Ferri  Carbonatis , — Vallet’s  Mass, — Sulphate  of  Iron  100,  Carbonate  of  Sodium 
no,  Honey  38,  Sugar  25,  Syrup,  Distilled  Water,  each  q.  s.  ad  100  parts.  Has  42  per 
cent,  of  ferrous  carbonate.  Action, — non-astringent,  unirritating,  ferruginous  tonic.  Dose, 
gr.  iij-v  after  food. 

Mistura  Ferri  Co?nposita,  Griffith’s  Mixture, — Sulphate  of  Iron  6,  Myrrh  1 8,  Sugar  18, 
Carbonate  Potassium  8,  Spirit  of  Lavender  50,  Rose  water  900  parts.  Is  really  a  solu¬ 
tion  of  the  carbonate,  with  sulphate  of  potassium  to  suspend  the  iron  salt.  Is  an  excel¬ 
lent  mixture,  but  disagreeable.  Dose,  ^ss. 

Pilulce  Ferri  Coniposita ,  Griffith’s  Pills, — Sulphate  of  Iron  gr.  3^f,  Carbonate  of  Sodium 
gr.^f,  Myrrh  gr.  jss,  Syrup  q.  s.  in  each  pill  answering  in  composition  to  the  preceding. 
Dose,  ij-vj. 

Ferri  Chloridum ,  Perchloride  of  Iron,  Fe2Cl6.i2pI20, — orange-yellow,  deliquescent, 
crystalline  pieces,  of  styptic  taste  and  acid  reaction,  freely  soluble  in  water,  alcohol  or 
ether.  Action, — strongly  astringent,  hemostatic.  Never  used  internally. 

Liquor  Ferri  Chloridi, — an  aqueous  solution  of  the  preceding,  containing  37.8  per 
cent,  of  the  anhydrous  salt,  with  some  free  HC1  acid.  Action, — strongly  astringent  and 
styptic.  Rarely  used  internally.  Dose,  rrpij-x,  well  diluted. 

Tinctura  Ferri  Chloridi, — has  of  the  preceding  35  parts  in  65  of  Alcohol.  A  bright, 
brownish  liquid,  of  ethereal  odor,  styptic  taste  and  acid  reaction.  Is  used  in  Mistura 
Ferri  et  Ammonii  Acetatis.  One  of  the  best  preparations  of  iron.  Action, — ferruginous 
tonic.  Dose,  rrpv-xx,  in  water,  syrup  or  glycerin. 

Ferri  Citras,  Fe2(C6H507)2.6II20, — garnet-red,  transparent  scales,  slowly  soluble  in 
water,  not  in  alcohol.  Action, — mildly  stimulant.  Dose,  gr.  ij-v.  Formed  by  evapor¬ 
ating  the  following: 

Liquor  Ferri  Citratis, — is  an  aqueous  solution  of  the  preceding,  containing  about  3S/4 
per  cent,  of  the  anhydrous  salt.  A  dark-brown  liquid,  of  slightly  ferruginous  taste  and 
acid  reaction.  Action, — as  Ferri  Citras.  Dose,  rrpv-xv. 

Vinum  Ferri  Citratis, — made  from  the  Citrate  of  Iron  and  Ammonium  4,  Tincture  of 


2l6 


FERRUM. 


Sweet  Orange-peel  12,  Syrup  12,  stronger  White  Wine  72  parts.  An  iron  elixir.  Dose, 

3Hj- 

Fern  Hypophosphis ,  Fe2(H2P02)6,  Ferric  Hypophosphite, — a  white  or  grayish-white 
powder,  odorless,  tasteless,  slightly  soluble  in  water,  freely  so  in  HC1  acid  or  in  a  solution 
of  sodium  citrate.  Action,  ferruginous  tonic.  Dose,  gr.  v-x. 

Ferri  Iodidum  Saccharatum , — a  yellowish-white  powder,  very  hygroscopic,  odorless, 
of  sweetish,  ferruginous  taste,  and  slightly  acid  reaction,  soluble  in  7  of  water  at  590  F., 
insoluble  in  alcohol.  Action, — ferruginous  tonic.  Dose,  gr.  v-xxv  in  pill  or  elixir. 

Piluhe  Ferri  lodidi, — made  with  Reduced  Iron,  Iodine,  Licorice,  Sugar,  Acacia  and 
Water,  covered  with  a  coating  of  Balsam  of  Tolu  in  Ether.  “  Blancard’s  Pills  ”  only 
differ  from  these  by  being  covered  with  a  coating  of  reduced  iron  to  protect  the  interior 
from  oxidation,  but  it  also  protects  them  from  the  solvent  action  of  the  gastric  juice. 
Dose,  I  or  2  pills  ter  in  die. 

Syruptis  Ferri  lodidi , — is  a  syrupy  liquid  containing  10  per  cent,  of  ferrous  iodide.  A 
transparent,  pale-green  liquid,  of  sweet,  ferruginous  taste  and  neutral  reaction.  Action, — 
ferruginous  tonic.  Dose,  trpv-xxx. 

Ferri  Ladas,  Fe(C3H503)2.3H20,  Ferrous  Lactate, — pale,  greenish-white,  crystal¬ 
line  grains,  soluble  in  40  of  water  at  590  F.,  freely  in  citrate  of  sodium,  almost  insoluble 
in  alcohol.  Action, — feebly  ferruginous  tonic  Dose,  gr.  j-iij  in  pill  or  syrup.  Is  a 
constituent  of  Syrupus  Hypophosphitum  cum  Ferro. 

Liquor  Ferri  Adtratis, — is  an  aqueous  solution  of  Ferric  Nitrate,  Fe2(N03)6,  con¬ 
taining  about  6  per  cent,  of  the  anhydrous  salt.  A  transparent,  amber  colored  liquid,  of 
acid,  styptic  taste,  and  acid  reaction.  Action, — medium  as  to  irritation,  astringent  and 
hemostatic.  Dose,  rrpv-xv,  well  diluted. 

Ferri  Oxalis,  Ferrous  Oxalate,  FeC204.PI20, — a  pale  yellow,  crystalline  powder,  very 
slightly  soluble  in  water.  Dose,  gr.  ij  in  a  pill. 

Ferri  Oxidutfi  Hydratum ,  Ferric  Hydrate,  Fe  (HO)6,  is  a  brown-red  magma  wholly 
soluble  in  HC1  acid  without  effervescence.  Should  be  freshly  prepared  from  the  Solution 
of  Tersulphate  of  Iron  10  parts  and  Water  of  Ammonia  8  parts.  Is  the  chemical  anti¬ 
dote  for  Arsenic.  Dose,  a  teaspoonful  in  water  frequently  repeated.  The  solutions 
should  be  kept  ready  for  use. 

Ferri  Oxidum  Hydratum  cum  Magnesia, — is  made  by  mixing  when  required  for  use 
(1)  Solution  of  Tersulphate  of  Iron  1000  grains,  Water,  2000  grains.  (2)  Magnesia  150 
grains,  Water  Sj  xxxij.  This  should  be  administered  as  directed  under  the  preceding 
head.  It  is  more  convenient  and  a  more  efficient  antidote  for  Arsenic  than  the  simple 
ferric  hydrate,  as  the  excess  of  the  alkaline  precipitant  is  non-irritant  and  is  itself  an  anti¬ 
dote  to  arsenic. 

Emplastrum  Ferri ,  Strengthening  Plaster, — has  of  Hydrated  Oxide  of  Irion,  dried,  10 
parts,  Canada  Turpentine  10,  Burgundy  Pitch  10,  Lead  Plaster  70. 

Trochisci  Ferri , — each  has  of  Hydrated  Oxide  of  Iron,  dried,  gr.  v,  Vanilla  gr.  yo> 
Sugar,  and  Mucilage  of  Tragacanth.  Dose,  j-iij,  ter  die. 

Ferri  Phosphas , — Bright-green,  transparent  scales,  of  acidulous,  saline  taste,  soluble  in 
water,  not  in  alcohol.  Used  as  an  adjuvant  to  laxative  pills  to  prevent  the  after  reaction¬ 
ary  constipation.  Dose,  gr.  v-x.  Made  by  reaction  between  the  Citrate  of  Iron  and  the 
Phosphate  of  Sodium. 

Ferri  Pyrophosphas, — Green,  transparent  scales,  of  acidulous  taste,  soluble  in  water 
but  not  in  alcohol.  Is  almost  tasteless  and  unirritating,  and  non-constipative.  Dose,  gr. 
ij-v.  Made  by  reaction  between  the  Citrate  of  Iron  and  the  Pyrophosphate  of  Sodium. 

Ferri  Sulphas ,  Ferrous  Sulphate,  FeS04-7H20, — large,  pale  bluish-green  prisms,  efflo¬ 
rescent,  of  saline,  styptic  taste,  and  acid  reaction,  soluble  in  1.8  of  water  at  590  F., 
insoluble  in  alcohol.  Is  chiefly  used  to  make  the  Dried  Sulphate  and  other  preparations. 

Ferri  Sulphus  Exsiccatus ,  Dried  Ferrous  Sulphate,  FeS04.II20, — a  grayish-white 
powder,  nearly  soluble  in  water,  consisting  of  the  preceding  salt,  heated  gradually  to  300° 
F.,  until  it  ceases  to  lose  weight.  The  mod  astringent  and  irritating  ferrous  salt,  but  an 
excellent  one  in  small  doses.  Is  a  constituent  of  Pil.  Aloes  et  Ferri.  Dose,  gr.  ss-ij 
in  pill. 

Ferri  Sulphas  Prcecipitatus ,  Precipitated  Ferrous  Sulphate,  FeS04.7PI20, — is  the 
same  salt  as  above  described,  precipitated  by  Alcohol  from  solution  in  dilute  sulphuric 
acid.  Dose,  gr.  ss-ij. 

Liquor  Ferri  Suhsulphatis,  Monsel’s  Solution, — is  an  aqueous  solution  of  Basic  Ferric 
Sulphate,  Fe40(S04)5,  containing  43.7  per  cent,  of  the  salt.  A  dark  reddish-brown, 
almost  syrupy  liquid,  of  very  astringent  but  not  caustic  taste,  and  acid  reaction,  mixing 
with  water  or  alcohol  in  all  proportions  without  decomposition.  Is  but  slightly  irritating 


FERRUM.  217 

and  powerfully  astringent,  chiefly  used  locally  as  an  astringent  and  hemostatic,  but  may 
be  given  internally  in  doses  of  rtyij-x,  well  diluted. 

Liquor  Ferri  Tersulphatis, — is  an  aqueous  solution  of  Normal  Ferric  Sulphate, 
Fe2(S04)3,  containing  28.7  per  cent,  of  the  salt.  Has  the  same  properties  as  described 
for  the  preceding,  but  a  less  sp.  gr.  Is  used  to  make  other  preparations  of  Iron. 

Ferri  Valerianas ,  Fe2( C5H902)6, — a  dark,  tile-red,  amorphous  powder,  of  faint, 
valerianic  odor,  and  mildly  styptic  taste,  insoluble  in  cold  water,  decomposed  by  hot 
water,  readily  soluble  in  alcohol.  Of  doubtful  value  as  a  valerianate.  Dose,  gr.  j-iij  in 
pill. 

Preparations  of  Compound  Iron  Salts. 

Ferri  et  Ammonii  Citras,  Ammonio-ferric  Citrate, — prepared  from  Solution  of  Citrate 
of  Iron  3  parts,  Water  of  Ammonia  I,  mixed  and  evaporated.  Transparent,  garnet-red 
scales,  deliquescent,  soluble  readily  in  water,  insoluble  in  alcohol.  Dose,  gr.  ij-v. 

Ferri  et  Ammonii  Sulphas ,  Ammonio-ferric  Alum, — pale,  violet  crystals,  efflorescent, 
of  styptic  taste  and  slightly  acid  reaction,  soluble  in  3  of  water  at  590  F.,  insoluble  in 
alcohol.  Is  the  least  astringent  of  the  sulphates  of  iron,  but  more  so  than  any  of  the  salts 
formed  by  vegetable  acids.  Dose,  gr.  iij-xv. 

Ferri  et  Ammonii  Tartras,  Ammonio-ferric  Tartrate, — made  from  Liq.  Ferri  Tersul¬ 
phatis  90,  Tartaric  Acid  60,  Aq.  Ammonise  72,  Ammonium  Carbonate,  Water  q.  s. 
Transparent,  reddish  brown  scales,  slightly  deliquescent,  of  sweetish  and  slightly  ferru¬ 
ginous  taste,  very  soluble  in  water,  insoluble  in  alcohol.  Contains  an  equivalent  of  about 
25  per  cent,  of  Ferric  Oxide,  and  has  but  slight  irritant  qualities.  Dose,  gr.  v-xx. 

Ferri  et  Potassii  Tartras ,  Potassio- ferric  Tartrate, — made  from  Liq.  Ferri  Tersulphatis 
12,  Potassii  Bitart.  4,  Aq.  Destil.  32,  Aq.  Ammonias,  et  Aquae  q.  s.  Transparent,  garnet- 
red  scales,  slightly  deliquescent,  of  sweetish  and  slightly  ferruginous^  taste,  very  soluble  in 
water,  insoluble  in  alcohol.  Is  the  least  disagreeable  in  taste  of  all  the  iron  preparations, 
and  contains  a  little  more  ferric  oxide  than  the  preceding  salt.  Is  but  slightly  astringent 
and  is  not  constipating.  Dose,  gr.  v-x. 

Ferri  et  Quinince  Citras , — prepared  from  Ferri  Citras  88,  Quinine,  dried,  1 2,  Aq. 
Destil.  q.  s.  ad  ICO,  mixed  and  evaporated.  Thin,  transparent  yellowish-brown  scales, 
slowly  deliquescent,  of  bitter  taste,  slowly  soluble  in  water,  slightly  soluble  in  alcohol. 
Contains  12  per  cent,  of  dry  quinine.  Action, — astringent  and  stimulant  to  the  digestive 
tract.  Dose,  gr.  iij-v. 

Liquor  Ferri  et  Quinince  Citratis, — made  directly  from  Ferri  et  Ammonii  Citras  65, 
Quinine,  dried,  12,  Ac.  Citric.  28,  Alcohol  30,  Aq.  Destil.  q.  s.  ad  200.  A  greenish- 
brown  liquid,  of  bitter  taste  and  slightly  acid  reaction.  Contains  6  per  cent,  of  quinine. 
Is  very  slowly  soluble  and  of  doubtful  value.  Dose,  tt^v-xv. 

Vinum  Ferri  Amarum ,  Bitter  Wine  of  Iron, — has  of  the  preceding  8  parts,  Tinct. 
Aurantii  Dulcis  12,  Syrup  36,  Stronger  White  Wine  44.  May  replace  the  various 
“  elixirs  of  iron  and  calisaya.”  Dose,  gj-iv. 

Ferri  et  Strychnines  Citras , — Ferri  et  Ammonii  Citras  98,  Strychninse  I,  Ac.  Citric  1, 
Aq.  Destil.  120,  mixed  and  evaporated.  Transparent,  garnet-red  scales,  deliquescent, 
readily  soluble  in  water,  slightly  so  in  alcohol.  Contains  1  per  cent,  of  Strychnine. 
Action, — astringent  and  stimulating.  Dose,  gr.  j-iij. 

Syrupus  Ferri ,  Quinince  et  Strychnines  Phosphatum ,  Syrup  of  the  Phosphates  of  Iron, 
Quinine  and  Strychnine.  [Described  under  Phosphorus .] 

Syrupus  Ffypophosphitum  cum  Ferro ,  Syrup  of  Hypophosphites  with  Iron.  [Described 
under  Phosphorus .] 

Mistura  Ferri  et  Ammonii  Acetatis,  Basham’s  Mixture, — is  properly  a  Liquor,  and  is 
prepared  from  Tr.  Ferri  Chloridi  2,  Ac.  Acet.  Dil.  3,  Liquor  Ammonii  Acet.  20,  Elixir 
Aurantii  10,  Syrup  15,  Water  50  parts.  An  elegant  and  agreeable  preparation,  having 
some  power  as  a  diuretic  and  a  diaphoretic.  Dose,  3  ij-v,  well  diluted. 


Unofficial  Preparations  of  Lron. 

Ferri  Albuminas,  Albuminate  of  Iron, — a  cinnamon-brown  powder,  soluble  in  water 
acidulated  slightly  with  IICl.  Dose,  gr.  x-xxx,  in  simple  aqueous  solution,  or  in  pill. 

Ferri  Arsenias ,  Ferrous  Arseniate,  Fe3As208, — a  green,  tasteless  powder,  insoluble  in 
water,  soluble  in  HC1  acid.  Its  activity  is  due  to  the  arsenic  alone.  Dose,  gr. 

Ferrum  Dialysatum ,  Dialysed  Iron, — composition  varies  from  Fe2Cl6.i2Fe203  to 
Fe2ClG.95Fe203,  and  is  a  10  per  cent,  solution  of  Ferric  Oxychloride  in  water.  Prepared 
by  treating  a  solution  of  Chloride  of  Iron  with  Ammonia,  ferric  hydrate  being  precipitated, 


21  8 


FERRUM. 


this  being  dissolved  by  agitation  is  placed  in  a  dialyzer  and  suspended  in  water,  which  is 
renewed  as  long  as  it  shows  a  trace  of  HC1  acid.  It  is  a  reddish-brown  liquid,  free  from 
astringent,  styptic  taste,  but  is  a  very  feeble  chalybeate,  incapable  of  absorption  except  by 
change  into  a  hydrated  sesquioxide  in  the  alimentary  canal.  Is  used  as  a  chalybeate,  and 
as  an  antidote  to  Arsenic,  but  is  not  considered  an  eligible  preparation.  Dose,  TTLx-xxx. 

Svrupus  Ferri  et  Manganesii  Iodidi,  Syrup  of  the  Iodide  of  Iron  and  Manganese, — is 
a  pale,  straw  colored  liquid,  containing  a  little  sulphate  of  potassium,  and  in  each  fluid  5 
has  50  grains  of  the  mixed  iodides  in  the  proportion  of  Iodide  of  Iron  3  parts,  to  1  of 
Iodide  of  Manganese.  Dose,  rtyx-xxx-gj 

Syrupus  Ferri  et  Manganesii  Phosphatis,  Syrup  of  the  Phosphate  of  Iron  and  Man¬ 
ganese, — as  used  by  Dr.  Simpson  of  Edinburgh,  contains  in  each  3  of  syrup  2  grains  of 
the  Phosphate  of  Iron  and  I  grain  of  Phosphate  of  Manganese.  Dose,  ^j. 

Mistura  Ferri  Aromatica, — Pale  Bark  4,  Calumba  2,  Cloves  1,  Iron  wire  2,  Tr.  Car- 
damomi  Co.  12,  Tr.  Aurantii  Cort.  2,  Aq.  Menth.  Pip.  50, — Macerate  the  first  4  in  the 
last  one  for  3  days,  filter,  add  the  tinctures  and  make  up  to  50.  Dose,  sjj-ij. 

Mistura  Ferri  Laxans, — Ferri  Sulph.  gr.  ij,  Magnesii  Sulph.  £j,  Ac.  Sulphurici  Dil. 
rtyij,  Spt.  Chloroformi  rr^xx,  Aq.  Menth.  Pip.  ad  f)). 

Mistura  Ferro-salina , — Magnesii  Sulph.  ^j,  Potassii  Bitart,  ^j,  Ferri  Sulph.  Exsic. 
gr.  x,  Aquae  quart  j.  Dose,  a  wineglassful. 


Notes  on  the  Preparations. 

Oxides  and  Carbonates,  including  Ferrum  Reductum,  Ferri  Car- 
bonas  Saccharatus,  Mistura  Ferri  Composita,  Pil.  Ferri  Comp.,  Massa 
Ferri  Carb.,  Ferri  Oxidum  Hydratum,  Ferri  Oxidum  Hyd.  cum  Mag¬ 
nesia,  and  Mist.  Ferri  Aromatica, — possess  the  haematinic  action  of  iron 
with  but  little  astringency,  and  are  therefore  selected  to  restore  the  blood 
in  anaemia,  chlorosis  and  amenorrhoea,  with  tendency  to  dyspepsia  and 
constipation.  The  Hydrated  Oxides  are  only  used  as  antidotes  in 
arsenical  poisoning.  Ferrum  Reductum  is  one  of  the  best  forms  for 
internal  use,  but  gives  rise  to  sulphuretted  or  phosphoretted  eructations 
which  are  very  disagreeable.  The  Subcarbonate  is  little  more  than  the 
Red  Oxide,  but  in  the  Massa  Ferri  Carb.  the  oxidation  is  prevented  by 
the  sugar. 

Mineral  Acid  Salts  and  their  preparations  comprise  the  Sulphate  in 
its  3  forms,  the  solutions  of  the  Subsulphate  and  Tersulphate,  the  Phos¬ 
phate,  Pyrophosphate  and  Hypophosphite,  the  Chloride  and  its  prepara¬ 
tions  and  the  Liquor  Ferri  Nitratis.  They  are  characterized  by  their 
astringent  and  corrugating  action,  and  are  used  locally  especially  as 
hemostatics,  the  Solution  of  the  Subsulphate  being  preferred  for  topical 
use  as  it  is  powerfully  styptic  but  not  corrosive.  The  Tincture  of  the 
Chloride  is  one  of  the  best  preparations  for  internal  use,  and  is  most 
agreeable  in  the  form  of  Creuse’s  tasteless  preparation,  which  is  made  as 
follows, — Liq.  Ferri  Chloridi  3j>  Acidi  Citrici  544  grains,  Sodii  Carb. 
1000  grains  or  q.  s.,  Aquae  Destil.  3j>  Alcoholis  q.  s.  Dissolve  the  citric 
acid  in  the  distilled  water  and  heat  to  the  boiling  point,  gradually  adding 
sodium  carbonate  until  the  acid  is  saturated  ;  mix  this  with  the  iron  solu¬ 
tion  and  make  up  to  'Siv  with  alcohol.  Of  the  Phosphates  the  best  is 
the  Pyrophosphate,  which  is  easily  assimilated,  readily  soluble  and  entirely 
unirritating. 


FERRUM. 


219 


Vegetable  Acid  Salts  and  their  preparations  comprise  the  Lactate, 
Citrate  and  its  preparations,  Oxalate,  and  the  preparations  of  the  Acetate 
and  the  Tartrate.  They  are  the  least  irritating  to  the  stomach  but  are 
also  the  least  efficient  as  chalybeates.  They  may  be  administered  in 
white  wines,  or  with  alkalies  and  vegetable  acids  in  effervescing  mix¬ 
tures. 

The  Albuminate  is  considered  by  several  authorities  to  be  the  most 
readily  assimilated  of  all  the  iron  preparations. 

Other  Compounds  are  those  in  which  Iron  is  combined  with  bodies 
equally  active,  as  the  Syrup  of  the  Bromide,  the  preparations  of  the 
Iodide,  those  with  Quinine,  Strychnine,  etc.  Generally  these  prepara¬ 
tions  are  used  for  a  two-fold  purpose,  namely  to  relieve  anaemia  and  at 
the  same  time  act  upon  the  specific  ailment  on  which  the  anaemia 
depends. 

Physiological  Action. 

Metallic  Iron  is  not  inert,  for  in  the  stomach  it  acquires  molecular 
activity  through  its  oxidation,  setting  hydrogen  free.  It  is  a  normal  con¬ 
stituent  of  the  blood  (1  part  to  230  of  red  corpuscles),  existing  probably 
as  an  oxide  in  combination  with  haematin,  which  is  not  formed  without 
it.  It  is  also  found  in  the  bile,  lymph,  chyle,  gastric  juice,  in  the  pigment 
of  the  eye,  in  the  milk  and  the  urine.  Given  medicinally  in  small  doses 
it  promotes  appetite  and  digestion,  and  improves  the  quality  of  the  blood, 
increasing  the  number  of  the  red  corpuscles.  In  the  stomach  all  the  salts 
of  iron  are  converted  into  the  Chloride  and  in  the  duodenum  into  an  alka¬ 
line  albuminate,  entering  the  blood  along  the  whole  length  of  the  ali¬ 
mentary  canal.  Large  doses,  or  small  ones  long-continued  are  directly 
unfavorable  to  digestion,  nausea  and  vomiting  are  produced  by  the  soluble 
preparations,  the  per-salts  are  actively  irritant,  the  Iodide,  Chloride, 
Nitrate  and  Sulphate  being  active  poisons,  highly  astringent,  and  act 
injuriously  on  the  teeth.  Only  a  small  portion  of  iron  is  absorbed,  the 
rest  being  eliminated  by  the  intestinal  canal,  blackening  the  faeces  by 
conversion  into  a  sulphide.  Of  the  portion  absorbed  from  the  alimentary 
canal,  only  a  small  part  reaches  the  systemic  circulation  and  is  eliminated 
by  the  kidneys,  the  greater  part  being  excreted  by  the  liver  with  the  bile. 

Locally  most  of  the  iron  salts  are  more  or  less  constringing  to  the 
tissues  and  the  mucous  membranes,  acting  as  hemostatics  and  astringents 
by  virtue  of  their  power  to  coagulate  albumen,  and  acting  injuriously  on 
the  teeth.  The  Tincture  of  the  Chlorate  is  considered  diuretic. 


Incompatibles. 

Alkalies  and  their  carbonates,  acids,  acidulous  salts  and  vegetable  astringents  are 
incompatible  with  most  preparations  of  iron,  the  latter  group  being  so  by  virtue  of  their 
tannic  and  gallic  acids  which  form  a  deep  blue-black  precipitate  (tannate  of  iron)  with 
the  per-salts.  The  Tincture  of  the  Chloride  is  decomposed  by  alkalies,  alkaline  earths 


220 


FERRUM. 


and  their  carbonates,  astringent  vegetable  infusions,  and  by  mucilage  of  acacia,  which 
latter  produces  therewith  a  brown,  semi-transparent  jelly. 

Therapeutics. 

The  chief  indication  for  the  internal  administration  of  Iron  is  anaemia  ; 
when  plethora  exists  it  is  contraindicated.  It  should  always  be  given 
after  meals,  and  occasionally  suspended  for  a  time,  to  avoid  deranging 
the  stomach.  When  appetite  and  digestion  are  promoted  by  Iron  it  will 
do  the  greatest  amount  of  good,  many  authorities  holding  that  the  prin¬ 
cipal  benefit  derived  from  its  use,  even  in  anaemia,  is  due  to  its  stimulating 
digestion  and  the  primary  assimilation.  The  Sulphate  is  here  probably 
the  most  efficient  salt  and  is  well  used  in  combination  with  aloes  when 
there  exists  any  intestinal  torpor,  especially  as  it  increases  the  cathartic 
power  of  the  latter  drug,  economizing  it,  and  conferring  upon  it  a 
permanence  of  action,  which  alone  it  does  not  possess.  In  pseudo-leuco- 
cythaemia,  chorea  of  anaemic  girls  at  the  age  of  puberty,  epilepsy  and 
neuralgia  of  the  anaemic,  amenorrhcea  and  other  menstrual  disorders  of 
the  same  class  of  subjects,  and  in  acute  rheumatism  of  pale,  cachectic 
persons,  the  chalybeates  are  generally  very  efficient  remedies,  especially 
the  Tincture  of  the  Chloride.  The  same  preparation  is  extensively 
employed  in  erysipelas  and  diphtheria  with  good  results.  In  albumi¬ 
nuria  with  chronic  disease  of  the  kidneys  the  Tinctures  of  the  Chloride 
and  of  the  Acetate  are  useful  as  chalybeate  diuretics.  In  many  cardiac 
diseases  of  the  anaemic,  fatty  heart,  weak  heart,  dilatation,  mitral  disease, 
etc.,  ferruginous  preparations  are  often  of  signal  advantage.  In  the 
syphilitic  cachexia,  chancroid,  and  sloughing  phagedena,  the  Iodide 
gives  good  results,  particularly  when  the  subject  is  one  of  debilitated 
constitution.  In  the  nocturnal  incontinence  of  children  the  Syrup  of  the 
Iodide  is  one  of  the  most  efficient  remedies.  In  all  chronic  affections  of 
the  respiratory  organs,  when  hemorrhage  is  not  existing  or  threatened, 
the  Phosphate  of  Iron,  Quinine  and  Strychnine  is  used  with  much  benefit. 
In  passive  hemorrhages,  especially  when  due  to  anaemia,  the  Tincture  of 
the  Chloride  is  very  effective,  and  in  all  active  bleeding  the  Solution  of 
the  Subsulphate  locally  used  is  a  prompt  and  efficient  hemostatic.  A  weak 
solution  of  this  preparation  (5j  ad  Sviij)  used  in  the  form  of  spray  is  the 
most  serviceable  astringent  in  obstinate  epistaxis,  and  in  hematemesis  the 
same  solution  maybe  swallowed  in  small  quantities  at  short  intervals.  In 
chronic  diarrhoea  and  dysentery  the  Solution  of  the  Nitrate  is  an  efficient 
astringent,  and  a  weak  solution  of  the  Chloride  is  used  as  a  rectal  injection 
against  thread-worms. 

In  arsenical  poisoning  the  most  effective  antidote  is  the  Hydrated  Oxide, 
which  forms  with  Arsenious  Acid  an  almost  insoluble  compound.  The 
solutions  used  in  its  preparation  should  be  kept  on  hand  and  only  mixed 
when  wanted  for  use. 


FICUS - FCENICULUM - FRANGULA. 


221 


FICUS,  Fig  , — is  the  fleshy  receptacle  of  Ficus  Carica ,  bearing  fruit 
upon  its  inner  surface.  The  fig-tree  is  a  member  of  the  nat.  ord.  Urtica- 
cese  and  a  native  of  the  shores  of  the  Levant,  but  is  cultivated  in  Southern 
Europe  and  in  other  warm  countries.  Figs  contain  about  62  per  cent,  of 
grape  sugar,  also  gum,  fat,  etc.,  and  are  a  constituent  of  the  official 
Confectio  Sennae. 

Figs  are  demulcent,  laxative  and  nutritious.  They  are  used  in  their 
fresh  state  as  an  aliment,  but  if  eaten  in  quantity  may  produce  flatulence, 
enteralgia  and  diarrhoea.  They  are  chiefly  used  as  an  article  of  diet  in 
habitual  constipation,  but  maybe  employed  as  an  ingredient  of  demulcent 
decoctions,  and  locally  as  a  poultice  to  gum-boils. 


FCENICULUM,  Fennel,  — is  the  fruit  of  Fceniculum  vulgare ,  a 
European  cultivated  plant  of  the  nat.  ord.  Umbelliferae.  It  is  ^  to  yi 
of  an  inch  long,  oblong,  slightly  curved,  separable  into  2  mericarps,  and 
having  5  ribs,  and  several  oil-tubes,  odor  and  taste  aromatic.  It  contains 
a  volatile  oil,  united  with  a  terpene,  and  is  a  constituent  of  Pulvis  Glycyr- 
rhizae  Compositus. 

Oleu?n  Fozniculi, — the  volatile  oil  a  light-yellow  colored  liquid,  having  the  odor  of 
fennel,  a  warm  taste  and  neutral  reaction,  soluble  in  alcohol.  It  is  an  ingredient  of  Spiri- 
tus  Juniperi  Compositus.  Dose,  rrpij-v. 

Aqua  Fceniculi , — contains  2  parts  of  the  oil  in  1000  of  distilled  water  percolated  through 
cotton.  Dose,  ^ss-^j. 

Fennel  is  an  aromatic  stomachic  and  a  mild  stimulant.  It  is  chiefly 
used  as  an  agreeable  carminative  in  flatulence  and  colic,  and  as  a  corri- 
gent  to  Senna,  Rhubarb,  and  other  disagreeable  medicines.  An  infusion 
is  often  used  as  an  enema  to  expel  flatus  in  infants. 


FRANGULA,  Buckthorn, — the  bark,  collected  at  least  one  year 
before  being  used,  of  Rhamnus  Frangu/a,  or  Alder  Buckthorn,  a  Euro¬ 
pean  shrub  of  the  nat.  ord.  Rhamnaceae.  Occurs  in  quilled  pieces  .j1--  inch 
thick,  outer  surface  of  gray-brown  color,  with  numerous  small  warts.  It 
contains  several  principles,  of  which  the  only  important  one  is  Frangulin, 
or  Rhamnoxanthin ,  a  lemon-yellow,  odorless  and  tasteless  glucoside,  in¬ 
soluble  in  water  and  but  sparingly  so  in  alcohol  or  ether,  and  thought  to 
be  identical  with  Cathartin,  the  active  principle  of  Senna.  Another 
species  of  the  genus  Rhamnus  is  described  under  the  title  Cascara 
Sagrada,  see  ante ,  p.  158. 

Extractum  Frangulce  Fluiduni , — Dose,  3  ss-ij. 

* 

Frangula-bark  when  fresh  is  a  violent  irritant  to  the  gastro-intestinal 
tract,  producing  vomiting,  purging,  and  much  pain.  The  old  dried  bark 


222 


FUCHSIN — FUCUS  VESICULOSUS - GALBANUM. 


is  a  safe  purgative  without  irritant  qualities,  and  is  much  used  in  the  con¬ 
stipation  of  pregnancy,  and  other  conditions  requiring  purgation.  The 
fluid  extract  is  the  best  form  for  administration. 


FUCHSIN,  Roseine,  Magenta,  Anilin  Red  (Unofficial), — is 
the  Hydrochlorate  of  Rosanilin,  C20H10N3.  HC1,  occurring  in  brilliant, 
elongated  crystals  having  a  green  lustre,  readily  soluble  in  water  and 
therein  making  a  bright  red  solution.  Given  internally  it  has  produced 
salivation,  vomiting,  and  diarrhoea;  and  when  injected  intravenously  it 
has  caused  trembling,  staggering,  albuminuria  and  fatty  degeneration  of 
the  kidneys,  symptoms  which  are  thought  to  be  possibly  due  to  the 
presence  of  Arsenic  or  Anilin  as  impurities.  It  imparts  a  magenta  color 
to  the  urine,  and  is  excreted  by  the  kidneys,  liver  and  salivary  glands.  It 
has  been  found  to  be  very  efficient  in  reducing  albuminuria,  in  many 
instances  having  entirely  arrested  it.  It  is  best  administered  in  pill  with 
a  vegetable  extract  as  Licorice  or  Gentian,  and  in  doses  of  gr.  j^-iv, 
according  to  age. 


FUCUS  VESICULOSUS,  Bladder-wrack,  Sea-wrack  (Un¬ 
official), — is  a  perennial  plant  of  the  nat.  ord.  Algae,  growing  on  the 
shores  of  the  Atlantic  and  Pacific  Oceans  as  a  sea- weed.  It  has  a  flat  leaf, 
with  a  midrib  throughout  its  length,  and  small  spherical  vesicles,  filled 
with  air,  in  the  leaf.  It  contains  mucilage  and  much  Soda  in  saline  com¬ 
bination,  also  Iodine,  but  less  of  the  latter  than  other  algae  growing  in 
deeper  water.  A  decoction  of  the  fresh  plant  is  the  best  form  for  admin¬ 
istration. 

Fucus  Vesiculosus  is  one  of  a  number  of  marine  plants  which  are 
used  in  various  parts  of  the  world  as  food  for  man  and  cattle  and  as 
manure.  The  species  under  consideration  is  considered  alterative  and 
tonic,  and  has  been  employed  in  goitre,  glandular  and  joint  enlargements 
and  psoriasis,  but  especially  to  produce  absorption  of  adipose  tissue  in  the 
obese.  An  extract  is  sold  under  the  title  “Anti-fat.” 


GALBANUM,  — is  a  gum-resin  obtained  from  Ferula  galbaniftua , 
an  Asiatic  plant  of  the  nat.  ord.  Umbellifene,  and  probably  from  other 
allied  plants.  It  occurs  in  minute  tears,  agglutinated  into  a  hard  mass, 
of  balsamic  odor  and  acrid,  bitter  taste.  It  contains  a  Volatile  Oil  iso¬ 
meric  with  Turpentine,  a  Gum,  and  a  mixture  of  Resins  which  yield  by 
dry  distillation  a  blue  oil  and  Umbelliferon,  a  tasteless  substance  in  satiny 
crystals.  Dose,  gr.  x-xx,  in  pill  or  emulsion. 


GALLA - GAULTHERIA. 


223 


Pilulce  Galbani  Composites , — each  pill  contains  of  Galbanum  i1/,  grain,  Myrrh  1  yz 
grain,  Asafetida  y2  grain,  and  Syrup.  Dose,  ij-iij. 

Emplastrum  Galbani , — Galbanum  16,  Turpentine  2,  Burgundy  Pitch  6,  and  Lead- 
plaster  76  parts. 

Galbanum  is  also  an  ingredient  of  Emplastrum  Asafcetidae. 

Galbanum  is  stimulant,  expectorant  and  antispasmodic,  acting  much 
like  Ammonia  and  Asafetida,  and  usually  given  with  either  of  these  sub¬ 
stances.  It  is  used  in  chronic  bronchitis  and  catarrh  of  mucous  mem¬ 
branes  generally,  in  amenorrhoea  and  chronic  rheumatism.  The  plaster 
is  used  as  a  stimulant  application  to  indolent  swellings. 


GALLA,  Nutgall  , — is  an  excrescence  on  Quercus  lusitanica ,  the 
Dyer’s  Oak,  a  shrub  of  the  nat.  ord.  Cupuliferae,  growing  in  Western 
Asia,  and  is  caused  by  the  puncture  and  deposited  ova  of  the  insect  Cynips 
Gallce  tinctorice.  Galls  are  hard,  globular  bodies,  from  ^  to  ^  inch  in 
diameter,  of  blackish-gray  color,  tuberculated  on  the  surface,  having  a 
central  cavity,  and  an  intensely  astringent  taste.  They  contain  from  15 
to  75  per  cent,  of  Tannic  Acid,  about  5  percent,  of  Gallic  Acid,  and 
other  unimportant  constituents.  Dose,  gr,  v-xv. 

Tinctura  Gallce , — strength  20  per  cent.  Dose,  ^ss-iij. 

LJnguentum  Gallce , — strength  10  per  cent. 

The  action  of  Nut-galls  is  powerfully  astringent,  due  to  the  Tannic  and 
Gallic  Acids  contained  in  them.  Having  no  special  action  or  use  of 
their  own,  their  qualities  may  be  learned  by  consulting  the  articles 
Acidum  Tannicum  and  Acidum  Gallicum,  a?ite,  pages  74  and  63. 


GAULTHERIA,  Wintergreen  , — is  the  leaf  of  Gaultheria  pro- 
cutnbens,  an  American  evergreen  plant  of  the  nat.  ord.  Ericaceae,  having 
a  peculiar  flavor,  a  fragrant  odor,  and  an  aromatic  and  astringent  taste. 
Its  active  principle  is  the  Volatile  Oil,  which  is  official.  It  also  contains 
Tannic  Acid,  Arbutin,  Urson,  Ericolin,  etc. 

Oleum  Gaidtherice,  Oil  of  Wintergreen, — is  the  volatile  oil,  a  liquid  of  peculiar  and 
aromatic  odor,  sweetish,  warm  taste,  and  a  slightly  acid  reaction.  It  is  readdy  soluble  in 
alcohol,  and  consists  of  Methyl  Salicylate  90  per  cent.,  and  Gaullherilene,  a  hydrocarbon, 
10  per  cent.  Dose,  npiij-x. 

Spiritus  Gaultheriee , — has  of  the  oil  3  per  cent.,  dissolved  in  97  of  alcohol.  Used  for 
flavoring.  Dose,  3  ss— ij. 

Gaultheria  is  stimulant  and  slightly  astringent.  Its  chief  value  is  as 
one  of  the  sources  of  the  oil  named  after  it,  which  is  also  found  in  the 
sweet  birch  and  many  other  plants,  and,  containing  so  large  a  proportion 


224 


GELSEMIUM. 


of  Methyl  Salicylate  or  Methylsalicylic  Acid,  is  powerfully  antiseptic  and 
antipyretic.  In  large  doses  it  is  irritant  to  the  stomach,  in  one  case  5j 
having  caused  death  by  violent  gastritis. 

Oil  of  Gaultheria  is  used  successfully  as  a  substitute  for  Salicylic  Acid 
in  many  conditions,  especially  in  rheumatic  and  gouty  disorders.  The 
plant  has  been  used  as  an  emmenagogue  and  a  galactagogue,  but  its  prin¬ 
cipal  employment  is  in  the  form  of  the  spirh  as  an  agreeable  flavoring 
agent. 


GELSEMIUM,  Yellow  J  asmine, — is  the  rhizome  and  rootlets  of 
Gelsemium  sempervirens ,  a  climbing  plant  of  the  nat.  ord.  Loganiaceae, 
with  showy  yellow  flowers,  which  grows  in  the  forests  of  the  southern 
U.  S.  forming  festoons  from  one  tree  to  another.  The  rhizome  is  cylin¬ 
drical,  long,  about  an  inch  thick,  of  a  light  yellowish-brown  color,  an 
aromatic,  heavy  odor  and  a  bitter  taste.  It  contains  a  volatile  oil,  a  resin 
and  an  alkaloid  Gelsemine  in  combination  with  Gelse?nic  Acid.  Dose, 
gr.  ij-xx. 

Preparations. 

Extractnt7i  Gelsemii  Fluidum , — alcoholic.  Dose,  tipij-xx. 

Tinctura  Gelsemii , — strength  15  per  cent.  Dose,  ttyx-^j. 

Gelsemina,  Gelsemine,  CnHj9N02  (Unofficial), — an  amorphous,  colorless,  inodorous, 
nearly  insoluble  solid,  of  intensely  bitter  taste,  and  strong  basic  properties,  neutralizing 
the  strongest  acids  and  with  them  forming  soluble  salts.  Dose,  gr.  gVsV 

Physiological  Action. 

Gelsemium  is  a  powerful  motor-depressant,  causing  paralysis  of  motility 
and  depression  of  sensibility  by  central  action  on  the  spinal  cord.  It  is 
also  antispasmodic  and  diaphoretic.  In  moderate  doses  it  produces 
languor,  slowing  of  the  cardiac  rate,  enfeebled  muscular  action,  impaired 
sensibility,  drooped  eyelids  and  dilated  pupils,  with  some  diaphoresis. 
In  toxic  dose,  as  a  teaspoonful  of  the  fluid  extract,  it  produces  vertigo, 
diplopia,  drooped  eyelids  and  dilated  pupils  (paralysis  of  3d  nerve), 
labored  respiration,  slow  and  feeble  heart,  dropped  jaw,  staggering  gait, 
extreme  muscular  weakness  and  almost  complete  anaesthesia,  profuse 
diaphoresis,  loss  of  articulation,  and  death  by  asphyxia  from  paralysis  of 
the  muscles  of  respiration,  consciousness  being  preserved  until  C02  nar¬ 
cosis  sets  in.  Convulsions  occur  in  animals  with  backward  movements, 
but  not  in  man.  Motion  is  affected  before  sensibility  in  warm-blooded 
animals,  sensibility  before  motion  in  frogs. 

Gelsemium  is  not  an  arterial  depressant,  although  it  lowers  the  heart- 
rate,  and  is  not  irritant  to  the  gastro-intestinal  tract,  but  it  produces  a 
decided  lowering  of  the  body  temperature.  The  effects  of  a  moderate 
dose  pass  off  in  about  three  hours. 


GENTIANA. 


225 


Antagonists  and  Incompatibles. 

Morphine  is  the  most  complete  antagonist,  so  are  also  Digitalis,  Ammonia,  Alcohol, 
and  to  some  extent  the  tincture  of  Xanthoxylum  fraxineum.  Emetics,  heat,  faradization 
of  the  respiratory  muscles  and  artificial  respiration  are  measures  of  prime  importance. 
The  caustic  alkalies  and  tannic  acid  are  chemically  incompatible. 


Therapeutics. 

Gelsemium  is  indicated  in  all  conditions  of  exalted  nerve  function,  and 
contra-indicated  whenever  there  is  a  weak  heart.  It  is  best  used  in 
cerebro-spinal  meningitis,  mania  with  great  motor  excitement  and  persist¬ 
ent  insomnia,  delirium  tremens,  many  forms  of  sleeplessness,  pneumonia 
and  pleurisy  if  the  heart  be  strong,  coughs  of  convulsive  and  spasmodic 
character,  neuralgia  of  the  fifth  nerve,  remittent  fever,  after-pains,  ovarian 
neuralgia,  dysmenorrhoea,  irritable  bladder  of  women,  and  incontinence 
of  urine  from  spasm  of  the  vesical  muscular  fibres.  In  most  of  these 
affections  the  remedy  must  be  pushed  to  the  inducing  of  some  physio¬ 
logical  symptoms,  but  its  action  should  not  be  carried  beyond  the  produc¬ 
tion  of  drooped  eyelids,  diplopia  and  muscular  debility.  It  has  also  been 
used  with  varying  success  in  intercostal  neuralgia,  myalgia,  sciatica, 
spasmodic  asthma,  sick  headache,  eczema,  pruritus  and  tetanus.  Its  espe¬ 
cial  field,  however,  is  in  remittent  and  typho-malarial  fevers  and  cerebro¬ 
spinal  meningitis.  It  is  not  suitable  to  low  fevers  and  has  not  sufficient 
power  as  a  cardiac  depressant  to  be  of  much  use  in  sthenic  forms. 

There  is  much  evidence  for  the  claim  made  for  the  drug  Gelsemine, 
of  singular  efficiency  in  antagonizing  the  mental  condition  occasionally 
manifested  by  an  unusual  degree  of  dread ,  in  regard  to  some  approach¬ 
ing  ordeal,  or  ordinary  trial  of  life  ;  as  for  example,  that  of  a  woman 
concerning  her  impending  confinement,  or  of  a  student  in  reference  to 
his  examinations.  In  very  many  such  cases,  the  use  of  Gelsemine,  in 
small  doses  frequently  repeated  (gr.  yiy  ter  die),  has  seemed  to  remove 
the  state  of  abnormal  fear  entirely. 


GENTIANA,  Gentian  , — is  the  root  of  Gentiana  lutea ,  the  Yellow 
Gentian,  one  of  a  numerous  family  of  plants  (nat.  ord.  Gentianaceae), 
which  inhabit  the  mountainous  districts  of  Europe.  An  American  species, 
G.  Catesbcei ,  Blue  Gentian,  is  considered  nearly  equal  in  value  to  the 
official  species.  Gentian  occurs  in  cylindrical  pieces  or  longitudinal 
slices  of  the  root,  which  is  to  1  inch  thick  and  several  inches  long, 
brown  externally,  yellowish-brown  within,  of  faint,  peculiar  odor,  and 
taste  at  first  sweetish,  afterwards  persistently  bitter.  It  contains  an  active, 
bitter  glucoside,  Gentopicrin  or  Gentianin ,  which  is  crystalline 

15 


226 


GERANIUM. 


and  soluble  in  water,  also  an  inert,  amorphous  body  Gentia?iic  or  Gentesic 
Acid ,  gum,  considerable  sugar,  and  a  trace  of  a  volatile  oil,  but  no  tannin. 


Preparations. 

Extraction  Gentiance , — aqueous.  Dose,  gr.  j-v. 

Extraction  Gentiance  Fluidnm, — Dose,  gss-j. 

Tinctura  Gentiance  Composita, — Gentian  8,  Bitter  Orange  Peel  4,  Cardamom  2,  Di¬ 
luted  Alcohol  to  100.  Dose,  3  ss — ij. 

Unofficial  Preparations. 

Infusion  Gentiance  Composition , — contains  Gentian  10,  Bitter  Orange  Peel  2*4,  Cori¬ 
ander  2 yz.  Alcohol  40,  Water  to  320.  Dose,  ^j-gj. 

Mistura  Gentiance  Alkalina, — Ac.  Hydrocyan.  Dil.  rtpuj,  Sodii  Bicarb,  gr.  xv,  Infusum 
Gentiance  Co.  to  gj.  One  dose. 

Mistura  Gentiance  et  Sennce, — Infusum  Sennae  ^iij,  Tr.  Cardamomi  Co.  gj,  Infusum 
Gentianae  Co.  3  vj.  One  dose. 

Physiological  Action  and  Therapeutics. 

Gentian  is  a  simple  bitter  without  astringency  or  aroma,  its  action  cor¬ 
responding  to  that  of  Calumba  (see  ante ,  page  145),  but  it  is  more  apt  to 
disagree  with  the  stomach.  In  addition,  like  Cornus,  a  member  of  the 
same  class,  it  has  considerable  repute  as  an  antiperiodic  and  febrifuge. 

Gentian  has  been  considered  a  valuable  tonic  throughout  all  Europe 
from  the  earliest  historical  times.  It  is  highly  esteemed  as  a  stomachic 
tonic  in  dyspepsia  connected  with  a  gouty  diathesis,  in  hysteria,  jaundice, 
and  in  convalescence  from  acute  diseases  and  from  malarial  fever.  The 
compound  tincture  is  an  excellent  vehicle  for  cod-liver  oil,  and  the  now 
unofficial  infusion  is  a  good  vehicle  for  the  administration  of  chalybeates, 
mineral  acids  and  neutral  salts.  The  discoloration  which  iron  salts  make 
with  gentian  preparations  is  probably  due  to  Gentesic  Acid  and  not  to 
tannin,  as  it  contains  none  of  the  latter. 


GERANIUM,  Cranesbill-root, — is  the  rhizome  of  the  indigenous 
perennial  Geranium  maculatum  (nat.  ord.  Geraniaceae).  It  is  2  or  3 
inches  long,  horizontal,  contorted  and  tuberculated,  with  thin,  fragile 
rootlets,  inodorous,  taste  astringent.  Its  active  constituents  are  tannic  and 
gallic  acids. 

Preparation. 

Extraction  Geranii  Fluidum, — Dose,  ripv-3  j. 

Physiological  Action  and  Therapeutics. 

Geranium  is  an  efficient  astringent,  and  its  action  corresponds  with  that 
of  Tannic  Acid  (see  ante ,  page  74).  Having  no  unpleasant  taste  it  is  a 
useful  agent  for  infants  and  others  having  delicate  stomachs,  and  is  a  very 
popular  domestic  remedy  in  many  parts  of  the  country.  It  is  especially 
used  in  diarrhoeas,  dysentery,  cholera  infantum,  hemorrhages,  relaxed 
conditions  of  mucous  membranes,  gleet  and  leucorrhoea. 


GLYCERINUM. 


227 


GLYCERINUM,  Glycerin,  — is  a  liquid  obtained  by  the  decom¬ 
position  of  fats  or  fixed  oils,  containing  not  less  than  95  per  cent,  of 
absolute  Glycerin,  C3H5(HO)3,  which  exists  in  fats  and  fixed  oils  in  com¬ 
bination  with  the  fatty  acids. 

Glycerin  is  clear  and  colorless,  of  syrupy  consistence,  hygroscopic,  non-drying,  odorless, 
of  warm  and  very  sweet  taste,  neutral  reaction,  sp.  gr.  1.250,  soluble  in  water  and  alcohol, 
but  insoluble  in  ether,  chloroform  and  fixed  oils.  It  dissolves  tannin,  gallic  acid,  carbolic 
acid,  salicylic  acid,  bromine,  iodine,  etc.,  and  with  the  aid  of  heat  metallic  salts  and 
oxides,  alkaloids,  etc.  With  strong  Nitric  Acid  it  forms  Nitro-glycerin,  and  it  reduces 
potassium  permanganate,  chromic  acid  and  chlorinated  lime  with  great  violence.  An 
impurity  frequently  present  in  it  is  Acrolein ,  formed  by  the  use  of  too  high  a  heat  in  its 
manufacture,  and  which  is  very  acrid  and  poisonous.  Glycerin  is  a  constituent  of  Glvce- 
ritum  Amyli,  Glyceritum  Vitelli,  Piluloe  Phosphori,  Mucilago  Tragacanthae,  Massa  Hy- 
drargyri,  and  several  extracts  and  fluid  extracts.  Dose,  ^j-ij,  diluted. 


Physiological  Action. 

Glycerin  is  highly  antiseptic,  abstracts  water  from  tissues  with  which  it 
comes  in  contact,  and  unless  pure  is  often  very  irritating  to  the  skin.  It 
is  freely  absorbed  by  all  surfaces,  cutaneous  and  mucous,  and  is  decom¬ 
posed  in  the  system,  passing  out  as  formic  and  other  acids.  On  the 
stomach  it  has  no  particular  action,  but  in  large  quantities  it  is  laxative 
and  is  said  to  cause  the  solution  of  the  red  blood  corpuscles  and  haemo- 
globinuria.  The  urine  of  persons  using  glycerin  contains  a  body  which 
acts  like  sugar  in  the  copper  and  fermentation  tests,  but  is  not  sugar. 
Glycerin  is  a  good  emollient  and  is  considered  nutritive  by  many  au¬ 
thorities. 

Therapeutics. 

Glycerin  has  been  used  as  a  substitute  for  Cod-liver  Oil  in  wasting  dis¬ 
eases,  but  with  little  benefit.  It  has  also  been  tried  as  a  remedy  in 
diabetes,  but  with  unsatisfactory  results  so  far  as  reported,  except  as  a 
sweetening  substitute  for  sugar  in  the  dietary  of  those  afflicted  with  that 
disease.  It  is  said  to  be  fatal  to  intestinal  trichinae,  and  to  be  an  efficient 
internal  remedy  in  acne  and  flatulence.  In  chronic  constipation,  most 
excellent  results  are  obtained  from  rectal  enemata  of  Glycerin,  or  from 
suppositories  thereof  made  with  soap  or  gelatin  (y1^)  to  give  them  consis¬ 
tency.  As  a  vehicle  it  is  used  for  many  drugs,  and  is  a  good  ingredient 
of  solutions  for  hypodermic  use,  promoting  the  solubility  of  many  alka¬ 
loids  and  acting  as  an  antiseptic.  It  is  also  employed  to  preserve  and 
aid  the  action  of  the  digestive  ferments,  Pepsin  and  Pancreatin,  as  well  as 
to  prevent  the  decomposition  of  vaccine  lymph. 

Locally  it  is  valuable  in  many  cutaneous  affections  as  an  emollient  and 
softening  agent.  In  acute  coryza  it  gives  great  relief  if  applied  by  a 
brush  or  as  a  spray  to  the  nasal  mucous  membrane.  It  is  used  on  cotton 
to  the  cervix  uteri  as  a  depleting  agent,  and  mixed  with  an  infusion  of 
flaxseed  as  an  enema  to  relieve  tenesmus  in  acute  dysentery.  With  tine- 


228 


GLYCYRRHIZA. 


ture  of  Benzoin  it  is  an  excellent  application  to  chapped  hands  or  lips  and 
fissured  nipples.  In  the  external  auditory  canal  it  is  usefully  employed 
to  soften  cerumen,  diminish  the  secretion  of  pus,  deplete  the  tissues,  and 
keep  the  surface  moist.  [For  other  uses  of  Glycerin  in  combination  see 
Glyceritum  Vitelli,  Glyceritum  Amyli,  and  Glyceritum  Acidi  Tannici, 
under  the  titles  of  their  respective  bases.] 


GLYCYRRHIZA,  Liquorice  Root, — is  the  root  of  Glycyrrhiza 
glabra ,  a  plant  of  the  nat.  ord.  Leguminosae,  native  in  southern  Europe 
and  Asia,  but  largely  cultivated  in  many  other  parts.  It  occurs  in  long 
pieces,  ]  to  i  inch  thick,  longitudinally  wrinkled,  of  a  grayish-brown 
color  externally,  tawny-yellow  internally,  pliable  and  tough,  and  of  a 
somewhat  acrid,  sweet  taste.  It  contains  a  yellow,  amorphous  glucoside, 
Glycyrrhizin ,  C24H3609,  also  Glycyrrhizic  Acid,  Asparagin,  sugar,  resin, 
gum,  etc.  Glycyrrhizin  when  boiled  with  dilute  acids  yields  glucose  and 
a  very  bitter  substance  named  Glycyrretin. 

Preparations. 

Extraction  Glycyrrhiza, — is  the  commercial  extract  of  the  root,  occurring  in  glossy- 
black  rolls,  of  sweet,  peculiar  taste.  Not  less  than  60  per  cent,  of  it  should  be  soluble  in 
cold  water. 

Extraction  Glycyrrhiza  Purum , — made  with  Aqua  Ammonia  and  Water,  by  percola¬ 
tion  and  evaporation  to  a  pilular  consistence.  Dose,  indefinite. 

Extractum  Glycyrrhiza  Eluidum , — made  with  Aqua  Ammonia  and  diluted  Alcohol. 
Dose,  indefinite. 

Mistura  Glycyrrhiza  Composita,  Brown  Mixture, — has  of  the  Pure  Extract  3  parts, 
Sugar  3,  Acacia  3,  Tr.  Opii  Carnph.  12,  Vinum  Antimonii  6,  Spt.  ZEtheris  Nitrosi  3,  and 
Water  70.  Dose,  ^j-^ss. 

Pulvis  Glycyrrhiza  Compositus, — Senna  18,  Glycyrrhiza  16,  Fennel  8,  Washed  Sul¬ 
phur  8,  Sugar  50  parts.  Dose,  a  teaspoonful. 

Trochisci  Glycyrrhiza  et  Opii , — each  has  of  Extract  of  Glycyrrhiza  gr.  ij,  Extract  of 
Opium  gr.  Jq  >  Acacia,  Sugar  and  Oil  of  Anise.  Dose,  j-ij  every  hour. 

Glycyrrhizinum  Ammoniatum ,  Ammoniated  Glycyrrhizin, — the  sweet  principle  of 
Liquorice  rendered  soluble  and  therefore  tasteable  by  Ammonia,  believed  to  be  the  form 
in  which  Glycyrrhizin  exists  in  the  root.  Occurs  in  brownish-red  scales,  very  sweet,  and 
soluble  in  water  or  in  alcohol.  Dose,  gr.  v-xv.  Is  a  constituent  of  Veloutine,  for  which 
see  page  182. 

Physiological  Action  and  Therapeutics. 

Liquorice  is  demulcent  and  mildly  laxative.  It  has  an  agreeable  taste, 
and  increases  the  flow  of  saliva  and  mucus  when  slowly  chewed  or  sucked, 
the  increased  secretions  acting  as  emollients  to  the  throat.  It  is  used  in 
many  pharmaceutical  preparations,  covering  the  taste  of  Senna,  Senega, 
Hyoscyamus,  Turpentine,  Chloride  of  Ammonium,  bitter  Sulphates,  and 
to  some  degree  the  bitterness  of  Quinine.  The  powdered  extract  or  root 
is  used  as  an  excipient  in  pills  and  troches.  The  Compound  Mixture  is 
an  efficient  expectorant,  much  employed  in  acute  bronchitis  and  catarrhal 
laryngitis,  but  owing  its  power  over  cough  mainly  to  the  Opium  contained 
in  it.  The  Compound  Powder  is  a  gentle  laxative,  of  which  Senna  is  the 


GOSSYPIUM. 


229 


most  active  ingredient.  The  Troches  are  used  for  cough,  but  must  be 
carefully  prescribed  to  children  as  they  contain  gr.  of  Extract  of 
Opium  in  each. 


GOSSYPIUM,  Cotton, — is  the  hair  of  the  seed  of  Gossypium  her- 
baceum ,  and  of  other  species  of  Gossypium  (nat.  ord.  Malvaceae),  freed 
from  adhering  impurities  and  deprived  of  fatty  matter.  In  this  form  it  is 
known  as  Purified  or  Absorbent  Cotton ,  is  insoluble  in  water,  alcohol  or 
ether,  but  is  soluble  in  an  ammoniacal  solution  of  Cupric  Sulphate.  Cot¬ 
ton-fibre  is  familiar  in  appearance  to  every  one,  but  when  examined 
microscopically,  it  shows  as  flattened,  hollow  and  twisted  bands,  spirally 
striate,  and  slightly  thickened  at  the  edges.  It  is  a  modification  of  Cel¬ 
lulose,  C12H10O10,  and  corresponds  therewith  in  all  its  ordinary  chemical 
properties. 

Preparations  of  the  Cotton  Plant. 

Gossypii  Radicis  Cortex,  Cotton  Root  Bark, — thin  bands  or  quilled  pieces,  brownish 
yellow  exteriorly,  white  interiorly,  of  slightly  acrid  and  astringent  taste.  Dose,  gr. 

xxx-3i- 

Extraction  Gossypii  Radicis  Fluidum , — made  with  Glycerin  and  Alcohol,  by  macera¬ 
tion  and  percolation.  Dose,  rr^xxx-^j. 

Oleuin  Gossypii  Seminis,  Cotton-seed  Oil,—  the  fixed  oil  expressed  from  the  seeds  and 
purified.  Is  yellow,  odorless,  of  bland  taste  and  neutral  reaction,  soluble  in  ^ether,  but 
slightly  soluble  in  alcohol.  Is  introduced  into  the  pharmacopoeia  for  the  reason  that  it 
constitutes  most  of  the  “  Olive  Oil  ”  sold  in  foreign-shaped  bottles  and  under  foreign- 
appearing  labels.  It  is  directed  to  be  used  in  the  official  Liniments  of  Ammonia,  Lime, 
Camphor,  and  Sub-acetate  of  Lead.  * 

Pyroxylinum,  Pyroxylin,  Soluble  Gun  cotton, — is  official  for  the  purpose  of  making 
Collodium.  It  is  prepared  by  macerating  Cotton  in  a  mixture  of  Sulphuric  and  Nitric 
Acids,  washing,  draining  and  drying. 

Collodium ,  Collodion, — made  by  dissolving  Pyroxylin  4,  in  Ether  70  and  Alcohol  26 
parts. 

Collodium  Flexile,  Flexible  Collodion, — Collodion  92,  Canada  Turpentine  5,  Castor 
Oil  3  parts. 

Collodium  Stypticum,  Styptic  Collodion, — Collodion  55,  Ether  20,  Alcohol  5,  Tannic 
Acid  20  parts. 

Collodium  cum  Cantharide ,  Cantharidal  Collodion, — Cantharides  60,  Flexible  Collo¬ 
dion  85,  Chloroform  q.  s. 

Physiological  Action. 

Cotton-root  is  believed  to  be  an  efficient  emmenagogue  and  oxytocic 
by  Southern  practitioners,  also  somewhat  of  a  galactagogue,  but  experi¬ 
ments  on  pregnant  animals  have  not  confirmed  this  view  of  its  action. 
The  Oil  of  the  seed  is  very  bland  and  may  be  applied  to  all  the  purposes 
for  which  Olive  Oil  is  used.  Cotton  itself,  when  freed  from  oily  matter, 
is  remarkably  absorbent  of  water,  and  is  a  good  agent  for  excluding  air 
from  injured  surfaces.  Pvroxylin  is  highly  inflammable,  and  explosive 
at  300  F.  Collodion  is  also  inflammable,  and  rapidly  dries  on  exposure 
to  the  atmosphere  by  evaporation  of  its  ether,  leaving  a  transparent  film 
of  Pyroxylin  on  the  surface  to  which  it  has  been  applied  ;  which  film,  if 
the  flexible  collodion  be  used,  does  not  contract  on  drying  or  readily 


230 


GRANATUM. 


crack,  making  it  an  excellent  protective  application.  Styptic  Collodion 
is  a  solution  of  Tannin,  and  is  an  excellent  hemostatic.  Cantharidal 
Collodion  is  a  convenient  blistering  agent,  suitable  for  cases  where  the 
patient  is  inclined  to  remove  a  blister  if  applied  in  the  ordinary  way. 

Therapeutics. 

Absorbent  Cotton  is  a  valuable  agent  in  surgical  practice,  being  em¬ 
ployed  as  an  application  in  burns  and  scalds,  erysipelas,  articular  rheuma¬ 
tism,  etc.,  to  exclude  the  atmosphere,  allay  pain,  and  when  covered  with 
oiled-silk  or  rubber  cloth  to  keep  up  local  perspiration.  It  may  be  car- 
bolated,  borated  or  salicylated  by  soaking  in  the  respective  solutions,  and 
then  used  as  an  antiseptic  dressing  for  wounds,  ulcers,  etc.  It  is  employed 
by  the  pharmacist  in  funnels  to  filter  oils,  and  for  the  preparation  of  the 
official  waters. 

Cotton-root  Bark  is  much  employed  by  the  negroes  of  the  southern 
states  in  decoction  as  a  supposed  abortifacient,  oxytocic  and  emmena- 
gogue.  It  is  used  in  the  south  for  intensifying  uterine  action  in  normal 
labor,  in  dysmenorrhoea  and  amenorrhcea.  A  decoction  of  5  iv  in  a 
quart  of  water  boiled  to  a  pint  is  the  favorite  preparation,  administered  in 
wineglassful  doses. 

Collodion  is  used  as  a  protective  covering  for  superficial  burns,  ulcers 
and  wounds,  slight  cuts,  cracked  nipples,  anal  fissures,  and  erysipelas. 
For  these  affections  the  flexible  collodion  should  be  used,  but  where  it  is 
desirable  to  produce  pressure  on  the  part  .the  ordinary  form  is  best,  as  it 
contracts  in  drying  with  considerable  force.  This  property  makes  it 
highly  useful  in  drawing  the  edges  of  wounds  together,  bringing  pressure 
on  buboes,  incipient  boils,  carbuncles,  etc. 

Styptic  Collodion  has  many  uses  as  a  hemostatic  and  protective  which 
will  suggest  themselves,  and  the  Cantharidal  form  is  a  convenient  epi- 
spastic  for  uneven  surfaces,  the  therapeutics  of  which  are  detailed  under 
Cantharis.  (See  ante ,  page  152.) 


GRANATUM,  Pomegranate, — is  the  bark  of  the  root  of  Putiica 
Granatum ,  a  small  tree  of  the  nat.  ord.  Granataceae,  cultivated  in  sub¬ 
tropical  countries.  It  occurs  in  thin  quills  of  yellowish-gray  color,  warty 
or  ridged  on  the  external  surface,  inodorous,  of  astringent  and  slightly 
bitter  taste.  It  contains  Tannic  and  Punico-tannic  Acids,  Mannite  and 
an  active  liquid  alkaloid  Pelleiierine ,  C8H13NO,  which  is  soluble  in  water, 
alcohol,  ether,  chloroform,  etc.,  and  has  strong  basic  properties.  There 
are  no  official  preparations. 

Unofficial  Preparations. 

Extraction  Granati  Fluidum , — Dose,  3  ss-jss. 

Decoctum  Granati , —  3  xvij  of  bark  from  the  fresh  root  in  5  xvij  of  boiling  water, 


GRINDELIA. 


231 


boiled  down  to  xij  and  strained.  Dose,  3iv-vj  every  hour,  preceded  and  followed  in 
a  few  hours  by  a  brisk  cathartic.  The  decoction  of  the  Br.  Phar.  is  of  I  to  8  strength 
and  is  given  in  doses  of  ^  ij-iv. 

Pelletierince  Tannas,  Tannate  of  Pelletierine, — Dose,  gr.  v-xx,  taken  fasting  and  fol¬ 
lowed  in  15  minutes  by  a  sharp  purgative. 

Physiological  Action  and  Therapeutics. 

Granatum  and  its  alkaloid  are  taeniafuge,  and  very  efficiently  so,  rarely 
failing  to  bring  away  the  whole  worm.  The  decoction  is  usually  em¬ 
ployed,  but  lately  Pelletierine  has  been  coming  into  fashion,  a  proprietary 
form  being  sold  as  “Tanret’s  Pelletierine”  in  bottles  containing  one 
adult  dose  at  three  dollars  each.  The  decoction,  in  full  doses,  causes 
nausea  and  vomiting,  flatulence,  purging,  and  sometimes  cramps  in  the 
legs,  giddiness,  dimness  of  vision,  general  numbness  of  the  limbs  and  in¬ 
crease  of  the  quantity  of  urine. 

For  the  expulsion  of  tape-worm  a  mixed  treatment  by  Pomegranate- 
root  bark,  Pumpkin  seeds  and  Oleo-resin  and  Male-fern  is  preferred  by 
many  practitioners.  The  following  formula  has  proved  very  efficient. 
R.  Granati  5ij>  Aquae  Ojss,  boiled  to  5 vij ;  Pepinis  5j>  deprived  of 
outer  coats  and  beaten  to  a  paste  with  fine-powdered  sugar;  Oleoresinse 
Aspidii,  gr.  xxx,  made  into  emulsion  with  Acacia  and  the  above  decoction 
of  Granatum,  then  added  to  the  paste  of  Pepo,  and  flavored  with  Syrups 
up  to  Six,  one-third  of  this  to  be  taken  in  the  morning  after  a  light  diet 
and  a  laxative  on  the  previous  day.  If  not  successful  the  second  and 
third  portions  may  be  taken  at  intervals  of  3  hours.  The  worm  should 
be  passed  sitting  in  a  tepid  sitz-bath  to  prevent  the  expelled  portion 
tearing  off  the  head  by  its  weight. 


GRINDELIA, — the  leaves  and  flowering  tops  of  Grindelia  7'obusta , 
an  herbaceous  Californian  plant,  of  the  nat.  ord.  Compositae,  having  a 
branched  stem,  lower  leaves  spatulate  and  tapering  at  the  base,  upper 
leaves  oblong,  pointed  and  have  broad  bases,  flowers  yellow,  odor  bal¬ 
samic,  taste  pungently  aromatic  and  bitter.  It  contains  a  resin,  a  volatile 
oil,  and  an  alkaloid  with  basic  properties. 

Preparation. 

Extractum  Grindelioe  Fluiditm, — Dose,  npx-gj. 

Physiological  Action. 

Grindelia  is  antispasmodic  and  a  motor-depressant,  inducing  paralysis 
in  small  animals  beginning  in  the  hind  extremities.  It  slightly  slows  the 
heart  and  respiration,  and  produces  mydriasis  and  hypnotic  effects  if 
given  in  sufficient  quantity,  with  reduced  cutaneous  sensibility  and  slug¬ 
gish  reflexes.  It  has  a  pungent  taste,  creates  a  sense  of  warmth  in  the 
stomach,  and  in  small  doses  promotes  appetite  and  digestion.  It  is  elimi- 


232 


GUAIACUM. 


nated  by  the  pulmonary  mucous  membrane  and  the  kidneys,  and  is 
markedly  diuretic. 

Therapeutics. 

Grindelia  has  been  used  chiefly  in  spasmodic  asthma,  bronchitis  and 
whooping-cough,  which  it  greatly  relieves.  It  is  a  useful  remedy  in  spas¬ 
modic  coughs,  dyspnoea  of  various  pulmonary  and  cardiac  affections, 
hay-fever,  and  chronic  cystitis.  Locally  it  is  highly  efficient  as  a  sedative 
lotion  (i  part  of  the  fluid  extract  to  io  of  water)  in  poisoning  by  Rhus 
toxicodendron,  and  in  skin  diseases  attended  with  itching  and  burning 
sensations. 


GUAIACUM,  Lignum  Vitae  , — is  official  in  two  forms,  Guaiaci 
Lignum,  the  heart-wood,  and  Guaiaci  Resina,  Guaiac,  the  resin  of  the 
wood  of  Guaiacum  officinale ,  a  large  West  Indian  tree  of  the  nat.  ord. 
Zygophyllacese.  The  Resin  is  the  important  constituent,  and  itself  con¬ 
sists  of  three  resins,  namely, — Guaiaconic  Acid,  C19H20O5,  70  per  cent., 
Guaiac  Acid,  C6H803,  resembling  Benzoic  Acid,  and  Guaiarec  Acid, 
C20H26O4;  also  an  indifferent  resin.  The  wood  also  contains  a  yellow 
coloring  matter,  gum,  etc. 

Guaiaci  Lignum,  Guaiacum  Wood, — generally  used  in  the  form  of 
raspings  of  greenish-brown  color  containing  whitish  particles,  of  resinous 
odor,  taste  slightly  acrid.  Is  a  constituent  of  Decoctum  Sarsaparillse 
Compositum. 

Guaiaci  Resina,  Guaiac, — occurs  in  large  masses  of  a  greenish-brown 
or  reddish-brown  color,  feebly  aromatic,  taste  somewhat  acrid,  fracture 
having  a  glassy  lustre,  insoluble  in  water,  soluble  in  alcohol,  ether, 
chloroform  and  alkaline  fluids.  Dose,  gr.  v-xxx,  in  wafer. 

Preparations. 

Tinctura  Guaiaci, — Guaiac  20  per  cent.  Dose,  in  mucilage  or  syrup,  as  the 

resin  is  precipitated  by  water. 

Tinctura  Guaiaci  Ammoniata, — Guaiac  20,  Aromatic  Spirit  of  Ammonia  80  parts. 
Dose,  npv-^ss. 

Physiological  Action. 

Guaiac  is  diaphoretic,  expectorant  and  alterative.  Its  taste  is  acrid  and 
very  disagreeable.  Internally  it  is  a  local  stimulant,  producing  salivation, 
an  acrid  sensation  in  the  throat,  warmth  in  the  epigastrium,  increase  of 
•  the  gastric  and  intestinal  secretions  and  the  flow  of  bile,  and  reflex  stimu¬ 
lation  of  the  heart.  Its  continued  use  causes  gastric  catarrh,  and  in  large 
doses  it  is  a  gastro-intestinal  irritant,  causing  vomiting,  purging  and 
severe  congestive  headache.  Though  a  colloidal  body  it  enters  the  blood, 
stimulates  the  liver  and  other  excretory  glands  and  the  production  of 
bronchial  mucus,  and  causes  increased  circulation  and  diaphoresis. 
Sometimes  it  fails  to  act  on  the  skin  and  then  is  markedly  diuretic. 


GUARANA — GURJUN  BALSAM. 


233 


Incompatibles. 

Mineral  Acids  and  Spirit  of  Nitrous  Ether  are  chemically  incompatible  with  Guaiac 
preparations. 

Therapeutics. 

Guaiacum  was  first  used  as  an  antisyphilitic,  being  used  in  decoction 
and  in  large  quantity,  with  a  spare  diet  and  external  warmth.  It  acquired 
a  great  reputation  in  this  disease  during  the  16th  century,  but  it  is  now 
abandoned  for  this  purpose  except  as  an  ingredient  of  the  Compound 
Decoction  of  Sarsaparilla.  It  is  a  very  efficient  remedy  in  tonsillitis, 
given  in  5  ss  doses  of  the  tincture  in  emulsion  with  mucilage  or  yolk  of 
egg,  to  abate  the  inflammation  and  abort  the  disease.  It  has  considerable 
reputation  in  neuralgic  dysmenorrhcea,  amenorrhoea,  chronic  rheumatism, 
gout,  lumbago  and  sciatica.  The  ammoniated  tincture  in  water  makes  a 
cleanly  and  not  very  disagreeable  gargle. 


GUARANA,  — is  a  dried  paste  prepared  from  the  crushed  or  ground 
seeds  of  Paullinia  sorbilis ,  a  climbing  plant  of  the  nat.  ord.  Sapindaceae, 
growing  in  Brazil.  It  occurs  in  brown  cakes  or  sticks,  having  an  odor  of 
chocolate  and  a  bitter,  astringent  taste,  partly  soluble  in  water  and  in 
alcohol.  It  contains  25  per  cent,  of  tannic  acid,  gum,  albumen,  starch, 
and  a  greenish  fixed  oil,  also  an  alkaloid  Guaranine  (5  per  cent.),  which 
is  identical  with  Caffeine.  The  specimens  of  Guarana  in  the  market  are 
very  untrustworthy,  unequal  in  quality  and  expensive,  it  being  a  secret 
mixture  prepared  in  Brazil.  Hence  it  has  been  omitted  from  the  list  of 
Squibb’ s  preparations,  and  a  fluid  extract  of  green  coffee  substituted  in 
its  place. 

Preparation.  • 

Extraclum  Guarance  Fluidum , — Dose,  ppx-gij. 

Physiological  Action  and  Therapeutics. 

Guarana  has  similar  actions  to  those  of  Coffee,  the  active  principles  of 
both  plants  being  identical,  both  chemically  and  physiologically.  It  is 
chiefly  employed  in  the  treatment  of  nervous  sick-headache  (migraine) 
administered  in  half-drachm  doses  of  the  fluid  extract  when  the  attack  is 
developing.  It  has  been  used  in  the  diarrhoea  of  phthisis,  convalescence 
from  acute  diseases,  and  generally  in  conditions  requiring  tonic  treatment. 


GURJUN  BALSAM,  Wood  Oil,  Balsamum  Dipterocarpi 

(Unofficial), — is  an  oleoresin  obtained  from  incisions  in  various  trees  of 
the  genus  Dipterocarpus,  growing  in  India.  It  is  thick,  opaque  and 
grayish-brown  by  reflected  light,  soluble  in  chloroform  and  partly  so  in 
alcohol,  ether  and  volatile  oils,  odor  balsamic,  taste  bitter.  It  contains 


234 


GUTTA  PERCHA — HtEMATOXYLON. 


from  40  to  70  per  cent,  of  a  Volatile  Oil,  a  Resin  and  Gurjunic  Acid. 
Dose,  npx-5ij,  in  emulsion,  or  in  capsules. 

Physiological  Action  and  Therapeutics. 

The  properties  of  this  balsam  are  similar  to  those  of  Copaiba,  but  it  is 
less  disagreeable  and  less  apt  to  upset  the  stomach,  also  less  actively  diu¬ 
retic.  It  has  been  used  with  good  success  in  leprosy,  given  internally  in 
full  doses  and  used  locally  at  the  same  time.  Mixed  with  4  parts  of  Lime- 
water  it  is  well  applied  in  chronic  eczema,  lupus  and  psoriasis. 


GUTTA-PERCHA  , — is  the  concrete  exudation  of  Isonandra  Gutta, 
a  large  tree  of  the  nat.  ord.  Sapotacese,  growing  in  the  Malay  peninsula 
and  adjoining  islands.  Occurs  in  tough  but  somewhat  flexible  pieces,  of 
grayish  or  yellowish  color,  plastic  above  140°  F.,  soft  at  2120  F.,  insol¬ 
uble  in  water  or  alcohol,  soluble  in  chloroform,  oil  of  turpentine,  carbon 
bisulphide,  benzin  and  benzol.  It  contains  a  hydrocarbon  Gutta ,  Ci0H16 
(80  per  cent.),  two  Resins  named  Fluavil  and  Albau ,  also  a  volatile  oil, 
salts,  fat  and  coloring  matter. 

Preparations.. 

Liquor  Gutta- Perchce, — a  solution  of  Gutta-Percha  9,  Carbonate  of  Lead  10,  in  Chlo- 
roformum  Venale  91  parts.  Used  as  a  protective  application  to  eruptions  and  slight 
wounds,  the  evaporation  of  the  menstruum  leaving  behind  a  thin  adhesive  and  non-irrita¬ 
ting  pellicle. 

Traumaticine  (Unofficial), — is  the  name  given  to  a  10  per  cent,  solution  of  Gutta-percha 
in  Chloroform,  which  forms  on  drying  a  permanent,  unirritating,  adhesive,  flexible  and 
non-contractile  skin  for  the  treatment  of  skin  affections  and  slight  wounds.  It  forms  an 
excellent  basis  for  the  application  of  Chrysarobin  to  psoriasis. 


.  Uses. 

Gutta-Percha  has  neither  physiological  action  nor  therapeutics,  being 
used  for  its  physical  qualities  alone.  In  surgical  practice  it  has  several 
applications,  making  a  good  material  for  splints,  as  it  can  be  softened  in 
hot  water  and  adapted  to  any  surface  while  pliable.  From  it  are  manu¬ 
factured  pessaries,  specula,  stethoscopes  and  other  instruments.  The 
solution  may  be  used  as  a  protective  covering  for  excoriations  and  slight 
wounds,  to  prevent  pitting  in  small-pox,  and  to  paint  over  the  line  of 
suture  after  post-mortem  examinations. 


HiEMATOXYLON,  Log-wood, — is  the  heart-wood  of  Hczma- 
toxyloji  campechianum ,  a  tree  of  the  nat.  ord.  Leguminosae,  native  of 
tropical  America,  but  naturalized  in  the  West  Indies.  It  occurs  in  chips 
or  powder  of  a  dark  brown-red  color,  often  with  a  greenish  lustre,  of 
feeble  and  agreeable  odor,  taste  sweet  and  astringent,  and  colors  the  saliva 
a  dark  pink  when  chewed.  It  contains  tannic  acid,  and  a  sweet,  crystal- 


HAMAMELIS.  235 

line  coloring  principle  named  Hczmatoxylin,  C10HuO6,  which  is  colorless 
when  pure,  but  turns  red  on  exposure  to  light. 

Preparations. 

Extraction  Hcematoxyli, — Dose,  gr.  v-xx. 

Decoctum  Hcematoxyli  (Unofficial), — strength  1  in  17.  Dose,  !|j-ij. 

Physiological  Action  and  Therapeutics. 

Logwood  is  mildly  astringent,  its  properties  depending  on  the  tannin 
contained  in  it.  As  it  is  devoid  of  irritating  qualities  it  is  well  adapted 
to  the  diarrhoeas  and  hemorrhages  of  young  children.  It  does  not  pro¬ 
duce  constipation  nor  disorder  the  bowels,  but  colors  the  urine  and  stools 
blood-red,  and  has  caused  phlebitis.  It  has  been  used  as  an  hemostatic 
in  bleeding  of  the  lungs,  and  hemorrhages  from  the  uterus  and  intestines, 
and  as  an  astringent  in  leucorrhoea. 


HAMAMELIS,  Witch-hazel, — the  leaves,  collected  in  autumn, 
of  Hamamelis  virginica ,  a  shrub  of  the  nat.  ord.  Hamamelaceae,  growing 
in  the  United  States,  having  yellow  flowers  and  oval-shaped  leaves  about 
4  inches  long,  which  are  inodorous,  but  of  a  bitter  and  astringent  taste. 
They  contain  about  8  per  cent,  of  tannic  acid,  a  bitter  principle  and 
probably  some  volatile  matters,  but  the  chemistry  of  the  plant  has  not 
been  fully  studied. 

Preparations. 

Extraction  Hamamelidis  Fluidum , — Dose,  is  the  only  official  preparation,  and 

is  prepared  from  the  leaves. 

Hamamelin  (Unofficial), — is  an  uncertain  extract  of  very  indefinite  composition.  Dose, 

gr-j-T 

Distilled  Extracts ,  so-called,  but  really  Waters  distilled  from  the  bark,  are  sold  by 
various  manufacturers,  and  are  said  by  the  vendors  to  contain  the  volatile  principles 
of  the  plant.  Pond's  Extract  is  such  a  preparation,  said  to  be  made  by  distilling  the 
bark  with  a  very  dilute  alcohol,  and  is  a  proprietary  medicine  of  uncertain  composition. 

Physiological  Action  and  Therapeutics. 

No  trustworthy  experimentation  has  yet  been  made  with  this  drug.  It 
is  tonic,  astringent,  styptic  and  sedative,  owing  most  of  its  properties  to 
its  tannin,  but  appears  to  possess  some  special  influence  over  the  venous 
circulation  similar  to  that  of  Aconite  on  the  arterial  system.  In  full 
doses  it  may  produce  severe  throbbing  pain  in  the  head.  It  is  used  both 
internally  and  locally  with  great  benefit  in  hemorrhoids,  particularly  those 
of  the  bleeding  variety,  varicose  veins  and  ulcers,  varicocele,  venous  con¬ 
gestions  and  threatening  local  inflammations.  It  is  highly  recommended 
in  hemorrhages  from  the  nose,  stomach,  lungs,  rectum  and  kidneys, 
threatened  abortion,  and  externally  for  sprains  and  bruises,  foul  ulcers, 
the  pruritus  of  eczema,  leucorrhoea  and  gonorrhoea.  An  Ointment  of 
Witch-hazel  is  found  in  the  shops,  and  suppositories  may  be  prepared 


236 


HEDEOMA - HELLEBORUS. 


extemporaneously  by  evaporating  the  fluid  extract  and  incorporating  the 
residue  with  cocoa-butter. 


HEDEOMA,  Pennyroyal, — the  leaves  and  tops  of  Hedeoma  pule- 
gioides ,  a  plant  of  the  nat.  ord.  Labiatae,  common  to  all  parts  of  the  U.  S., 
having  a  four-sided,  hairy  stem,  pale  blue  flowers,  leaves  *4  inch  long, 
glandular  on  the  under  surface,  odor  strong  and  mint-like,  taste  pungent. 
Its  only  important  constituent  is  the  Volatile  Oil,  which  is  official. 

Preparations. 

Oleum  Hedeoma ,  Oil  of  Pennyroyal, — is  the  volatile  oil,  readily  soluble  in  alcohol. 
Dose,  rtyij-x. 

Spiritns  Hedeomee  (Unofficial), — contains  I  part  of  the  oil  in  9  of  alcohol.  Used  ex¬ 
ternally  or  as  spray. 

Physiological  Action  and  Therapeutics. 

Hedeoma  is  a  stimulant  aromatic,  also  somewhat  carminative  and 
emmenagogue.  Its  odor  is  extremely  repulsive  to  insects,  especially  fleas 
and  mosquitoes.  In  warm  infusion  it  is  a  popular  remedy  for  amenorrhoea 
and  flatulent  colic.  It  may  be  used  as  a  corrective  with  other  medicines, 
and  the  spirit  is  well  employed  on  the  hands  and  face  to  keep  away  mos¬ 
quitoes.  The  writer  has  known  death  by  narcosis  to  result  from  an  over¬ 
dose  of  the  oil  taken  to  produce  an  abortion. 


HELLEBORUS,  Hellebore  (Unofficial), — the  rhizome  and  root¬ 
lets  of  Helleborus  niger  (Black  Hellebore)  and  Helleborus  viridis  (Green 
Hellebore),  plants  of  the  nat.  ord.  Ranunculaceae,  natives  of  Europe.  A 
third  variety,  Helleborus  occidentalism  growing  in  Greece,  is  probably  the 
true  Hellebore  of  the  ancients.  The  rhizome  is  1  to  3  inches  long, 
knotty,  with  transverse  rings,  of  rancid  odor  when  freshly  bruised,  and 
bitter,  acrid  taste.  Its  most  important  constituents  are  two  glucosides, 
Helleborin  and  Helleborein ,  both  crystalline  and  very  poisonous. 

Preparations. 

Extractum  Hellebori  Ni^ri  (Unofficial), — Dose,  gr.  j-x,  cautiously. 

Extraction  Hellebori  Nigri  Fluidutu  (Unofficial), — Dose,  npij-xv. 

Helleborin ,  C36H4206  (Unofficial), — crystalline,  insoluble  in  water,  soluble  in  alcohol 
and  chloroform. 

Helleborein ,  C26H44015  (Unofficial), — crystalline,  very’ soluble  in  water,  slightly  so  in 
alcohol,  insoluble  in  ether.  Dose,  gr.  A--L. 

Physiological  Action. 

Black  Hellebore  is  a  drastic,  hydragogue  cathartic,  and  an  emmen¬ 
agogue.  In  overdoses  it  is  a  violent  gastro-intestinal  irritant,  producing 
vomiting,  hypercatharsis,  vertigo,  cramps  and  convulsions,  which  may  re¬ 
sult  fatally.  Locally  applied,  the  fresh  root  is  violently  irritant  to  the 
skin,  producing  inflammation  and  vesication. 


HOANG-NAN. 


237 


Helleborin  is  an  active  poison,  acting  on  the  tongue  like  Aconite, 
and  on  the  nervous  system  as  a  narcotic,  producing  in  animals  paresis  of 
motion  and  sensation,  cerebral  and  spinal  congestion,  dilated  pupils  and 
death.  It  is  less  irritant  than  Helleborei'n  to  the  mucous  membranes. 

Helleborein  is  less  actively  toxic  to  animals,  but  is  very  irritant, 
producing  conjunctivitis,  sneezing,  salivation,  nausea,  vomiting  and 
purging.  It  affects  the  heart  like  Digitalis,  small  doses  frequently  re¬ 
peated  slowing  its  action,  but  large  ones  quicken  it  and  then  suddenly 
paralyze  it  through  the  pneumogastric  nerve.  Respiration  is  at  first 
accelerated,  then  slowed  and  rendered  laborious.  Diuresis  is  a  constant 
result,  the  kidneys  and  uterus  are  congested,  gradual  paralysis  and  severe 
convulsions  follow,  and  death  occurs  by  paralysis  of  the  heart. 

Therapeutics. 

Black  Hellebore  is  an  old  remedy,  having  been  highly  esteemed  by 
the  early  physicians  in  insanity,  dropsies,  worms,  cutaneous  affections  and 
amenorrhcea.  It  has  at  present  gone  out  of  fashion,  but  might  be  usefully 
employed  in  dropsies  and  as  a  revulsant  in  acute  cerebral  affections. 
Recently  Helleborein  has  come  into  notice  as  a  substitute  for  Digitalis  in 
cardiac  affections,  as  being  of  less  bulk  and  more  definite  composition. 
Its  action  on  the  heart  is  obtained  by  doses  much  smaller  than  those 
necessary  for  its  irritant  effects  on  the  gastro-intestinal  canal.  Its  solu¬ 
bility  in  water  and  the  freedom  with  which  it  can  be  used  hypodermically 
are  important  qualities  to  recommend  it. 


HOANG-NAN,  or  Hwang-Nao, — is  the  bark  of  Strychnos  Gaul- 
theriana ,  or  Tropical  Bind-weed,  a  creeping  vine  of  the  nat.  order 
Loganiaceae,  found  in  the  mountains  of  Tonquin.  It  contains  the  alka¬ 
loids  Strychnine  and  Brucine ,  thus  resembling  in  composition  its  con¬ 
geners  Nux-Vomica  and  Ignatia,  but  differing  from  them,  as  they  do  from 
each  other,  in  the  proportional  quantities  in  which  the  alkaloids  are 
contained, — Brucine  predominating  in  this  plant,  as  Strychnine  does 
in  the  other  two. 

Physiological  Action  and  Therapeutics. 

Like  the  other  members  of  the  Strychnos  family,  Hoang-Nan  is  an 
active  tetanizer,  its  action  generally  corresponding  with  that  of  Nux- 
Vomica.  It  was  first  brought  into  notice  by  the  missionary  fathers 
stationed  in  the  French  colonies  in  Asia,  they  having  found  its  employ¬ 
ment  general  among  the  natives  for  leprosy  and  hydrophobia.  Along  the 
coast  of  Tonquin  and  Cochin-China,  and  in  Pondicherry,  Trinidad, 


238 


HUMULUS. 


Venezuela,  etc.,  it  has  an  established  reputation  in  the  two  terrible 
diseases  mentioned,  also  as  a  remedy  for  the  bites  of  venomous  serpents 
and  other  reptiles,  scrofulous  and  syphilitic  ulcers,  indolent  sores,  etc. 
It  has  been  used  successfully  for  malarial  fevers,  in  lieu  of  quinine,  and  is 
highly  spoken  of  by  Father  Brosse,  as  a  stimulant  to  the  intellect,  without 
producing  any  subsequent  depression. 

The  Dose  of  the  powdered  drug  is  about  gr.  iij-v ; — of  the  aceto- 
alcoholic  Extract,  gr.  — and  of  the  concentrated  Tincture,  rqj-v. 


HUMULUS,  Hops,  — the  strobiles  (fruit-cones)  of  Humulus  Lupu- 
l us ,  a  cultivated  creeping  plant  of  the  nat.  ord.  Urticaceae.  They  are 
ovate,  1  to  inch  long,  and  consist  of  a  hairy,  undulating  axis  and  several 
membranous,  greenish  scales,  odor  aromatic,  taste  bitter,  aromatic  and 
slightly  astringent.  Its  constituents  are  wax,  resins  (50  per  cent.),  tannin 
(5  per  cent.),  a  liquid  volatile  alkaloid  Lupuline ,  a  Volatile  Oil  (2  per 
cent.)  which  consists  in  part  of  Valerol  and  Trimethylamine ,  and  a  crys¬ 
talline,  bitter  principle  Lupulinic  Acid  (n  per  cent.).  These,  except 
tannin,  are  more  abundant  in  the  glandular  powder  of  the  strobiles, 
which  is  named  Lupulin. 

Preparations. 

Tinctura  Humuli, — strength  20  per  cent.  Dose,  gj-ij. 

Infusum  Hnmuli  (Unofficial), —  ^ssto  the  pint.  Dose,  5j-iv. 

Lupulinum ,  Lupulin, — is  the  glandular  powder  separated  from  the  strobiles,  of  bright 
brownish-yellow  color,  aromatic  and  bitter  taste.  The  Volatile  Oil  resides  in  the  Lupulin 
grains,  and  contains  Valerol ,  which  is  changed  into  Valerianic  Acid  by  long  exposure, 
giving  a  disagreeable  odor  to  old  hops.  Dose,  gr.  v-xv. 

Extraction  Lupulini  Fluidum, — alcoholic.  Dose,  rtpx-  %j. 

Oleoresina  Lupulini , — an  ethereal  extract.  Dose,  gr.  ij-v. 

Tinctura  Lupulini  (Unofficial), — strength  Dose,  ^ss-ij. 

Mineral  acids  and  metallic  salts  are  chemically  incompatible  with  preparations  of 
Hops. 


Humulus  is  a  bitter  tonic,  a  feeble  hypnotic,  and  somewhat  diaphoretic, 
astringent  and  anaphrodisiac.  It  increases  the  cardiac  action  and  the 
cutaneous  circulation.  After  slight  cerebral  excitement  it  produces  calm 
and  a  soporific  disposition,  especially  if  the  solution  administered  be 
strongly  alcoholic.  The  stomachic  and  tonic  effects  are  due  to  the  bitter 
principle,  lupulinic  acid,  and  are  found  in  bitter  ale.  The  primary 
stimulant  and  secondary  sedative  effects  are  due  to  the  volatile  oil  and 
are  also  possessed  by  ales  and  beer. 


Hops  are  used  as  a  tonic  and  calmative  in  delirium  tremens,  in  which  a  combination  of 
the  tincture  with  Tr.  Capsici  is  very  efficient  and  is  an  excellent  substitute  for  alcohol.  In 
dyspepsia  of  atonic  form  Humulus  is  an  excellent  stomachic  tonic,  and  in  nervous 
irritability  the  fluid  extract  of  Lupulin  may  be  used  as  a  calmative  and  hypnotic, 
or  the  hop-pillow,  which  certainly  exercises  considerable  influence,  imaginary  or  other- 


HYDRANGEA - HYDRARGYRUM. 


239 


wise.  A  poultice  of  hops  is  a  favorite  domestic  application  in  inflammations  and  pain. 
Lupulin  has  been  used  with  benefit  in  irritable  bladder,  alcoholism,  and  as  an  ana- 
phrodisiac  in  the  treatment  of  chordee,  gonorrhoea,  spermatorrhoea  and  other  affections 
of  the  genito-urinary  organs. 


HYDRANGEA  (Unofficial)  , — is  the  root  of  Hydrangea  arborescens , 
a  plant  of  the  nat.  ord.  Saxifragaceae,  growing  in  the  southeastern  U.  S. 
It  is  a  white,  tough  root,  having  a  thin  brown  bark  which  peels  off  in 
spots,  inodorous,  taste  insipid,  afterwards  pungent.  It  contains  gum, 
albumen,  starch,  resin,  and  a  ferrous  salt,  with  other  salts.  Dose, 
3ss-5ij,  best  in  fluid  extract.  A  decoction  of  the  root  may  be  used 
in  doses  of  3j~ij- 

Hydrangea  has  been  long  used  by  the  Cherokee  Indians  in  calculous  affections,  and 
reports  of  cases  by  competent  observers  show  that  it  is  of  unquestionable  utility  in  this 
class  of  disorders,  promoting  the  removal  of  gravel  from  the  bladder,  and  relieving  pain 
during  the  passage  of  renal  concretions  through  the  ureters.  Large  doses  produce  vertigo, 
oppression  of  the  chest,  and  considerable  cerebral  disturbance. 


HYDRARGYRUM,  Mercury,  Quicksilver,  Hg, — is  a  shining, 
silver-white  metal,  fluid  and  slowly  volatile  at  ordinary  temperatures, 
solidifies  at  — 40°  F.,  boils  at  662°  F.,  volatilizes  without  residue, 
insoluble  in  ordinary  solvents,  wholly  soluble  in  nitric  acid,  of  sp.  gr. 
13.5,  odorless  and  tasteless. 


Preparations  of  Mercury. 

Hydrargyrum  cum  Creta ,  Mercury  with  Chalk,  Gray  Powder, — has  of  Mercury  38, 
Sugar  of  Milk  12,  Prepared  Chalk  50,  Ether  and  Alcohol,  triturated  together  to  a  uniform 
gray  powder.  Dose,  gr.  ss-x. 

Massa  Hydrargyri ,  Blue  Mass,  Blue  Pill, — contains  of  Mercury  33  parts,  Liquorice  5, 
Althaea  25,  Glycerin  3,  Honey  of  Rose  34.  Each  grain  contains  gr.  U  °f  Mercury. 
Dose,  gr.  ss-xx. 

Unguentum  Hydrargyri ,  Mercurial  Ointment,  Blue  Ointment, — Mercury  450,  Lard 
225,  Suet  225,  Compound  Tincture  of  Benzoin  40,  Old  Mercurial  Ointment  100  parts, 
triturated  until  globules  of  Mercury  cease  to  be  visible  under  a  magnifying  power  of  10 
diameters. 

Emplastrum  Hydrargyri ,  Mercurial  Plaster, — Mercury  30,  Olive  Oil  10,  Resin  10, 
Lead  Plaster  50  parts. 

Emplastrum  Ammoniaci  cum  Hydrargyro , — see  ante,  page  93. 


Chlorides  and  their  Preparations. 

Hydrargyri  Chloridum  Corrosivum ,  Corrosive  Chloride  of  Mercury,  Bichloride,  Mercuric 
Chloride,  Corrosive  Sublimate,  IIgCl2, — heavy  colorless  crystals,  of  acrid,  metallic  taste, 
acid  reaction,  soluble  in  16  of  water  and  3  of  alcohol  at  590  F.,  in  2  of  boiling  water, 
1.2  of  boiling  alcohol  and  in  4  of  ether.  Dose,  gr.  A~tV 


240 


HYDRARGYRUM. 


Hydrargyri  Chloridum  Mite ,  Mild  Chloride  of  Mercury,  Subchloride,  Mercurous 
Chloride,  Calomel,  Hg2Cl2, — a  heavy,  white,  impalpable  powder,  insoluble  in  water, 
alcohol  or  ether,  odorless  and  tasteless.  Is  an  ingredient  of  Pil.  Antimonii  Co.  and  Pil. 
Catharticae  Co.  Dose,  gr.  J^-x. 

Hydrargyrum  Ammonia  turn,  Ammoniated  Mercury,  White  Precipitate,  Mercur- 
ammonium  Chloride,  NH2HgCl, — is  a  white,  insoluble  powder,  odorless  and  tasteless. 
Only  used  externally. 

Unguentum  Hydrargyri  Ammoniati ,  White  Precipitate  Ointment, — Ammoniated 
Mercury  io,  Benzoinated  Lard  90  parts. 


Oxides  and  their  Preparations. 

Hydrargyri  OJcidum  Flavian,  Yellow  Oxide  of  Mercury,  Precipitated  Oxide,  HgO, — 
an  orange-yellow,  heavy,  impalpable  powder,  odorless  and  tasteless,  insoluble  in  water  or 
alcohol,  but  wholly  soluble  in  nitric  or  hydrochloric  acid.  Used  to  prepare : 

Unguentum  Hydrargyri  Oxidi  Flavi, — strength  1  to  9  of  Ointment. 

Oleatujn  Hydrargyri , — Yellow  Oxide  10,  Oleic  Acid  90. 

Hydrargyri  Oxidum  Rubrum ,  Red  Oxide  of  Mercury,  HgO, — a  heavy,  orange  red 
crystalline  powder,  having  the  same  properties  as  the  yellow  oxide,  from  which  it  differs 
only  in  being  crystalline  and  not  in  such  a  minute  state  of  subdivision.  Dose,  gr. 

Unguentum  Hydrargyri  Oxidi  Rubri , — strength  1  to  9  of  Ointment. 


Iodides  and  their  Preparations. 

Hydrargyri  Iodidum  Rubrum ,  Red  Iodide  of  Mercury,  Biniodide,  Mercuric  Iodide, 
Hgl2, — a  scarlet-red,  crystalline  powder,  almost  insoluble  in  water,  soluble  in  130  of 
alcohol,  in  solution  of  iodide  of  potassium  or  of  mercuric  chloride.  Prepared  by  double 
decomposition  between  Iodide  of  Potassium  1 1  parts  and  Mercuric  Chloride  9  parts. 
Dose,  gr.  ^-tV 

Liquor  Arsenii  et  Hydrargyri  Iodidi ,  Solution  of  Iodide  of  Arsenic  and  Mercury, 
Donovan’s  Solution, — see  ante ,  page  117. 

Hydrargyri  Iodidum  Viride ,  Green  Iodide  of  Mercury,  Protiodide,  Mercurous  Iodide, 
Hg2I2, — a  dull  green  or  greenish-yellow  powder,  insoluble  in  alcohol  or  ether  and  almost 
so  in  water.  Dose,  gr.  TL-i. 

Acid  Combinations  and  their  Preparations. 

Liquor  Hydrargyri  Nitratis,  Solution  of  Mercuric  Nitrate, — a  liquid  containing  in 
solution  about  50  percent,  of  Mercuric  Nitrate,  Hg(N03)2,  with  some  free  Nitric  Acid. 
Prepared  from  the  Red  Oxide  of  Mercury  40,  by  Nitric  Acid  45,  and  Distilled  Water  15 
parts.  Used  as  a  caustic. 

Unguentum  Hydrargyri  Nitratis,  Citrine  Ointment, — prepared  by  dissolving  Mercury 
7,  in  Nitric  Acid  17,  and  adding  Lard  Oil  76. 

Hydrargyri  Subsulphas  Flavus ,  Yellow  Subsulphate  of  Mercury,  Basic  Mercuric 
Sulphate,  Turpeth  Mineral,  Hg(PIg0)2S04, — a  heavy,  lemon-yellow  powder,  insoluble  in 
water  or  alcohol,  soluble  in  nitric  acid  and  in  20  parts  of  hydrochloric  acid  without  residue. 
Dose,  as  an  emetic,  gr.  ij-v. 


Sulphide  and  Cyanide. 

Hydrargyri  Sulphidum  Rubrum ,  Red  Mercuric  Sulphide,  Cinnabar,  HgS, — Red, 
crystalline  masses,  or  a  fine,  scarlet  powder,  insoluble  in  ordinary  solvents,  but  soluble  in 
nitro-hydrochloric  acid  with  separation  of  sulphur.  Used  only  for  mercurial  fumigation. 
Hydrargyri  Cyanidum,  Mercuric  Cyanide,  Hg(CN)2, — colorless,  prismatic  crystals,  of 

bitter,  metallic  taste,  soluble  in  12.8  of  water  and  in  15  of  alcohol  at  590  F.  Dose,  gr. 

1 _ i_ 

100  To* 

Ti'iturations. 

These  maybe  prepared  according  to  the  general  formula  under  “  Triturationes  ”  in 
the  Pharmacopoeia,  10  parts  of  the  substance  to  90  of  Sugar  of  Milk.  Mercury  itself 
or  any  of  its  salts  may  be  so  treated  with  excellent  results,  the  particles  being  much 
finer  and  therefore  more  easily  absorbed  than  if  rubbed  up  with  any  other  agent. 


HYDRARGYRUM. 


241 


Unofficial  Preparations. 

Lotio  Hydrargyri  Flava,  Yellow  Wash, — prepared  by  adding  Corrosive  Sublimate  gr. 
xviij  to  Lime-water  5X,  producing  the  yellow  oxide,  a  favorite  application  for  syphilitic 
sores. 

Lotio  Hydrargyri  Nigra,  Black  Wash, — prepared  by  adding  Calomel  gr.  xxx,  to  Lime- 
water  5  x,  producing  the  black  oxide,  and  used  as  an  application  to  syphilitic  sores. 

Unguentum  Hydrargyri  Nitratis  Rubrnm, — Red  Ointment  of  Mercuric  Nitrate,  Brown 
Citrine  Ointment, — differs  from  the  official  ointment  only  in  being  made  with  Cod-liver 
Oil,  which  gives  it  a  brown  color,  and  a  more  agreeable  odor. 

Physiological  Action. 

Mercury  is  tonic,  purgative,  alterative,  antiphlogistic  and  sorbefacient, 
but  not  directly  cholagogue.  Some  of  its  salts  are  corrosive  poisons, 
others  are  local  caustics,  all  produce  by  long-continued  administration  the 
peculiar  cachexia  termed  Hydrargyrism.  The  metal  itself  is  inert,  but  by 
combination  with  the  acids  and  fluids  of  the  body  becomes  active,  and  is 
easily  absorbed  in  any  form,  passing  into  the  blood  from  the  skin,  mucous 
membranes,  lungs  and  stomach,  in  each  case  probably  as  an  Oxyalbuminate 
of  Mercury.  Entering  the  stomach  in  any  form  it  is  first  converted  into  a 
double  Chloride  of  Sodium  and  Mercury,  then  uniting  with  the  albuminous 
juices  to  form  a  complex  molecule  of  Mercury,  Sodium,  Chlorine  and 
Albumen,  which  being  soluble  in  an  excess  of  sodium  chloride  or  albumen, 
exists  in  solution,  and  is  easily  absorbed,  being  decomposed  in  the  blood 
and  changed  to  the  oxyalbuminate.  Entering  the  intestines  a  purgative 
action  is  soon  set  up,  of  more  or  less  severity  according  to  the  preparation 
used,  a  small  portion  only  is  absorbed,  the  rest  being  converted  into  a 
Sulphide  and  excreted  with  the  faeces,  unless  combined  with  opium  which 
delays  its  progress  through  the  intestines  and  permits  of  its  greater  ab¬ 
sorption.  In  the  blood  its  effects  are  tonic  in  small  doses,  but  in  quantity 
it  indirectly  produces  impoverishment  thereof,  impairs  the  ozonizing 
function,  diminishes  the  red  corpuscles,  and  consequently  disorders  nutri¬ 
tion  and  deranges  digestion.  From  the  blood  it  enters  the  tissues,  where 
it  remains  for  an  indefinite  period,  exerting  a  peculiar  influence,  termed 
“  alterative  ”  on  all  processes  characterized  by  growth  of  young  cells,  but 
not  producing  any  definite  anatomical  changes  either  in  the  viscera  or  the 
nervous  tissue,  though  in  the  latter  a  low  form  of  inflammation  arises, 
resulting  in  loss  of  coordination-power.  It  stimulates  most  of  the  glands 
of  the  body,  especially  the  salivary  glands  and  the  pancreas,  to  the  pro¬ 
duction  of  pathological  secretions,  and  is  excreted  with  comparative 
slowness  by  all  the  secretory  organs,  being  found  in  the  saliva,  sweat,  milk, 
urine  and  bile.  It  tends  to  accumulate  in  the  liver,  while  stimulating  its 
cells,  and  is  not  a  cholagogue,  though  stimulating  the  flow  of  bile  already 
secreted  by  reflex  action  on  the  bile-ducts  due  to  its  direct  purgation  of 
the  duodenum.  Its  excretion  is  hastened  and  completed  by  the  use  of  the 
iodide  of  potassium. 

In  small  doses  administered  for  a  short  time  the  mercurial  preparations 

16 


242 


HYDRARGYRUM. 


are  blood-tonics,  improving  its  general  condition,  increasing  the  number 
of  red  corpuscles  and  the  body  weight.  They  soon  begin  to  promote 
waste  by  stimulating  the  lymphatic  system,  and  if  the  small  doses  are  long 
continued  or  the  quantity  is  increased,  symptoms  of  mercurial  poisoning 
being  to  manifest  themselves. 

The  first  symptoms  of  Hydrargyrism  are  fetid  breath,  swollen  and 
spongy  gums  having  a  bluish  line  along  their  margins,  stomatitis,  sore  and 
loosened  teeth,  inflamed  and  tender  salivary  glands  pouring  out  a  peculiar, 
thin  saliva  of  foul  odor  in  large  quantity,  and  a  metallic  taste  in  the  mouth. 
Anorexia,  diarrhoea  and  fever  follqw,  also  ulceration  and  in  some  cases  even 
gangrene  of  the  lips  and  tongue.  If  the  use  of  the  drug  be  continued 
nutrition  will  be  greatly  impaired  through  the  extreme  promotion  of  ret¬ 
rograde  metamorphosis,  and  various  nervous  disturbances  will  follow,  the 
effects  being  emaciation,  pallor,  oedema,  ulcerated  skin,  erythematous, 
vesicular  or  pustular  eruptions,  headache,  insomnia,  neuralgia,  tremor 
through  paresis  of  the  muscles  of  the  head  and  extremities,  epilepsy,  coma 
and  convulsions.  In  pregnant  women  abortion  will  occur  by  reason  of 
the  impoverishment  of  the  blood.  Indeed,  as  Dr.  Ringer  said  in  the 
earlier  editions  of  his  Handbook  of  Therapeutics ,  the  phenomena  produced 
by  mercury  are  singularly  similar  to  those  which  will  result  from  syphilis, 
and  the  serious  symptoms  known  as  secondary  and  tertiary  syphilis  can  be 
produced  both  by  syphilis  and  by  mercury.  The  drug  is  probably  a  true 
vital  antidote  against  the  syphilitic  virus,  and  is  capable  of  bringing  about 
a  radical  cure  of  the  disease,  if  introduced  into  the  system  in  considerable 
quantity  and  its  use  protracted  over  a  very  long  time,  the  action  of  the 
drug  in  all  cases  being  kept  short  of  ptyalism  or  any  pronounced  physio¬ 
logical  effects. 

Salivation  is  most  readily  produced  by  Blue  Mass,  next  by  Calomel, 
and  less  easily  by  Gray  Powder.  Individuals  differ  greatly  in  their  sus¬ 
ceptibility  to  the  action  of  mercury,  some  persons  having  been  affected 
after  a  single  moderate  dose.  Children  are  not  easily  salivated.  Inhala¬ 
tion  of  mercurial  vapors  is  apt  to  affect  the  nervous  system  most,  its 
internal  administration  and  that  by  inunction  are  more  likely  to  produce 
salivation. 

The  observations  on  the  antiphlogistic  and  sorbefacient  actions  of 
Mercury  are  clinical  rather  than  physiological,  but  it  is  generally  agreed 
that  exhibited  in  inflammation  mercurials  antagonize  the  increase  of  the 
haemic  fibrin  which  is  so  constant  an  effect  of  the  inflammatory  process, 
and  that  in  chronic  diseases  attended  by  the  formation  of  semi-organized 
deposits,  a  mild  mercurial  course  will  almost  insensibly  remove  the  new- 
formed  material. 

A  not  uncommon  result  of  full  doses  of  Blue  Pill  is  an  acute  coryza  of 
very  severe  character,  which  the  writer  has  frequently  observed  to  follow 


HYDRARGYRUM. 


243 


on  neglect  of  the  old-fashioned  precaution  to  “work  off”  the  mercurial 
by  a  saline  cathartic.  The  symptoms  produced  are  those  of  a  severe 
attack  of  influenza,  epistaxis,  conjunctivitis  and  obstinate  muco-purulent 
discharge  from  the  nasal  passages  being  especially  marked.  Similar  effects 
have  been  observed  during  physiological  experiments  with  mercury  on 
animals  by  Overbeck  and  Bennett. 

Notes  on  The  Action  of  the  Preparations. 

Metallic  Mercury  is  not  used  internally  except  in  the  finely-divided 
form  obtained  in  Blue  Pill  and  Gray  Powder,  which  are  capable  of  pro¬ 
ducing  all  the  effects  above  described.  Mercurial  Ointment  is  the  pre¬ 
paration  generally  used  for  inunction,  a  piece  the  size  of  a  small  nut  being 
daily  rubbed  into  the  soft  skin  at  the  flexures  of  joints.  The  Oleate  painted 
over  the  surface  is  a  more  cleanly  method  of  making  the  same  application. 
Both  these  preparations  are  efficient  parasiticides. 

The  Bichloride  is  the  most  actively  toxic  of  the  mercurial  salts.  It  is 
probably  the  most  active  zymoticide  and  parasiticide,  a  solution  of  1  part 
in  2000  being  efficiently  antiseptic  for  use  as  injections  or  dressings,  and 
one  of  1  to  250  being  the  usual  strength  for  use  against  epizoa  and  parasitic 
skin  affections.  It  is  a  very  active  gastro-intestinal  irritant,  in  toxic  dose 
producing  nausea,  retching  and  vomiting,  a  metallic  taste,  constriction  of 
the  fauces,  burning  pain  in  the  stomach,  suppression  of  urine,  bloody 
diarrhoea,  collapse  and  death  often  preceded  by  convulsions.  It  affects 
specifically  the  lower  bowel  [Calomel  preferring  the  upper  intestine],  and 
produces  inflammation  and  ulceration  of  the  rectum.  It  is,  however,  one 
of  the  most  manageable  and  efficient  of  the  mercurials  when  used  in  proper 
doses. 

The  Subchloride  (Calomel)  is  very  insoluble  and  unirritating,  taste¬ 
less,  laxative  in  grain  doses,  decomposed  by  the  alkaline  contents  of  the 
intestines,  the  Oxide  of  Mercury  being  formed,  and  acts  especially  on 
the  excrementitious  glandular  appendages  of  the  upper  intestine,  stimu¬ 
lating  the  liver  by  indirect  reflex  action  as  a  duodenal  purgative.  In  the 
presence  of  alkaline  chlorides  it  is  converted  into  the  Bichloride,  but  not 
in  sufficient  quantity  to  render  it  dangerous  in  the  gastro-intestinal  canal. 
Externally  applied  it  is  very  sedative  to  the  mucous  membranes  and  the 
skin.  Calomel  is  a  very  efficient  diuretic. 

Ammoniated  Mercury  is  an  Ammonio-Chloride,  and  a  useful  stimu¬ 
lant  and  parasiticide  when  used  locally  in  the  form  of  ointment. 

The  Iodides  are  actively  poisonous,  the  Red  being  much  the  most 
irritant,  in  overdoses  producing  symptoms  and  results  very  similar  to 
those  caused  by  the  Bichloride.  The  Cyanide  is  also  actively  poisonous. 
The  Yellow  Subsulphate  is  a  prompt  and  usually  harmless  emetic,  but 
has  occasionally  produced  fatal  results  by  local  irritant  action.  The 


244 


HYDRARGYRUM. 


Oxides  are  irritant,  the  Red  being  the  most  so,  and  are  rarely  used  inter¬ 
nally.  The  Acid  Nitrate  is  a  good  escharotic,  the  pain  caused  by  it 
being  transient  though  severe,  and  its  caustic  action  being  comparatively 
superficial.  The  Ointment  of  the  Nitrate  (Citrine  Ointment)  is  more 
irritant  than  that  of  the  Ammoniated  Mercury,  and  generally  needs  dilu¬ 
tion.  All  these  preparations  may  produce  the  constitutional  effects  of 
mercury,  and  their  administration  should  be  carefully  watched  for  the  first 
symptoms  of  mercurialization. 


Antidotes  and  Incompatibles. 

Albumen  in  some  form,  the  white  of  one  egg  to  gr.  iv  of  the  bichloride,  forms  the 
albuminate,  which  must  be  at  once  evacuated  by  emesis  or  the  stomach  pump,  as  it  is 
soluble  in  excess  of  albumen  or  in  the  alkaline  contents  of  the  intestines. 

The  Chlorides  are  incompatible  with  very  many  agents,  and  the  Bichloride  should  be 
administered  in  distilled  water  or  pill  by  itself,  being  easily  decomposed.  Calomel  is 
decomposed  by  alkaline  Iodides  or  Bromides.  The  combination  of  Calomel  with  Hydro¬ 
chloric  Acid  or  Chlorides  is  apt  to  produce  Corrosive  Sublimate.  In  the  “  mixed  treat¬ 
ment  ”  of  syphilis,  a  mercurial  is  combined  in  solution  with  Iodide  of  Potassium,  and  the 
Red  Iodide  is  the  preparation  usually  selected,  as  the  Bichloride  is  decomposed  by  the 
Potassic  Iodide,  Red  Iodide  of  Mercury  being  precipitated.  All  trouble  regarding  incom¬ 
patibility  can  be  avoided  by  using  sugar  of  milk  triturations  according  to  the  general 
official  formula.  In  this  form,  says  Piffard,  “  a  larger  proportion  of  the  drug  is  utilized  for 
specific  purposes,  while  but  a  small  amount  remains  to  give  rise  to  local  irritation.” 


Therapeutics. 

Mercury  is  undoubtedly  a  specific  in  syphilis,  but  is  not  applicable  to 
the  tertiary  form  of  that  disease.  It  is  best  administered  in  very  small 
doses  carefully  watched  and  stopped  just  short  of  ptyalism,  but  renewed 
and  so  continued  for  a  long  time.  Fumigation  by  Calomel  volatilized  by 
heat,  or  inunction  by  the  Oleate  or  by  Mercurial  Ointment  may  be  used 
when  the  stomach  will  not  bear  any  mercurial.  The  hypodermic  method 
is  also  used,  employing  a  solution  of  the  Bichloride  gr.  j  to  5j  each  of 
glycerin  and  distilled  water,  of  which  the  dose  is  upx  once  daily;  or  the 
Albuminate  in  solution  with  Sodium  Chloride.  The  Green  Iodide  in 
doses  of  gr.  to  -J-  thrice  daily  with  Opium  is  the  best  preparation  for 
internal  use.  Accuracy  of  diagnosis  is  an  absolutely  necessary  prelimi¬ 
nary  to  the  administration  of  Mercury,  for  where  there  is  no  syphilitic 
virus  to  be  antagonized  the  constitutional  effects  of  mercurials  will  become 
manifest  sooner  and  may  do  great  harm  in  feeble  subjects,  besides  the  risk 
of  mistaking  them  for  the  results  of  the  disease  supposed  to  be  present. 

Tonsillitis,  parotitis  and  other  acute  glandular  inflammations  of  the 
throat  and  neck  may  often  be  rapidly  cured  by  Calomel  gr.  2V or  Gray 
Powder  gr.  -3-  every  two  hours.  In  irritable  stomach  with  obstinate  vom¬ 
iting  the  same  small  doses  of  Calomel  every  half  hour  are  very  efficient. 
The  dysentery  of  adults  with  slimy  and  bloody  stools  is  best  treated  by 
small  doses  (gr.  y^)  of  the  Bichloride,  and  in  the  diarrhoea  and  dysen¬ 
tery  (ileo-colitis)  of  infants  Gray  Powder  gr.  -5-  or  Calomel  gr.  will  be 


HYDRARGYRUM. 


245 


found  very  effective.  In  gastric  ulcer  and  in  the  first  stage  of  hepatic 
cirrhosis,  the  Bichloride  in  doses  of  gr.  to  ^  thrice  daily  is  a  good 
remedy.  Typhoid  fever  is  treated  in  Germany  by  daily  doses  of  Calomel, 
gr.  x,  for  three  days  as  an  antipyretic.  Diphtheria  is  by  many  practition¬ 
ers  considered  to  be  best  antagonized  by  Calomel  in  large  doses,  and  in 
this  affection  the  Cyanide  has  many  advocates,  given  in  doses  of  gr.  T-I-g— 
-5^  every  hour,  a  weak  solution  being  at  the  same  time  used  as  a  gargle. 
Asiatic  cholera  is  frequently  treated  by  small,  repeated  doses  of  Calomel 
with  Opium  from  the  start.  Inflammations  of  sthenic  character  in  the 
stage  of  exudation,  especially  when  affecting  serous  membranes,  are  con¬ 
sidered  by  many  authorities  to  be  best  met  by  the  free  use  of  mercurials, 
but  this  treatment  is  fast  going  out  of  favor,  excepting  in  cases  of  iritis, 
which,  however,  is  very  often  of  syphilitic  causation,  and  pneumonia, 
which  is  frequently  treated  according  to  the  best  American  authorities 
with  sedative  doses  (gr.  xv-xx)  of  Calomel. 

In  the  general  condition  known  as  “biliousness,”  manifested  by 
whitish  or  clay-colored  stools,  constipation,  nausea,  anorexia,  coated 
tongue,  slight  jaundice,  etc.,  mercurial  purgatives  have  long  been  a  rou¬ 
tine  remedy,  but  mild  saline  purgatives  are  by  many  authorities  considered 
equally  efficient.  As  an  antiseptic  to  the  gastro-enteric  tract  in  many 
forms  of  stomach  and  intestinal  disorders  (dyspepsia  septica),  the  admin¬ 
istration  of  minute  doses  of  the  Yellow  Oxide  of  Mercury  will  be  found 
remarkably  efficient.  It  is  best  used  in  trituration  with  sugar  of  milk,  1 
to  1000,  and  in  daily  doses  of  gr.  g-V^V  By  the  use  of  these  small 
doses  failing  digestion  and  nutrition  may  almost  certainly  be  improved. 

In  membranous  laryngitis  or  true  croup  the  Subsulphate  as  an  emetic 
is  by  many  considered  to  have  some  specially  beneficial  influence. 

Locally,  an  ointment  of  Calomel  5j  to  3j  of  Lard  is  an  excellent 
antipruritic,  and  ointments  of  the  Chlorides  and  Iodides  are  much  used 
in  skin  diseases,  particularly  psoriasis,  herps,  acne,  and  pityriasis.  In 
parasitic  affections  a  lotion  of  the  Bichloride,  gr.  ij  to  5j  of  distilled 
water,  or  a  5  per  cent.  Oleate  with  ^th  part  of  Ether,  are  very  efficient. 
The  Oleate  is  a  serviceable  application  to  syphilitic  indurations,  but  is  not 
deemed  advisable  when  ulceration  exists.  In  conjunctivitis  Calomel  may 
be  used  as  a  sedative  application,  or  still  better  an  Ointment  of  the  Yellow 
Oxide,  gr.  x  to  5j  of  Vaseline,  triturated  to  the  utmost  fineness  before 
mixing.  Goitre  and  enlarged  spleen  are  often  speedily  reduced  by  rubbing 
into  the  skin  covering  them  the  Ointment  of  the  Red  Iodide  somewhat 
diluted  and  applied  before  a  hot  fire  or  in  the  direct  sunlight.  The  Acid 
Nitrate  Solution  is  one  of  the  best  caustics  for  destroying  chancroid  and 
syphilitic  warts  and  vegetations.  Black  and  Yellow  Wash  are  used  as 
applications  to  syphilitic  erosions  and  ulcerated  indurations. 

As  an  antiseptic  injection  or  application  to  dressings  a  solution  of  the 


246 


HYDRASTIS. 


Bichloride,  gr.  vijss  in  a  quart  of  hot  water  (yuVtt)*  Pr°bably  the  most 
efficient  that  can  be  used,  and  still  weaker  solutions  (yoVoO  are  sufficiently 
antiseptic  for  most  purposes. 


HYDRASTIS,  Golden  Seal, — the  rhizome  and  rootlets  of  Hydrastis 
canadensis ,  a  small  plant  of  the  nat.  ord.  Ranunculaceae  growing  in  most 
parts  of  the  U.  S.  The  rhizome  is  1^2  inch  long,  rough,  bent  and  branched, 
externally  of  a  yellowish-gray  color,  internally  a  bright  reddish-yellow, 
having  numerous  thin,  brittle  rootlets,  a  slight  odor  and  a  bitter  taste. 
It  contains  an  unnamed  Resin  and  3  alkaloids,  Hydrastine ,  C22H23N06, 
white  and  crystalline,  soluble  in  alcohol,  ether,  etc.,  Berberine ,  c20h17no 
yellow  crystals  soluble  in  hot  water  and  alcohol,  but  not  in  ether  (see  page 
130),  and  Xanthopuccine ,  also  yellow  and  crystalline.  All  these  alkaloids 
unite  with  acids  to  form  salts. 

Preparations. 

Extraction  Hydrastis  Fluidum , — Dose,  rrpv-xxx. 

Tindura  Hydrastis, — strength  20  per  cent.  Dose,  £  ss-ij. 

Hydrastin  (Unofficial), — an  impure  extract  precipitated  by  Hydrochloric  Acid  from  the 
alcoholic  solution,  chietly  consisting  of  Muriate  of  Berberine.  Dose,  gr.  ij-v. 

Physiological  Action. 

Hydrastis  is  a  simple  bitter  and  a  stomachic  tonic.  It  promotes  appetite 
and  digestion  and  increases  the  secretions  of  the  gastro-intestinal  tract  and 
the  flow  of  bile,  but  if  long  used  it  will  derange  digestion  and  produce 
constipation.  It  is  possessed  of  antiperiodic  powers,  and  is  a  protoplasmic 
poison,  arresting  the  movements  of  the  white  blood-corpuscles.  By  many 
observers  it  is  also  considered  alterative  to  the  mucous  membranes,  deob¬ 
struent  to  the  glandular  system,  cholagogue,  diuretic  and  antiseptic.  The 
alkaloid  Hydrastine  produces  effects  on  the  nervous  system  somewhat 
similar  to  those  caused  by  Quinine,  but  seems  to  be  devoid  of  toxic  power, 
large  doses  only  producing  a  sense  of  warmth  in  the  epigastric  region, 
and  noises  of  a  rushing  character  in  the  ears. 

Incompatibles. 

Tannic  Acid,  Hydrochloric  Acid  and  the  Alkalies  are  chemically  incompatible  with 
preparations  of  Hydrastis. 

Therapeutics. 

Hydrastis  is  chiefly  used  as  a  stomachic  tonic,  an  antiperiodic,  a  mild 
laxative  and  an  antiseptic.  Its  alkaloid  (Hydrastine)  and  extract 
(Hydrastin)  are  ranked  high  in  the  treatment  of  intermittents  and  chronic 
malaria,  though  much  less  efficient  than  Quinine.  It  is  an  excellent 
remedy  locally  and  internally  in  all  forms  of  catarrh,  especially  that  of 
the  stomach,  duodenum,  gall-ducts,  bladder,  uterus  and  vagina.  Internally 
it  is  efficient  in  many  glandular  swellings,  in  chronic  constipation  due  to 


HYDROCOTYLE - HYOSCYAMUS. 


247 


a  sluggish  state  of  the  liver  or  deficiency  of  the  other  intestinal  secre¬ 
tions,  in  chronic  dyspepsia,  and  as  a  substitute  for  alcohol  in  dipsomaniacs 
when  a  catarrhal  state  of  the  stomach  has  been  induced.  In  gonorrhoea, 
gleet,  and  chronic  nasal  catarrh  it  is  locally  employed  with  much  benefit, 
also  in  syphilitic  affections  of  the  mouth,  throat  and  nares.  As  a  local 
alterative  and  antiseptic  application  it  is  highly  recommended  for  unhealthy 
ulcers  and  sores,  cancerous  ulcerations,  mercurial  and  aphthous  stomatitis, 
rectal  fissure,  fistula  and  prolapse,  internal  and  external  hemorrhoids, 
cracks,  fissures  and  abrasions  of  the  nipples,  erosion  and  ulceration  of  the 
cervix  uteri,  and  in  conjunctivitis  with  muco  purulent  discharge.  In 
gonorrhoea  a  very  efficient  injection  is  an  infusion  of  Hydrastis,  5j  of  the 
powdered  root  to  Sviij  of  boiling  water,  or  the  fluid  extract  diluted 
in  the  proportion  of  5ss  or  5j  to  the  pint  of  water,  but  it  should  not  be 
used  until  the  acute  stage  has  subsided. 


HYDROCOTYLE,  Pennywort  (Unofficial), — is  the  leaf  of 
Hydrocotyle  asiatica ,  a  small  plant  of  the  nat.  ord.  Umbelliferae,  a  native 
of  southern  Africa  and  India.  It  contains  a  peculiar,  oleaginous  sub¬ 
stance  Vellarine ,  which  has  a  bitter,  persistent  taste,  and  is  thought  to  be 
the  active  principle.  It  has  long  been  used  in  its  native  countries  as  an 
alterative  to  purify  the  blood,  and  has  lately  been  found  of  great  service 
in  eczema,  lupus,  psoriasis,  syphilitic  and  scrofulous  sores,  and  in  leprosy. 
An  ounce  of  the  dried  plant  or  leaves  is  given  daily  in  infusion.  It  causes 
great  itching  over  the  whole  body,  ovarian  pain  in  females,  and  urinary 
irritation.  In  one  case  in  which  the  drug  was  being  given  for  lupus  of 
the  hand  a  severe  orchitis  was  set  up  without  any  other  apparent  cause.  It 
certainly  exerts  a  markedly  special  influence  on  the  genito-urinary  tract. 


HYOSCYAMUS,  Henbane, — the  leaves,  collected  from  plants  of 
the  second  year’s  growth,  of  Hyoscyamus  niger ,  a  biennial  plant  of  the 
order  Solanaceae,  growing  in  Europe  and  the  northern  U.  S.  The 
leaves  are  ovate,  often  10  inches  long  and  4  broad,  of  grayish-green  color, 
glandular-hairy,  midrib  prominent,  odor  heavy  and  narcotic,  taste  bitter 
and  acrid.  It  contains  an  alkaloid  Hyoscyamine ,  C17H23N03,  which  is 
isomeric  with  Atropine  and  identical  with  Daturine  and  Duboisine,  occur¬ 
ring  as  an  oily  liquid  or  in  tufted  crystals  of  silky  lustre  and  yellow  color, 
soluble  in  hot  water,  alcohol  or  ether.  Another  substance,  Hy  os  cine,  is 
by  some  authorities  considered  a  derivative  of  Hyoscyamine,  by  others  a 
second  alkaloid.  It  is  semi-liquid,  isomeric  with  Atropine,  and  yields 
Tropic  Acid  and  Pseudoiropine.  Hyoscyamus  leaves  also  contain  a  fatty 
Oil  and  much  Potassic  Nitrate,  while  from  their  destructive  distillation  an 
empyreumatic  Oil  is  obtained  which  is  a  powerful  narcotic. 


248 


HYOSCYAMUS. 


Preparations. 

Abstraction  Hyoscyami, — Dose,  gr.  iij-v. 

Extraction  Hyoscyami  Alcoholicum , — Dose,  gr.  j,  when  active. 

Extraction  Hyoscyami  Eluidum , — Dose,  rrpv-xx. 

Tinctura  Hyoscyami, — strength  15  per  cent.  Dose,  gj-iv;  as  a  hypnotic  3  ss-j  is 
necessary. 

All  the  preparations  of  Hyoscyamus  are  uncertain  in  strength  and  in  activity,  so  much 
so  that  the  effective  dose  of  the  extract  (no  longer  official)  ranged  from  2  to  250  grains. 

Hyoscyamime  Sulphas , — Sulphate  of  Hyoscyamine  (C17H23N03)2.H2S04, — occurs 
in  small,  yellow  scales  or  crystals,  which  are  deliquescent,  of  bitter  taste,  and  very  soluble 
in  water  and  in  alcohol.  It  varies  much  in  purity  of  the  base  and  consequently  in 
activity.  A  grain  of  the  commercial  article,  which  was  formerly  very  impure,  has  been 
given  with  impunity,  but  gr.  of  the  pure  alkaloid  has  produced  violent  poisoning. 
Dose,  hypodermically,  should  not  exceed  gr.  -fa ;  by  the  mouth  gr.  y(-j  may  be  given  in 
urgent  cases. 

Hyoscyamine  of  good  quality  is  difficult  to  procure  and  is  very  expensive,  while 
Duboisine  is  easily  obtained  in  any  quantity,  so  that  if  these  alkaloids  prove  to  be  physio¬ 
logically  as  well  as  chemically  identical  as  is  now  claimed,  the  latter  will  be  used  to  the 
exclusion  of  the  former. 

Hyoscina  Hydrobromas ,  Hydrobromate  of  Hyoscine  (Unofficial). — Merck’s  is  the  only 

reliable  preparation  on  the  market.  Dose,  hypodermically,  gr.  ;  by  the  mouth  gr. 
1 _ 1 

8T)  50* 


Physiological  Action. 

Hyoscyamus  has  similar  action  to  that  of  Belladonna,  Duboisia  and 
Stramonium,  except  that  it  is  the  least  powerful  and  irritant  of  the  group, 
but  the  most  calmative  and  hypnotic.  The  delirium  produced  by  it  is 
never  furious  and  is  without  hypersemia,  but  is  accompanied  by  insomnia. 
It  is  more  stimulant  to  the  vaso-motor  system  and  to  the  cardiac  accele¬ 
rator  apparatus  than  is  Stramonium,  but  is  less  active  on  the  pneumo- 
gastric.  It  has  decidedly  laxative  and  carminative  effects  on  the  intestines 
and  a  very  marked  sedative  influence  on  the  urinary  passages. 

Hyoscyamine  corresponds  in  action  to  the  plant  and  its  congeners, 
being  considered  by  many  authorities  as  almost  identical  with  Atropine, 
but  less  powerful.  No  death  has  directly  resulted  from  it.  Except  in 
very  large  doses  it  is  more  an  anodyne  or  anaesthetic  than  a  narcotic 
or  soporific.  It  is  a  mydriatic,  excites  the  cerebral  functions  and 
depresses  the  spinal.  Many  observers  deny  that  it  has  any  soporific 
influence. 

Hyoscine  is  a  powerful  hypnotic,  lowers  the  pulse-rate  and  lessens  the 
frequency  of  the  respirations.  It  especially  affects  the  motor  tract  of  the 
spinal  cord  and  the  cerebral  cortex,  slightly  depresses  the  heart,  but  para¬ 
lyzes  respiration.  It  is  free  from  irritant  qualities  and  may  be  used 
hypodermically.  Its  habitual  use  brings  on  muscular  paralysis  and 
delirium  of  violent  character.  It  is  coming  into  use  as  a  hypnotic  by 
alcoholics  and  nervous  subjects,  and  will  probably  ere  long  be  responsible 
for  many  deaths.  As  a  mydriatic  its  reputation  is  doubtful,  some  observ¬ 
ers  claiming  greater  power  for  it  in  this  respect  than  that  of  Atropine, 
while  others  say  that  mydriasis  may  follow  its  use  but  is  not  always  pro¬ 
duced  by  even  large  doses. 


ICHTHYOCOLLA. 


249 


Antagonists  and  Incompatibles. 

These  are  the  same  as  for  Belladonna  (see  ante  page  127).  Liquor  Potassoe  though 
incompatible  is  frequently  prescribed  in  combination  with  Hyoscyamus.  All  the  fixed 
caustic  alkalies  decompose  its  alkaloid  as  also  those  of  the  allied  plants. 

Therapeutics. 

Hyoscyamus  is  a  valuable  narcotic  and  is  chiefly  used  as  a  hypnotic  and 
anodyne  when  Opium  is  contraindicated,  and  for  children.  It  is  by  far 
the  best  agent  to  use  in  acute  mania  with  high  motor  excitement,  obsti¬ 
nate  insomnia  and  varied  hallucinations.  Chronic  mania  has  been  more 
benefited  by  it  than  by  any  other  drug,  and  it  is  very  efficient  in  insanity 
characterized  by  frequent  delusions.  In  delirium  tremens  and  the  delir¬ 
ium  of  fevers  it  is  an  excellent  hypnotic,  and  the  monomania  of  hypo¬ 
chondriacs  is  alleviated  and  often  cured  by  it.  Whooping  cough,  nervous 
coughs,  and  especially  a  dry,  tickling  night-cough,  are  greatly  alleviated 
by  full  doses  of  Hyoscyamus.  It  is  also  efficient  in  colic  of  various  forms, 
to  palliate  the  trembling  of  paralysis  agitans  and  mercurial  tremor,  and 
to  relieve  the  pains  and  disordered  coordination  of  locomotor  ataxia.  In 
constipation  it  is  a  good  remedy,  the  extract  being  much  employed  in 
combination  with  other  purgatives  to  render  them  more  efficient  and  less 
drastic,  but  the  quantity  used  is  generally  too  small  to  be  of  any  particu¬ 
lar  benefit.  The  tincture  is  an  efficient  remedy  in  irritability  of  the 
bladder  from  any  cause. 

Hyoscyamine  may  be  used  for  the  same  purposes  as  Atropine,  but 
being  liable  to  considerable  variation  in  purity  and  activity,  it  is  not  a 
popular  agent  with  the  profession. 

Hyoscine  has  been  used  in  neuralgia,  whooping-cough,  insomnia  from 
cerebral  excitement,  delirium  tremens,  asthma  and  enteralgia,  also  in 
ophthalmic  practice  as  a  mydriatic.  Doses  of  gr.  are  given  by  the 
stomach,  gr.  y-Jy  hypodermically. 


ICHTHYOCOLLA,  Isinglass, — is  the  swimming-bladder  of  Aci- 
penser  Huso ,  and  of  other  species  of  Acipenser  (Sturgeon).  It  occurs  in 
horny  sheets,  semi-transparent,  iridescent,  soluble  in  24  parts  of  boiling 
water,  forming  on  cooling  a  transparent  jelly.  It  is  the  purest  form  of 
Gelatin  known. 

Preparation. 

Emplastrum  Ichthyocollce,  Court  Plaster, — consists  of  Isinglass  10,  Glycerin  1,  Alcohol 
40,  Water  and  Tincture  of  Benzoin,  spread  on  taffeta  and  allowed  to  dry. 

Physiological  Action  and  Therapeutics. 

Isinglass  is  slightly  nutritious,  but  has  no  advantage  over  any  other  form 
of  gelatin.  It  is  used  for  clarifying  liquids,  and  in  solution  as  a  test  for 
tannin.  The  plaster  is  a  common  protective  application. 


250 


IGNATIA - ILLICIUM. 


IGNATIA,  St.  Ignatius’  Bean, — is  the  seed  of  Strychnos  Ignatiiy 
a  small  tree  of  the  nat.  ord.  Loganiaceae,  native  in  the  Philippine  Islands, 
and  also  called  Igjiatia  Amara.  The  seed  is  about  an  inch  long,  ovate, 
irregularly  angular,  hard  and  horny,  enclosing  an  irregular  cavity  con¬ 
taining  an  oblong  embryo,  inodorous,  taste  very  bitter.  It  contains  the 
alkaloids  Strychnine  and  Brucine ,  about  1  per  cent,  of  each,  for  a  descrip¬ 
tion  of  which  see  the  title  Nux  Vomica. 

Preparations. 

Abslractum  Ignaties , — Dose,  gr.  ss-j. 

Tinctura  Ignaties , — strength  10  per  cent.  Dose,  nVj-x. 

Physiological  Action. 

Ignatia  closely  resembles  Nux  Vomica  in  action,  a  poisonous  dose  pro¬ 
ducing  the  same  exaltation  of  the  spinal  functions,  muscular  writhing,  te¬ 
tanic  spasms,  and  death  by  asphyxia  through  tetanic  fixation  of  the  respi¬ 
ratory  muscles,  but  containing  a  greater  quantity  of  Strychnine  than  the 
latter  it  is  more  powerful  in  the  same  dose.  It  especially  exalts  the  sus¬ 
ceptibility  of  the  sensory  nerves,  and  of  the  nerves  of  special  sense,  for  a 
time,  but  an  opposite  condition  soon  succeeds,  manifested  by  numbness 
and  torpor  with  great  mental  depression.  It  causes  a  feeling  of  constric¬ 
tion  about  the  throat  and  a  sensation  of  intense  anguish  at  the  pit  of  the 
stomach.  Its  antagonists  and  incompatibles  are  the  same  as  for  Nux 
Vomica. 

Therapeutics. 

Ignatia  is  recommended  for  hysteria,  to  control  the  general  hypersesthe- 
sia,  insomnia,  clavus  hystericus,  mental  excitement  or  depression,  aphonia, 
diseased  appetite,  convulsive  crying  or  laughing,  etc.  It  will  often  re¬ 
move  the  intercostal  neuralgia  of  hysterical  subjects  and  the  sensation  as 
of  a  ball  rising  to  the  throat  (globus  hystericus).  Cerebro-spinal  irrita¬ 
bility  is  diminished  by  small  doses  though  excited  by  large  ones,  Ignatia 
being  probably  the  most  efficient  controller  of  functional  phenomena  of 
the  cerebro-spinal  axis.  In  the  convulsions  of  children  from  intestinal 
irritation  without  cerebral  congestion,  and  in  insomnia  from  nervous 
erethism,  small  doses  of  Ignatia  are  used  with  the  happiest  results.  It  is 
by  many  practitioners  preferred  to  Nux  Vomica  as  a  stomachic  tonic,  and 
is  useful  in  the  treatment  of  dyspepsia,  hyphochondriasis  and  various  ner¬ 
vous  affections. 

ILLICIUM,  Star  Anise, — is  the  fruit  of  Illicium  anisatum,  an 
Asiatic  shrub  of  the  nat.  ord.  Magnoliaceae,  and  is  formed  by  8  boat¬ 
shaped  carpels  arranged  in  a  star-shaped  whorl  around  a  central  axis  which 
is  the  top  of  the  stalk.  Each  carpel  contains  a  single  seed,  flat,  oval, 
glossy,  and  of  a  brownish-yellow  color.  It  contains  a  Volatile  Oil  which 


INULA - IODUM. 


251 


is  chemically  and  practically  identical  with  the  Oil  of  Anise.  Another 
species,  Illicium  religiosum ,  is  very  poisonous,  causing  vomiting,  epilepti¬ 
form  convulsions,  dilated  pupils  and  cyanosed  countenance.  Its  carpels 
are  more  woody,  shrivelled  and  wrinkled,  and  end  in  a  curved  beak.  Illi¬ 
cium  is  recognized  officially  as  a  source  of  the  Oil  of  Anise,  and  has  simi¬ 
lar  actions  and  uses  to  those  of  Anisum  (see  ante ,  page  101). 


INULA,  Elecampane, — is  the  root  of  Inula  Helenium ,  a  plant  of 
the  nat.  ord.  Compositae,  growing  in  Europe  and  N.  America.  It  occurs 
in  slices  or  sections,  externally  grayish-brown,  internally  white,  fleshy  and 
full  of  resin  cells,  of  peculiar,  aromatic  odor,  pungent  and  bitter  taste. 
It  contains  a  volatile  oil,  a  resin,  a  crystalline  substance  named  Helenin , 
C6H80,  and  a  peculiar  principle  resembling  starch,  Inulin ,  C6H10O5,  which 
is  found  in  Arnica,  Taraxacum  and  other  plants.  Having  the  same  chem¬ 
ical  composition  as  starch,  Inulin  differs  from  the  latter  in  being  colored 
yellow  by  iodine,  and  depositing  from  its  solution  in  hot  water  as  the  solu¬ 
tion  cools.  It  is  contained  in  Elecampane  in  large  quantity,  from  19  to 
44  percent.,  the  latter  in  autumn.  There  are  no  official  preparations,  but 
a  decoction  (Sss  to  Oj)  may  be  given  in  doses  of  Sj-ij.  Dose  of  the 
powdered  root,  gr.  xx-3j- 

Physiological  Action  and  Therapeutics. 

Inula  is  a  gentle  stimulant  to  the  secretory  organs,  and  is  said  to  be  ex¬ 
pectorant,  diaphoretic  and  diuretic.  In  large  doses  it  causes  nausea  and 
vomiting.  It  was  formerly  supposed  to  be  emmenagogue  and  was  much 
used  in  amenorrhoea.  It  is  now  chiefly  employed  as  a  domestic  remedy  in 
chronic  bronchitis  and  dyspepsia,  and  to  promote  the  eruption  in  exanthe¬ 
matous  fevers. 


IODUM,  Iodine,  I,  — is  a  non-metallic  element,  existing  in  sea-weed, 
sea-water,  some  fresh  waters  and  fresh-water  plants,  also  in  sponge, 
oysters,  eggs,  cod-liver  oil,  rock  salt  and  several  ores.  It  occurs  in  bluish- 
black  rhombic  plates,  of  metallic  lustre,  peculiar  odor,  acrid  taste  and 
neutral  reaction,  sparingly  soluble  in  water  (1  in  7000),  readily  so  in 
ether,  and  in  n  of  alcohol  at  590  F.,  also  in  a  solution  of  potassic  iodide 
or  sodic  chloride.  It  volatilizes  slowly  at  ordinary  temperatures,  and 
produces  a  dark-blue  color  with  gelatinized  starch  in  a  cold  solution. 
Internally  it  is  generally  administered  in  the  form  of  an  Iodide  or  as  the 
Compound  Solution  of  Iodine.  Dose,  gr.  ss-j. 

Preparations  of  Iodine. 

Tinctura  Iodi , — strength  8  per  cent.  Dose,  try-v,  but  it  is  generally  used  as  a  local 
application  or  for  injection  into  cavities. 


252 


I  ODUM. 


Liquor  lodi  Compositus,  Lugol’s  Solution, — is  a  solution  of  Iodine  5  and  Iodide  of 
Potassium  10  in  Distilled  Water  85  parts.  Dose,  rr\j-x,well  diluted. 

Uguentum  lodi, — has  of  Iodine  4,  Iodide  of  Potassium  1,  Water  2,  Benzoinated  Lard 
93  Parts- 

Amylum  Iodatum ,  Iodized  Starch, — contains  of  Starch  95,  Iodine  5,  Distilled  Water 
q.  s.  ad  100  parts,  triturated  together,  dried,  and  rubbed  to  a  fine  powder.  Intended  to 
enable  Iodine  to  be  given  without  irritating  the  stomach.  Dose, 

Iodized  Phenol,  Carbolate  of  Iodine  (Unofficial), — a  mixture  of  Iodine  and  crystallized 
Carbolic  Acid  in  varying  proportions,  generally  I  of  the  former  to  4  of  the  latter,  for 
local  use. 

Iodides  and  their  Preparations. 

Ammonii  Iodidum ,  NIIJ, — a  deliquescent,  granular,  white  salt,  soluble  in  I  of  water 
and  in  9  of  alcohol  at  590  F.  Dose,  gr.  ij-x. 

Potassii  Iodidum,  KI, — a  colorless,  deliquescent,  crystalline  salt,  of  saline  and  bitter 
taste,  soluble  in  0.8  of  water  and  in  18  of  alcohol  at  590  F.  Dose,  gr.  v-^j. 

Unguentum  Potassii  Iodidi, — has  of  the  Iodide  12,  Hyposulphite  of  Sodium  I,  Boil¬ 
ing  Water  6,  Benzoinated  Lard  81  parts. 

Sodii  Iodidum,  Nal, — deliquescent,  minute  crystals,  soluble  in  0.6  of  water  and  in  1.8 
of  alcohol.  Dose,  gr.  v-jij. 

Iodoformum,  Iodoform,  Iodide  of  Formyl, — small  lemon-yellow  crystals,  of  saffron- 
like  and  penetrating  odor,  unpleasant  and  iodine-like  taste,  sp.  gr.  2000,  soluble  in  80  of 
alcohol  at  590  F.,  and  in  chloroform,  ether,  benzol,  benzin,  carbon  bisulphide,  fixed  and 
volatile  oils,  not  perceptibly  soluble  in  water.  Its  solutions  have  a  neutral  reaction.  To 
remove  its  odor  without  forming  a  compound  the  best  agents  are  Thymol  (gtt.  ij  ad  ^  j), 
Oil  of  Mirbane  (gtt.  vj  ad  gr.  xv),  Oil  of  Bitter  Almonds,  or  Oil  of  Rose  (gtt.  j  ad  ^j). 
Dose,  gr.  j-v. 

Unguentum  Iodofor?n, — Iodoform,  finely  pulverized,  10,  Benzoinated  Lard  90  parts, 
thoroughly  mixed  by  trituration. 

Iodol,  Tetra-iodo-pyrol  (Unofficial), — is  a  grayish-yellow  powder,  insoluble  in  water, 
tasteless  and  odorless,  and  contains  85  to  90  per  cent,  of  Iodine  in  combination  with 
Pyrol ,  a  constituent  of  mineral  oil.  Dose,  gr.  ss-v,  in  tablet. 

Other  Iodides  and  preparations  thereof  are — Argenti  Iodidum,  Arsenii  Iodidum,  Liquor 
Arsenii  et  Hydrargvri  Iodidum,  Hydrargyri  Iodidum  Rubrum,  Plydrargyri  Iodidum  Vi- 
ride,  Syrupus  Ferri  Iodidi,  Pilulae  Ferri  Iodidi,  Plumbi  Iodidum,  Sulphuris  Iodidum  and 
Zinci  Iodidum.  As  these  preparations  are  allied  in  action  and  uses  less  to  Iodine  than  to 
the  other  elements  in  their  composition,  they  are  described  under  other  titles.  (See  Ar¬ 
gentum,  Hydrargyrum,  etc.)  The  Iodide  of  Ethyl  or  Hydriodic  Ether  is  described 
under  yEther  (see  ante,  page  81.) 

Preparation  of  Hydriodic  Acid. 

Syrupus  Acidi  Hydriodici , — contains  1  per  cent,  of  absolute  Hydriodic  Acid,  HI. 
Dose,  5J-iv,  well  diluted. 

Physiological  Action. 

Iodine  is  irritant  to  the  mucous  membranes  and  to  the  skin.  Applied 
to  the  latter  it  stains  a  deep  yellowish-brown  color  and  combines  with  the 
albumen  of  the  tissue,  causing  considerable  pain  and  subsequent  exfolia¬ 
tion  of  the  epidermis.  Vesication  may  be  quickly  produced  if  the  quan¬ 
tity  used  be  large.  Inhaled  its  vapor  irritates  the  respiratory  mucous 
membrane,  producing  sneezing,  cough,  dyspnoea,  also  pain  in  the  chest 
and  over  the  frontal  sinuses.  In  the  gastro-intestinal  canal  it  is  equally 
irritant,  but  is  gradually  converted  into  the  iodide  or  iodate  of  sodium, 
in  which  form  or  as  an  albuminate  it  is  absorbed  into  the  blood.  Iodine 
decomposes  organic  molecules,  and  in  the  presence  of  phosphoretted  or 
sulphuretted  gases  it  acts  like  chlorine  but  more  feebly,  uniting  with  their 
hydrogen  and  thus  breaking  up  those  noxious  compounds  it  is  disinfectant 
and  deodorant. 


IODUM. 


253 


The  Iodides  of  Sodium,  Potassium,  etc.,  are  very  diffusible  and  are  as 
rapidly  excreted ;  setting  free  nascent  oxygen  (Ozone)  and  Iodine  at  the 
points  of  their  elimination,  they  are  remotely  irritant  to  the  mucous  mem¬ 
branes,  setting  up  violent  coryza,  with  soreness  of  the  throat,  acute  con¬ 
junctivitis,  profuse  mucous  discharges,  headache  and  irritation  of  the 
kidneys  and  the  skin.  If  used  for  any  length  of  time  they  induce  great 
waste  and  rapid  elimination  of  waste  products,  causing  anaemia,  emacia¬ 
tion  and  mental  depression.  They  combine  with  certain  poisons  in  the 
system,  particularly  Lead,  Mercury,  and  the  products  of  the  syphilitic 
disease,  hastening  their  elimination.  Iodism  is  the  term  applied  to  the 
general  condition  produced  by  these  agents,  and  comprises  the  symptoms 
above  noted  together  with  frontal  headache,  ptyalism,  a  saline  taste  in 
the  mouth,  dysphagia,  temporary  impotence,  and  an  acneform  eruption 
on  the  face  and  limbs.  Sometimes  the  eruption  is  furuncular  or  even 
purpuric.  Copiously  diluting  these  salts  with  water  promotes  their  excre¬ 
tion  and  to  a  great  extent  prevents  the  development  of  these  results. 

Iodoform  contains  from  94  to  97  per  cent,  of  Iodine  and  naturally 
resembles  the  latter  in  action.  Locally  its  action  is  anaesthetic  and  pow¬ 
erfully  antiseptic.  It  is  one  of  the  best  agents  to  prevent  decomposition 
and  to  destroy  the  germs  of  putrefaction  and  of  disease,  but  must  be 
carefully  employed,  as  when  used  in  quantity  on  an  extensive  raw  surface 
it  has  often  produced  fatal  results  with  symptoms  of  narcotic  poisoning. 
The  first  sign  of  its  dangerous  absorption  is  increase  of  temperature,  which 
may  reach  104°  or  more,  then  headache,  quick  and  feeble  pulse,  marked 
anxiety  and  restlessness,  and  suddenly  collapse  and  death  may  supervene. 
The  quantities  which  have  produced  fatal  results  from  local  absorption 
have  varied  from  525  to  4500  grains.  In  small  doses  internally  it  is  con¬ 
sidered  to  be  a  tonic  and  alterative,  wasting  does  not  occur,  but  the  body 
weight  increases  and  the  general  condition  improves.  In  these  respects 
its  action  markedly  differs  from  that  of  Iodine  or  the  Iodides. 

Iodol  has  the  same  action  as  Iodoform,  but  is  odorless  and  is  said  to 
be  devoid  of  toxic  power.  Though  insoluble  in  water  it  dissolves  readily 
in  the  gastric  juices,  and  is  rapidly  absorbed  and  as  quickly  diffused 
through  the  system. 

Ethyl  Iodide  (see  ante ,  pages  79  and  81)  is  used  by  inhalation  to  bring 
the  system  rapidly  under  the  influence  of  Iodine.  It  is  a  good  antispas- 
modic  and  general  stimulant  and  a  very  slow  anaesthetic. 

Antagonists  and  Incompatibles. 

Restorative  agents  and  vaso-motor  tonics,  Quinine,  Digitalis,  etc.,  are  therapeutically 
antagonistic.  Starch  is  the  antidote  to  free  Iodine,  but  the  stomach  must  be  evacuated  as 
the  Iodide  of  Starch  is  not  inactive.  The  mineral  acids,  metallic  salts,  ammonia  and 
vegetable  alkaloids  are  incompatible  with  Iodine,  and  if  the  Potassium  salt  be  prescribed 
with  Potassium  Chlorate  a  poisonous  compound  will  result.  In  chronic  poisoning  by  the 
iodides  a  free  salivary  flow  induced  by  chewing  Pyrethrum  root  will  hasten  the  elimina¬ 
tion  of  the  drug. 


254 


IODUM. 


Therapeutics  of  Iodine. 

The  tincture  or  the  compound  solution  are  much  employed  locally  as 
counterirritants  and  by  injection  into  cavities  as  alterative  applications, 
instances  of  which  are  their  use  in  glandular  tumors,  hypertrophied  ton¬ 
sils,  cervical  and  ovarian  cysts,  empyema,  hydrocele,  etc.  In  various 
skin  diseases,  as  chloasma,  lentigo,  lupus,  etc.,  the  tincture  or  a  glycerite 
is  well  applied,  and  in  many  splenic  and  hepatic  disorders  of  chronic  type 
the  ointment  or  tincture  is  a  favorite  counterirritant  application.  In  sores, 
ulcers,  fissures,  etc.,  the  Iodide  of  Starch  or  a  mixture  of  Iodoform  and 
Tannin,  are  strongly  recommended,  and  the  tincture  is  much  used  locally 
to  promote  absorption  of  the  products  of  acute  inflammations.  In  acute 
catarrh  and  hay-fever  inhalations  of  iodine-vapor,  or  that  from  Iodized 
Phenol  are  very  serviceable,  and  in  the  vomiting  of  pregnancy  i  to  5 
drop-doses  of  the  tincture  every  hour  are  often  efficient.  The  compound 
solution  well  diluted  is  given  thrice  daily  in  typhoid  fever  with  good 
results  in  many  cases,  and  in  malarial  fevers  the  same  preparation  com¬ 
bined  with  Carbolic  Acid  has  remarkably  curative  power.  In  strumous 
conditions  Iodine  internally  is  much  more  efficient  than  any  of  the 
Iodides. 

Therapeutics  of  the  Iodides. 

The  Iodide  of  Potassium  is  the  most  frequently  used,  and  is  the  form 
in  which  Iodine  is  generally  administered  internally.  It  is  usually  admin¬ 
istered  in  simple  solution  or  in  the  compound  infusion  or  syrup  of  Sarsa¬ 
parilla.  Though  its  mode  of  action  has  never  been  explained  satisfactorily, 
it  is  known  by  clinical  experience  to  counteract  many  pathological  condi¬ 
tions,  to  promote  the  absorption  of  morbid  products,  and  the  elimination 
of  several  metallic  poisons.  It  is  almost  of  specific  rank  in  tertiary 
syphilis  and  its  results,  as  neuralgise,  paralyses  from  gummata,  ulcerations, 
syphiloma  of  the  internal  viscera,  lupus,  chronic  rheumatism  and  sciatica, 
in  all  of  which  when  of  syphilitic  origin  this  iodide  in  large  doses  (50  to 
150  grains  daily)  to  saturation  of  the  system  will  speedily  cause  improve¬ 
ment.  So  in  mercurial  poisoning  and  other  chronic  metallic  toxaemise, 
the  best  treatment  is  by  rapid  saturation  with  Potassic  Iodide.  The  pro¬ 
ducts  left  behind  by  pneumonia,  pleurisy  and  pericarditis  often  yield  to 
moderate  doses  (5  grains),  which  if  used  for  a  prolonged  period  seem  to 
retard  the  changes  of  chronic  nephritis.  It  is  the  best  remedy  for  the 
early  stage  of  hepatic  cirrhosis,  and  acts  as  a  most  efficient  expectorant  in 
chronic  bronchitis.  Aneurisms  are  often  cured  by  large  doses  (20  to  30 
grains)  of  Potassic  Iodide,  the  sac  becoming  perfectly  solid  by  fibrinous 
deposit.  In  acute  catarrh  and  hay-fever,  it  is  useful  with  Arsenic,  the 
Iodized  Phenol  being  at  the  same  time  used  locally  in  weak  solution.  In 
tonsillitis  and  simple  sore  throat  a  weak  solution  (gr.  ij-v  ad  5)  is  a  good 
gargle,  and  in  large  doses  it  is  often  very  efficient  in  spasmodic  asthma 
when  induced  by  bronchial  catarrh. 


IODUM. 


255 


The  Iodide  of  Ammonium  in  grain  dose  repeated  frequently  is  an  ex¬ 
cellent  remedy  in  acute  catarrh,  hay  fever,  duodenal  catarrh  and  its 
accompanying  jaundice,  in  chronic  and  capillary  bronchitis,  and  in 
catarrhal  pneumonia  to  prevent  caseation  of  the  products.  In  the  first 
stage  of  hepatic  cirrhosis  and  in  chronic  malarial  poisoning  it  is  equally 
efficient  administered  in  conjunction  with  Arsenic.  Being  somewhat 
more  irritating  than  the  other  iodides  it  is  usually  given  in  smaller  quan¬ 
tity,  but  being  less  stable  it  is  more  energetic  in  action. 

The  Iodide  of  Sodium  may  be  used  instead  of  the  potassium  salt,  and 
the  same  may  be  said  of  the  Syrup  of  Hydriodic  Acid  if  freshly  prepared. 

Hydriodic  Acid  is  used  as  a  substitute  for  Iodine  and  the  Iodides.  As 
an  alterative  it  is  believed  by  some  to  possess  all  the  powers  of  Iodine 
while  it  is  much  less  offensive  to  the  taste  and  the  stomach.  It  has  been 
used  with  benefit  in  asthma  and  bronchitis.  The  acid  itself  is  not  now 
official,  as  it  is  liable  to  change  by  the  development  of  free  Iodine. 

Therapeutics  of  Iodoform  and  Iodol. 

Iodoform  is  chiefly  employed  in  local  diseases  as  an  antiseptic,  anaes¬ 
thetic  and  alterative  agent.  It  may  be  dusted  in  fine  powder  over  a  wound 
or  sore,  or  used  in  ethereal  solution  to  saturate  gauze  or  absorbent  cotton. 
It  is  particularly  useful  as  an  application  to  sloughing  and  phagedenic 
ulcers,  gunshot  wounds,  chancroids,  fistulae,  sinuses  and  painful  affections 
of  the  rectum  or  uterus.  Internally  it  may  be  used  as  a  general  tonic  and 
alterative  in  syphilis  and  other  cachexise,  also  for  neuralgia,  and  is  fre¬ 
quently  prescribed  with  Iron.  Triturated  with  Tannin  it  forms  a  useful 
application  to  the  cervix  uteri  in  erosions  and  ulcerations  thereof,  or  an 
Iodo-tannin  may  be  prepared  by  saturating  the  Tincture  of  Iodine  with 
Tannic  Acid,  and  applied  on  a  cotton  tent  to  the  uterine  mucous  mem¬ 
brane  in  many  chronic  affections  of  that  organ. 

Iodol,  if  equally  efficient,  as  is  claimed,  will  doubtless  replace  Iodoform 
largely  as  a  topical  application.  Internally  they  are  both  highly  esteemed 
as  remedies  in  chronic  gastric  catarrh,  and  intestinal  catarrh,  ulceration 
of  the  gastro-intestinal  mucous  membrane,  etc.  Iodol  may  be  given 
midway  between  meals.  In  bronchitis,  bronchial  catarrh,  and  various 
respiratory  neuroses,  Iodol  has  been  found  highly  useful.  Tuberculosis 
is  successfully  treated  by  Iodoform,  which  certainly  does  check  the 
activity  of  the  bacillus  of  that  disease,  also  by  Iodol  in  many  cases. 

Diabetes  has  been  apparently  cured  by  Iodoform. 

Syphilis  will  be  combated  successfully  by  Iodoform  or  Iodol,  in  lieu  of 
the  Iodide  of  Potassium. 

Hydriodic  Acid  is  used  as  a  substitute  for  Iodine  and  the  Iodides, 
being  less  offensive  to  the  taste  and  stomach.  It  is  official  only  as  the 
Syrup,  the  Acid  itself  not  being  a  stable  preparation. 


256 


IPECACUANHA. 


IPECACUANHA,  Ipecac, — is  the  root  of  Cepha’elis  Ipecacuanha , 
a  small  shrubby  plant  of  the  nat.  ord.  Rubiaceae,  growing  in  Brazil.  The 
root  is  of  the  thickness  of  a  small  quill  and  about  4  inches  long,  of  dull 
gray-brown  color,  contorted  and  finely  wrinkled,  internally  white,  tough 
and  ligneous ;  odor  slight  but  nauseous,  taste  acrid,  bitter  and  nauseating. 
It  contains  starch,  gum,  a  trace  of  volatile  oil,  a  crystalline  alkaloid, 
Emetine ,  C2oH30N05,  and  a  glucoside  named  Ipecacuanhic  Acid.  Dose  of 
the  powdered  root,  as  an  expectorant  gr.  ss-ij,  as  an  emetic  gr.  xv-xxx. 

Preparations. 

Extraction  Ipecacuanha  Fluidum , — Dose,  TTpj-v. 

Syrupus  Ipecacuanha, — strength  5  percent.  Dose,  gj-^ss. 

Vinum  Ipecacuanha , —  strength  7  per  cent.  Dose  rr\j-£j. 

Trochisci  Ipecacuanha , — each  contains  gr.  of  Ipecac. 

Trochisci  Morphina  et  Ipecacuanha, — each  contains  of  Morphine  Sulphate  gr.  -pG,  of 
Ipecac  gr.  TV,  with  oil  of  Gaultheria,  Sugar,  etc. 

Pulvis  Ipecacuanha  et  Opii,  Dover’s  Powder, — consists  of  Ipecac  10,  Pulvis  Opii  10, 
Sugar  of  Milk,  80  parts.  Dose.  gr.  ij-xv. 

Tinctura  Ipecacuanha  et  Opii , — Deodorized  Tincture  of  Opium  100  parts  evaporated 
to  85,  Fluid  Extract  of  Ipecac  10,  Alcohol  q.  s.  ad  100.  Dose,  rtpv-xxx. 

Emetina,  Emetine  (Unofficial), — a  crystalline  alkaloid,  white  becoming  yellow,  odor¬ 
less,  bitter,  nearly  insoluble  in  water,  but  forming  with  acid  salts  which  are  readily 
soluble.  Is  powerfully  poisonous  in  large  doses.  Dose  as  an  expectorant,  gr.  ; 

as  an  emetic,  gr. 

Physiological  Action. 

Ipecac  isnauseant,  emetic,  expectorant,  cholagogue,  diaphoretic,  hemo¬ 
static,  sternutatory  and  counterirritant.  Applied  to  the  skin  it  produces 
pustulation,  and  used  as  snuff  it  excites  violent  sneezing  and  reflex 
mucous  secretion,  in  some  persons  the  smallest  inhalation  of  the  dust  ex¬ 
citing  an  asthmatic  paroxysm.  Internally  small  doses  (gr.  act  as 

a  stomachic  tonic  and  increase  the  gastric  secretions;  larger  doses 
(gr.  v-xx)  are  nauseant  and  emetic  in  from  20  minutes  to  half  an  hour, 
but  the  emesis  produced  is  not  violent  nor  is  it  followed  by  much  depres¬ 
sion.  If  these  doses  are  repeated  a  tolerance  of  the  stomach  to  the  drug 
becomes  established  and  a  cathartic  action  is  produced,  the  stools  having 
a  peculiar  bilious  character.  The  circulation  is  only  slightly  affected  by 
Ipecac,  but  it  relaxes  the  skin  and  increases  the  broncho-pulmonary 
mucus,  being  diaphoretic  and  expectorant.  In  large  doses  it  is  decidedly 
irritant  to  the  intestinal  canal,  but  here  also  it  is  capable  of  the  same  tol¬ 
erance  as  in  the  stomach.  In  poisonous  doses  it  has  frequently  produced 
hemoptysis  and  other  hemorrhages. 

Emetine,  the  active  principle,  causes  death  in  animals  by  cardiac 
paralysis,  and  the  autopsies  show  evidences  of  gastro-intestinal  irritation 
and  hypenemic  lungs  with  patches  of  hepatization. 

Antagonists  and  Incompatibles. 

Narcotics  generally  antagonize  the  emetic  action,  so  also  do  Bismuth,  Carbolic  and 
Hydrocyanic  Acids.  The  salts  of  Lead  and  Mercury,  Vegetable  Acids  and  astringent 
infusions  are  incompatible  with  Ipecac. 


IRIS. 


257 


Therapeutics. 

Ipecac  is  much  used  as  an  emetic,  being  safe,  efficient  and  non-depres¬ 
sant,  though  slow  of  action.  It  is  the  best  agent  of  the  kind  to  relieve 
the  stomach  in  acute  indigestion  and  bilious  sick-headache,  and  an  ipecac- 
vomit  is  frequently  very  serviceable  at  the  commencement  of  eruptive, 
continued  and  periodical  fevers.  The  syrup  is  a  favorite  domestic  emetic 
to  cut  short  an  attack  of  spasmodic  laryngitis,  and  it  may  be  used  bene¬ 
ficially  in  membranous  croup  and  capillary  bronchitis. 

Dysentery  is  a  disease  in  which  large  doses  of  Ipecac  (gr.  xx  every  4 
hours)  are  used  with  great  success,  especially  in  the  epidemic  form,  and 
in  the  summer  dysentery  of  teething  children.  Tolerance  must  be  estab¬ 
lished  to  produce  its  curative  action.  In  small  doses  (npj  of  the  wine) 
frequently  repeated,  it  will  relieve  many  kinds  of  vomiting,  especially 
those  of  nervous  origin,  perhaps  through  a  sedative  action  on  the  pneu- 
mogastric.  As  an  antihemorrhagic  it  has  been  efficiently  employed  in 
post-partum  hemorrhage,  menorrhagia,  epistaxis,  hemoptysis,  etc.,  and  it 
is  considered  very  useful  in  night  coughs,  acute  catarrh  and  bronchitis, 
spasmodic  asthma  and  hay  fever.  In  most  of  these  affections  slightly 
nauseating  doses  must  be  used. 


IRIS,  Blue  Flag, — is  the  rhizome  and  rootlets  of  Iris  versicolor ,  an 
indigenous  plant  of  the  nat.  ord.  Iridaceae,  growing  in  moist  meadows 
and  on  the  borders  of  swamps,  having  large  blue  flowers  and  a  horizontal 
rhizome,  2  to  4  inches  long,  with  long  rootlets,  slight  odor  but  an  acrid, 
nauseous  taste.  It  contains  tannin,  sugar,  starch,  gum,  an  acrid  resin, 
fixed  oil  and  traces  of  an  alkaloid.  Dose  of  the  powdered  root,  gr.  v-xx. 

Preparations. 

Extraction  Iridis , — Dose,  gr.  j-v. 

Extraction  Iridis  Fluidum , — Dose,  npv-  ’Zy 

Iridin  or  Irisin  (Unofficial), — is  a  so-called  resinoid  found  in  the  shops,  of  undetermined 
composition,  but  probably  an  oleoresin  precipitated  by  water  from  an  alcoholic  preparation. 
Dose,  gr.  j-v. 

Physiological  Action. 

Iris  when  fresh  is  actively  purgative,  emetic  and  diuretic,  producing 
severe  nausea  and  prostration.  Iridin  has  been  the  subject  of  experimen¬ 
tation  upon  dogs,  and  is  shown  to  be  a  powerful  hepatic  stimulant  with 
considerable  influence  on  the  intestinal  glands,  being  more  purgative  than 
Euonymin  and  less  irritant  than  Podophyllin.  In  very  small  doses  it 
causes  obstinate  constipation  by  producing  rectal  inactivity. 

Therapeutics. 

Iris  is  very  serviceable  in  duodenal  catarrh  with  obstruction  of  the  bile- 
ducts  and  consequent  jaundice,  also  in  malarial  poisoning,  bilious  remit¬ 
tents,  and  jaundice  of  malarial  origin.  It  is  used  in  many  hepatic  and 

17 


258 


JALAPA. 


intestinal  disorders  as  a  cholagogue  and  purgative  of  mild  but  efficient 
action,  also  as  a  diuretic  in  dropsies.  In  small  doses  (npj  of  a  tincture)  it  is 
strongly  recommended  in  a  peculiar  blinding  headache  in  the  right  supra¬ 
orbital  region  with  nausea  or  vomiting,  supposed  to  be  of  hepatic  origin. 

JALAPA,  Jalap  , — is  the  tuberous  root  of  Exogonium  purga ,  a  Mexi¬ 
can  plant  of  the  nat.  ord.  Convolvulacese.  It  is  large,  turnip-shaped, 
externally  dark-brown  and  wrinkled,  internally  grayish-brown  with  numer¬ 
ous  concentric  circles  composed  of  small  resin-cells,  odor  slight,  taste 
sweetish  and  acrid.  It  contains1 15  to  20  per  cent,  of  the  official  Resin, 
which  is  composed  of  two  resins,  Jalapin ,  soft,  soluble  in  ether,  and 
Convolvulin,  C31H50O16,  which  is  hard,  insoluble  in  ether,  and  the  most 
active  of  the  two. 

Preparations. 

Abstraction  Jalapce,— vs>  an  ingredient  of  Pil.  Catharticae  Compositae,  gr.  j  in  each.  (See 
ante ,  page,  185.)  Dose,  gr.  j-v. 

Resina  Jalapce , — prepared  by  precipitation  by  water  from  a  tincture.  Insoluble  in  water, 
soluble  in  alcohol,  Dose,  gr.  ij-v. 

Pulvis  Jalapce  Compositus, — Jalap  35,  Potassium  Bitartrate  65  parts,  triturated  together. 
Dose,  gr.  x-^j. 

Physiological  Action. 

Jalap  is  an  active  cathartic,  producing  copious  and  watery  stools,  with 
considerable  tormina  and  tenesmus,  also  sometimes  nausea.  It  does  not 
produce  hemorrhoids,  but  does  increase  the  secretions  of  the  intestinal 
canal  and  the  flow  of  bile.  Its  action  is  not  due  to  any  one  of  the  contained 
principles,  but  all  the  active  constituents  are  found  in  the  resin.  Com¬ 
pared  with  other  agents  of  the  same  class  its  action  most  resembles  that  of 
Scammony.  It  is  more  drastic  than  Senna  and  less  irritant  than  Gam¬ 
boge,  but  in  overdoses  may  produce  dangerous  hypercatharsis. 

Convolvulin  in  sufficient  dose  is  an  active  irritant  poison,  producing 
gastro-enteritis  and  narcotism.  Its  action  as  a  purgative  seems  to  be 
wholly  local,  as  from  its  intravenous  injection  no  catharsis  results,  yet  it 
exerts  little  if  any  irritant  action  on  the  conjunctiva,  nasal  mucous  mem¬ 
brane  or  skin.  It  is  not  eliminated  in  the  urine  or  the  faeces,  and  is  there¬ 
fore  probably  destroyed  in  the  system  by  oxidation. 

Therapeutics. 

In  olden  bowel-moving  times  Jalap  and  Calomel  were  used  together  in 
doses  of  gr.  x  each  (“  ten  and  ten  ”),  asa  routine  purgative  prescription. 
Less  ponderous  doses  are  now  considered  equally  efficient,  and  one  grain  of 
each  agent  with  the  same  quantity  of  Extract  of  Hyoscyamus  as  a  correct¬ 
ive  may  be  used  with  advantage  at  the  onset  of  fevers  and  inflammations. 
As  the  compound  powder  it  is  much  employed  to  produce  free  watery  evacu¬ 
ations  in  ascites  and  anasarca.  Being  nearly  tasteless  it  is  a  useful  cathartic 
for  children,  and  may  be  administered  in  Syrup  of  Rhubarb  (gr.  ij-v  in 


JUGLANS - JUNIPERUS. 


259 


Bss).  As  a  vermifuge  it  is  efficient  as  an  adjunct  to  more  powerful  agents, 
and  is  employed  with  Calomel  and  Santonin  for  the  expulsion  of  lumbrici. 
Jalap  is  contraindicated  in  all  inflammatory  conditions  of  the  intestinal 
mucous  membrane,  but  in  proper  doses  it  is  one  of  the  most  manageable 
and  efficient  cathartics. 


JUGLANS,  Butternut, — is  the  inner  bark  of  the  root,  collected  in 
autumn,  of  Juglans  cinerea ,  the  Butternut  or  White  Walnut,  an  indigenous 
forest  tree  of  the  nat.  ord.  Juglandaceae.  It  occurs  in  flat  or  curved 
pieces,  the  outer  surface  smooth,  dark-brown,  mottled,  and  nearly  free 
from  corky  remnants  of  the  outer  bark,  odor  feeble,  taste  bitter  and  acrid. 
It  contains  an  orange-yellow,  crystalline  and  acrid  substance  named  Ju- 
glandic  Acid  or  Nucin,  resembling  Chrysophanic  Acid,  also  some  resin, 
volatile  acid,  etc.,  but  neither  tannin  nor  any  alkaloid. 

Preparation. 

Extr actum  Juglandis, — Dose,  gr.  v-xx  or  more. 


Physiological  Action  and  Therapeutics. 

Juglans  is  a  mild  cathartic  operating  without  the  production  of  pain  or 
irritant  symptoms.  It  is  never  used  in  substance,  but  the  extract  is  a 
good  laxative  in  doses  of  gr.  v-x,  and  a  purgative  in  larger  doses.  It  has 
considerable  reputation  in  dysentery  and  chronic  constipation. 


JUNIPERUS,  Juniper, — is  the  fruit  of  Juniperus  communis ,  an 
evergreen  shrub  of  the  nat.  ord.  Coniferae,  growing  in  Europe  and  N. 
America.  The  fruit  or  berry  is  dark-purple  with  a  bluish-gray  bloom, 
having  a  three-rayed  furrow  at  the  apex,  internally  pulpy,  containing  3 
triangular,  bony  seeds.  It  contains  a  Volatile  Oil  which  is  official  and 
consists  of  terpenes  and  camphors  in  complex  combination,  also  a  non- 
crystallizable  principle  named  Juniper  in,  and  grape  sugar,  resin,  formic, 
acetic  and  malic  acids,  etc. 

Preparations. 

Oleum  Juniperi , — thevolatile  oil,  a  colorless  or  faintly  greenish-yellow  liquid,  of  sp.  gr. 
about  0.870,  of  terebinthinate  and  sweetish  taste,  and  the  odor  of  juniper,  soluble  in  12 
of  alcohol.  Dose,  rtyv-xx. 

Spiritus  Juniperi , — has  of  the  oil  3  parts  in  97  of  alcohol.  Dose, 

Spiritus  Juniperi  Composi/us , — approximates  closely  to  the  best  grade  of  “  Gin  ”  (see 
ante,  page  86).  It  contains  Oil  of  Juniper  10,  Oil  of  Caraway  1,  Oil  of  Fennel  1,  Alco¬ 
hol  3000,  and  Water  sufficient  to  make  5000  parts.  Dose,  jijss-j. 

Infusum  Juniperi  (Unofficial) — Juniper  Berries  ^ j  in  Oj  of  boiling  water.  Dose, 

3SS~ T 

Oleum  Cadini,  Oil  of  Cade  (Unofficial), — is  a  tar  obtained  by  the  destructive  distilla¬ 
tion  of  Juniper  wood,  but  is  of  uncertain  purity.  The  official  Oleum  Picis  Liquid®  (Oil 
of  Tar)  is  just  as  efficient  for  all  purposes  to  which  the  Oil  of  Cade  has  been  applied. 


26o 


KAMALA. 


Physiological  Action. 

Juniper  is  a  stomachic  tonic,  diaphoretic,  diuretic  and  aphrodisiac. 
The  oil  is  the  active  principle,  and  is  readily  diffused,  exciting  increased 
cardiac  action,  stimulating  the  renal  functions  and  the  action  of  the  skin, 
and  causing  a  subjective  sense  of  heat  throughout  the  system.  It  is  elimi¬ 
nated  chiefly  by  the  kidneys,  and  may  set  up  renal  irritation,  in  large 
doses  producing  stranguary,  priapism,  hematuria,  suppression  of  the  urine? 
and  uraemic  convulsions.  It  imparts  a  violet  odor  to  the  urine,  and  will 
produce  diuresis  when  inhaled. 

Therapeutics. 

The  Oil  of  Juniper  is  used  to  flavor  gin  and  to  impart  the  diuretic  power 
popularly  ascribed  to  that  liquor.  The  medicinal  use  of  the  juniper 
preparations  (spirit  and  compound  spirit)  is  restricted  to  their  employ¬ 
ment  as  vehicles  for  less  irritant  diuretics.  The  oil  acts  therapeutically 
like  the  Oil  of  Turpentine,  and  may  be  used  in  chronic  pyelitis  and  cys¬ 
titis,  prostatorrhoea,  gleet,  etc.,  but  it  is  contraindicated  in  all  cases  where 
acute  inflammation  of  the  kidneys  exists. 

Oil  of  Cade  is  used  locally  in  chronic  skin  diseases  as  a  stimulant 
application.  It  is  too  active  for  acute  eruptions,  but  has  been  used  with 
benefit  in  chronic  eczema  and  psoriasis.  The  official  Oil  of  Tar  (see  Pix) 
is  equally  efficient. 


KAMALA,  Rottlera, — the  glands  and  hairs  from  the  capsules  of 
Mallotus philippinensis ,  or  Rottlera  tinctoria ,  a  small  tree  of  the  nat.  ord. 
Euphorbiacese,  growing  in  Abyssinia,  Arabia,  India,  China,  etc.  It 
occurs  as  a  granular,  mobile,  brick-red  powder,  inodorous  and  nearly 
tasteless,  partly  soluble  in  alcohol  and  ether.  It  contains  several  resins, 
one  of  which  is  named  Rottlerin ,  CnH10O3,  also  tannin,  starch,  gum,  red 
coloring  matter,  etc.  There  are  no  official  preparations.  Dose,  3ss-iij. 

Physiological  Action  and  Therapeutics. 

Kamala  is  anthelminitic  and  purgative,  sometimes  causing  nausea  and 
colic,  seldom  vomiting.  It  is  used  as  a  tseniafuge  and  to  expel  lumbrici 
and  ascarides  vermiculares.  One  or  two  drachms  are  given  suspended  in 
water,  mucilage  or  syrup,  and  repeated  in  4  hours  if  necessary.  A  tinc¬ 
ture  (Svj  in  xvj  of  alcohol)  may  be  used  in  doses  of  5j_3ss.  In  India 
it  is  used  locally  in  scabies  and  other  skin  affections,  and  has  been  found 
of  especial  service  in  herpetic  ringworm.  As  a  remedy  against  tapeworm 
it  is  perhaps  next  after  Male-fern  in  efficiency,  and  requires  no  preparatory 
treatment. 


KINO - KRAMERIA. 


26l 


KAVA-KAVA,  Ava-Kava  (Unofficial), — the  root  of  Piper  methys- 
ticum ,  a  shrub  of  the  nat.  ord.  Piperacese  growing  in  South  America  and 
the  South  Sea  Islands.  The  root  is  large,  weighing  from  2  to  20  pounds, 
fibrous,  light  and  spongy,  and  contains  a  crystalline  principle,  Kavahin 
or  Methysticin ,  which  is  analogous  to  Piperin,  an  acrid,  greenish-yellow 
resin  Kawin ,  which  is  probably  the  active  principle,  also  a  Volatile  Oil. 
Dose,  3ss-j,  macerated  in  water,  or  the  same  quantity  of  a  fluid  extract. 

Physiological  Action  and  Therapeutics. 

Kava  is  intoxicant,  diuretic  and  motor-depressant.  A  beverage  is  pre¬ 
pared  in  the  Sandwich  Islands  by  chewing  the  root  and  then  infusing  it  in 
water  or  cocoanut  milk,  which  produces  a  drowsy  intoxication  with 
pleasant  dreams  often  of  erotic  character,  and  followed  by  severe  head¬ 
ache.  A  moderate  dose  is  tonic  and  stimulant,  lessening  the  sense  of 
fatigue  and  sharpening  the  mental  faculties.  It  is  highly  recommended 
in  gonorrhoea  and  gout,  also  in  chronic  gleet  and  obstinate  cystitis. 


KINO  , — is  the  inspissated  juice  of  Pterocarpus  Marsupium ,  a  tall  tree 
of  the  nat.  ord.  Leguminosse,  growing  in  India.  It  occurs  in  angular, 
brown-red  pieces,  shining  and  brittle,  inodorous,  taste  astringent  and 
sweetish,  soluble  in  alcohol.  It  contains  75  per  cent,  of  a  variety  of  tan¬ 
nin  named  Kino-tannic  Acid ,  C18H1808,  which  gives  a  greenish  precipitate 
with  persalts  of  iron,  also  a  crystalline,  neutral  substance,  Kinoin ,  C14H1206, 
and  Kino-red,  formed  from  Kino-tannic  Acid  by  oxidation,  besides  gum, 
pectin,  etc.  There  are  several  other  varieties  of  Kino  in  the  market, 
brought  from  S.  America,  Africa,  Australia,  etc.,  which  are  products  of 
other  trees  than  the  official  one. 

Preparations. 

Tinctura  Kino, — strength  10  per  cent.  Dose,  TT^x-  g  ij. 

Pulvis  Kino  Compositus  (Unofficial) — Kino  15,  Opium  1,  Cinnamon  4  (has  of  Opium 
1  in  20).  Dose,  gr.  v-xx. 

Physiological  Action  and  Therapeutics. 

The  action  of  Kino  is  the  same  as  that  of  Tannic  Acid,  though  less 
powerful  (see  ante,  page  74),  and  may  be  used  for  the  same  purposes,  both 
internally  and  locally.  It  is  chiefly  employed  as  an  astringent  gargle  and 
as  a  constituent  of  diarrhoea-mixtures. 


KRAMERIA,  Rhatany,  is  the  root  of  Krameria  triandra  and 
Krameria  iomentosa,  shrubs  of  the  nat.  ord.  Polygalacete,  growing  in  S. 
America,  the  first-named  in  Peru  and  the  latter  in  New  Granada.  It  is 
about  an  inch  thick,  branched  below,  more  or  less  knotty,  covered  with 


262 


KUMYSS. 


a  brownish  bark  which  is  very  astringent ;  and  contains  20  to  45  per  cent, 
of  Rhatania-tannic  Acid,  C54H24021,  and  Rhatanine ,  C10H13NO3,  an  alka¬ 
loid, — also  wax,  gum,  etc. 

Preparations. 

Extractum  Krainerice , — aqueous.  Dose,  gr.  v-x. 

Extraction  Krainerice  Fluidum , — Dose,  rrpv-^ss. 

Tinctura  Krainerice, — 20  per  cent.  Dose,  rrpv-gj. 

Syrupus  Krainerice , — Fluid  Extract  35,  Syrup  65.  Dose,  3SS-5SS. 

Trochisci  Krainerice, — each  troche  contains  gr.  j  of  the  extract,  with  Tragacanth,  Sugar 
and  Orange-Flower  Water. 


Physiological  Action  and  Therapeutics. 

Krameria  possesses  the  same  astringent  qualities  as  Tannic  Acid  (see 
ante ,  page  74),  and  may  be  employed  for  the  same  purposes  except  as  an 
antidote  to  Antimony.  It  has  long  had  a  high  reputation  as  an  injection 
for  fissure  of  the  anus,  as  a  local  application  to  spongy  gums,  and  as  a 
tonic  for  debilitated  subjects. 


KUMYSS,  Koomiss  (Unofficial), — is  an  effervescing  fermented 
liquor  originally  prepared  by  the  Tartars  from  mare’s  milk,  but  now 
imitated  with  cow’s  milk  by  adding  sugar  of  milk,  fermenting  in  open 
tanks,  skimming  off  the  casein  and  butter,  then  bottling  during  active 
fermentation.  Wolff’s  formula  for  its  preparation  in  small  quantity  is  as 
follows, — 

Dissolve  ;jss  (a  tablespoonful)  of  grape  sugar  in  t^iv  of  water.  Dissolve  gr.  xx  (a 
teaspoonful)  of  Fleischmann’s  compressed  yeast  or  well  washed  and  pressed-out  brewer’s 
yeast  in  3  ij  of  cow’s  milk.  Mix  the  two  solutions  in  a  quart  champagne  bottle,  and  fill 
to  within  2  inches  of  the  top  with  good  cow’s  milk.  Cork  well,  secure  the  cork  with 
wire,  keep  it  in  a  cellar  or  ice  chest,  maintaining  a  temperature  of  50°  F.  or  less,  and 
agitate  thrice  daily.  In  three  or  four  days  it  is  ready  for  use,  but  should  not  be  kept 
longer  than  four  or  five  days.  Draw  it  with  a  champagne  tap. 

The  following  table  of  analysis  shows  the  average  composition  of  milk, 
koumiss  and  kefir  : — 


Cow’s  milk. 

Koumiss. 

Kefir. 

Albumen, . 

.  48 

II. 2 

38 

Butter, . 

.  38 

20.5 

20 

Sugar  of  milk,  .  .  .  . 

.  41 

22. 

20 

Lactic  acid, . 

.  — 

1 1  5 

9 

Alcohol, . 

,  .  .  .  .  — 

16.5 

8 

Water  and  salts,  .  .  .  . 

....  873 

918.3 

905 

Physiological  Action  and  Therapeutics. 

The  taste  of  Kumyss  is  acidulous  and  peculiar.  In  large  quantity  it 
takes  the  place  of  food,  each  quart  equalling  four  ounces  of  solids.  It  is 
said  to  be  a  powerful  diuretic  especially  in  cold  weather,  and  in  warm 
weather  to  produce  free  diaphoresis.  It  is  stimulating  and  tonic,  increases 
the  body  nutrition  and  produces  considerable  somnolence.  The  stomach 


'  LACTUCARIUM - LANOLINUM.  263 

is  very  tolerant  of  it,  and  retains  it  when  any  other  food  will  be  rejected. 
It  is  easily  assimilated  and  very  nutritious. 

Kumyss  is  an  invaluable  article  of  diet  in  many  wasting  diseases,  espe¬ 
cially  phthisis.  It  is  also  of  great  benefit  in  dyspepsia,  the  diarrhoea  of 
children,  convalescence  from  acute  maladies,  chronic  affections  of  the 
kidneys,  chronic  bronchitis,  and  other  cachexiae.  In  cases  of  feeble 
digestive  power  5j  every  hour  is  sufficient,  but  as  its  digestion  and  assimi¬ 
lation  increase  it  may  be  given  almost  ad  libitum ,  and  when  used  with 
other  food  a  half-pint  may  be  taken  after  each  meal. 

Kefir  is  the  name  of  a  fermented  drink  prepared  from  the  milk  of  a 
cow  or  mare  by  the  addition  of  a  mushroom-like  ferment  found  near  the 
snow-line  in  the  Caucasian  mountains.  It  is  used  by  the  natives  of  the 
Asiatic  plains  as  a  remedy  for  struma,  anaemia,  lung  and  stomach  diseases. 
Kefir  is  richer  in  albumen  than  Kumyss,  is  less  alcoholic  and  less  acid. 


LACTUCARIUM,  Lettuce  , — is  the  concrete  milk-juice  of  Lactuca 
virosa ,  or  Acrid  Lettuce,  a  biennial  European  plant,  of  the  nat.  ord. 
Compositae.  It  occurs  in  sections  of  cakes  or  irregular  pieces  showing  the 
form  of  the  vessel  in  which  it  hardened,  externally  reddish-brown,  internally 
white  or  yellowish  and  of  waxy  lustre,  odor  heavy  and  narcotic,  taste 
bitter,  partly  soluble  in  alcohol  and  in  ether,  and  yielding  a  turbid  mixture 
when  triturated  with  water.  Lactucarium  is  a  mixture  of  several  substances, 
the  most  important  being  Lactucerin ,  42  per  cent.,  a  crystalline,  tasteless 
body,  resembling  caoutchouc,  insoluble  in  water  and  probably  inert ; 
Lactucin ,  0.3  per  cent.,  a  neutral  principle,  crystallizing  in  pearly  scales, 
insoluble  in  cold  water,  persistently  bitter;  Lactucic  Acid ,  bitter,  amor¬ 
phous,  but  crystallizes  after  long  standing. 

Preparations. 

Extractum  Lactucarii  Fluidum , — Dose,  for  a  child  TT\j-iij,  for  an  adult  rrpx-  3  j , 
according  to  the  activity  of  the  drug. 

Syrupus  Lactucarii, — 5  per  cent.  Dose,  gj-^j. 

Physiological  Action  and  Therapeutics. 

Lactucarium  is  feebly  hypnotic,  somewhat  sedative  and  diuretic.  It  is 
supposed  to  act  similarly  to  Opium,  but  very  feebly  and  without  depressing 
after-symptoms.  Its  preparations  are  very  uncertain  in  activity,  and  are 
chiefly  used  as  placebos,  to  allay  cough  and  quiet  nervous  irritability. 
The  syrup  is  a  good  vehicle  for  expectorants  and  antispasmodics. 


LANOLINUM,  Lanolin,  — is  a  cholesterin  fat  obtained  from  the 
suds  from  the  washing  of  sheep’s  wool,  by  a  process  patented  in  the  United 
States  by  Prof.  Liebreich,  the  discoverer  of  Chloral ;  and  though  a  very  old 
medicament,  being  mentioned  by  Ovid,  Herodotus,  Pliny  and  Aristo- 


264 


LAPPA - LAVANDULA. 


phanes,  it  is  now  being  introduced  to  the  medical  world  as  the  best  basis 
for  ointments.  It  contains  25  to  30  per  cent,  of  water,  and  readily  unites 
with  no  percent,  of  its  own  weight  of  water ;  differing  from  all  other  fatty 
substances,  chiefly  in  resisting  saponification  and  the  action  of  water,  having 
no  tendency  to  become  rancid.  It  readily  passes  through  the  integument, 
carrying  with  it  any  medicament  with  which  it  is  charged.  It  is  a  perfectly 
neutral  base,  and  hence  is  not  liable  to  decompose  any  ordinary  substance. 
The  difficulty  about  its  use  has  been  its  very  disagreeable  sheepy  smell, 
but  recent  samples,  exhibited  to  the  British  Medical  Association,  seem 
to  have  been  devoid  of  this  objectionable  quality.  It  is  particularly  useful 
in  chronic  skin  diseases  where  there  is  infiltration,  and  a  penetrative 
action  is  desired  for  medicaments.  In  a  few  cases  of  acute  and  subacute 
eczema  it  has  proved  irritating,  but  as  a  rule  it  is  perfectly  bland.  Where 
a  simple  protective  action  is  desired  it  is  inferior  to  Lard,  Vaseline  or 
Cold  Cream. 

LAPPA,  Burdock  , — is  the  root  of  Lappa  officinalis ,  the  common 
Burdock,  acoarse-looking  biennial  weed  of  the  nat.  ord.  Compositae,  found 
in  waste  places  and  along  roadsides  in  Europe,  Asia  and  N.  America.  Three 
varieties  are  recognized, — Lappa  7najor  Z.  tomentosa  and  Z.  minor ,  of 
which  the  first-named  is  most  frequently  met  with  in  this  country.  The 
root  about  a  foot  long,  an  inch  thick,  has  a  feeble  odor  and  a  muci¬ 
laginous,  bitterish  taste,  and  contains  a  bitter  principle,  traces  of  a  volatile 
oil,  also  inulin,  resin,  tannin,  mucilage,  sugar,  etc.  There  are  no  official 
preparations.  Dose,  5j-ij>  in  infusion,  decoction  or  tincture.  Dr.  Squibb 
recommends  a  tincture  of  the  seed,  lb  j  of  ground  seed  to  gall,  j  of  whiskey, 
allowed  to  stand  for  2  weeks  before  decanting,  and  used  in  doses  of  3ij-iij 
before  meals. 

Physiological  Action  and  Therapeutics. 

Lappa  promotes  all  the  secretions  and  is  considered  aperient,  diuretic 
and  diaphoretic,  without  irritating  qualities.  In  decoction  it  has  been  a 
popular  domestic  remedy  for  many  morbid  conditions,  especially  rheuma¬ 
tism,  gout,  pulmonary  catarrhs  and  chronic  cutaneous  affections.  By 
several  practitioners  it  is  praised  as  an  alterative  in  constitutional  diseases, 
as  syphilis  and  scrofula,  also  as  an  external  application  to  swellings, 
hemorrhoids  and  chronic  sores.  A  tincture  of  the  seed  has  proved  re¬ 
markably  efficient  as  a  stomachic  tonic  and  has  cured  several  cases  of 
psoriasis  inveterata.  (See  Squibb’s  Ephemeris ,  vol.  i,  page  116.) 


LAVANDULA,  Lavender, — the  flowers  of  Lavandula  vera,  a 
small  European  shrub  of  the  nat.  ord.  Labiatae,  largely  cultivated  in 
England.  They  have  a  bluish-gray  tubular  calyx,  a  violet-blue  corolla,  a 


LEPTANDRA - LICOPERDON  GIGANTEUM. 


265 


fragrant  odor,  and  an  aromatic,  camphoraceous  taste,  and  contain  resin 
and  tannin,  also  a  Volatile  Oil  which  is  official.  Lavender  is  a  constitu¬ 
ent  of  Vinum  Aromaticum. 

Preparations. 

Oleum  Lavandula, — is  a  volatile  oil  distilled  from  the  flowering  tops  or  the  whole  herb. 
It  is  much  coarser  than  the  oil  of  lavender  flowers  and  more  stimulant.  Dose,  rrpj-v. 

Oleum  Lavandula  Florum , — is  a  volatile  oil  distilled  from  fresh  Lavender,  and  having 
the  fragrant  odor  of  the  flowers.  Sp.  gr.  0.890,  soluble  in  alcohol  and  in  acetic  acid  of 
90  per  cent.  It  is  a  constituent  of  Spiritus  Odoratus.  (See  ante,  page  86.)  Dose,  ff\j-v. 

Spiritus  Lavandula — has  of  the  Oil  of  Lavender  Flowers  3  parts  in  97  of  Alcohol. 
A  perfume  and  flavoring,  Dose,  gss-j. 

Tinctura  Lavandula  Co?nposita , — an  aromatic  stimulant  composed  of  Oil  of  Lavender 
8,  Oil  of  Rosemary  2,  Cinnamon  18,  Cloves  4,  Nutmeg  10,  Red  Saunders  8,  Alcohol  680, 
Water  270,  Diluted  Alcohol  q.  s.  add  1000  parts.  Dose,  3  ss-ij.  Is  a  constituent  of 
Liquor  Potassii  Arsenitis. 


Physiological  Action  and  Therapeutics. 

Lavender  is  aromatic,  stimulant  and  carminative,  but  is  rarely  used 
alone  as  a  medicine.  It  is  an  agreeable  flavoring  and  perfume,  in  the 
form  of  the  official  spirit,  which  is  sold  under  the  name  of  “  Lavender- 
water,”  after  the  addition  of  Oil  of  Bergamot  and  Essence  of  Ambergris. 
The  compound  tincture,  formerly  called  the  compound  Spirit  of  Lavender, 
is  a  very  agreeable  compound  of  spices,  and  is  much  used  as  a  remedy  for 
gastralgia,  nausea,  flatulence,  etc.,  and  as  an  adjuvant  or  corrigent  of 
other  medicines. 


LEPTANDRA,  Culver’s  Root,  — is  the  rhizome  and  rootlets  of 
Leptandra  virginica,  an  indigenous  perennial  plant  of  the  nat.  ord.  Scrofu- 
lariaceae.  The  rhizome  is  horizontal,  about  5  inches  long  and  inch 
thick,  bent  and  branched,  with  thin,  wrinkled  rootlets,  inodorous,  taste 
bitter  and  feel  acrid.  It  contains  a  glucoside  named  Leptandrin ,  which 
is  probably  the  active  principle,  also  Saponin,  resin,  tannin,  etc.  The 
Leptandrin  of  the  shops  is  an  impure  alcoholic  extract. 

Preparations. 

Extractum  Leptandra , — Dose,  gr.  j-iij. 

Extr actum  Leptandra  Fluidum, — Dose,  TT^xx-^j. 

Physiological  Action  and  Therapeutics. 

Leptandra  is  tonic,  laxative,  and  like  other  resin-bearing  purgatives  is 
decidedly  cholagogue.  The  recent  root  is  a  violent  cathartic,  but  in  the 
dried  state  it  is  less  active.  It  is  indicated  in  duodenal  indigestion  and 
chronic  constipation  with  insufficiency  of  the  biliary  and  intestinal  se¬ 
cretions. 


LICOPERDON  GIGANTEUM,  Puff-Ball,  — is  a  common 
fungus  of  the  nat.  ord.  Trichogastres,  found  in  hilly  and  wooded  districts. 


266 


LIMON. 


The  dust,  which  consists  of  the  capillitium  and  spores,  is  a  valuable 
hemostatic,  and  dusted  over  bleeding  surfaces  acts  promptly  in  arresting 
hemorrhage.  It  has  been  proposed  as  a  surgical  dressing,  but  while  use¬ 
ful  in  emergencies  where  other  agents  are  unattainable,  the  fetor  which 
*  results  from  its  application  to  wounds  will  prevent  its  use  becoming  general 
for  this  purpose.  It  may  prove  of  value  as  an  internal  hemostatic  in 
hematemesis  and  the  hemorrhage  of  typhoid  fever. 


LIMON,  Lemon, — is  the  fruit  of  Citrus  Limonum ,  a  tree  of  the 
nat.  ord.  Aurantiacese,  native  in  Asia  but  cultivated  in  southern  Europe 
and  many  other  countries.  It  is  official  in  the  two  forms  described  below. 
The  Orange  (  Citrus  vulgaris  and  C.  Aurantium ),  the  Citron  ( Citrus  med¬ 
ico),  and  the  Lime  ( Citrus  acris),  all  belong  to  the  same  genus  as  the 
Lemon  ( Citrus  Limonum ). 

Limonis  Cortex,  Lemon  Peel, — is  the  rind  of  the  recent  fruit,  and 
contains  a  Volatile  Oil ,  C10H16,  which  is  official,  and  a  bitter  crystalline 
glucoside,  Hesperidin ,  C.22H26012,  chiefly  contained  in  the  white  portion  of 
the  rind. 

Limonis  Succus,  Lemon  Juice, — is  the  freshly  expressed  juice  of  the 
ripe  fruit,  each  lemon  yielding  from  ^  to  i  fluid  ounce.  It  contains 
about  7  percent,  of  free  Citric  Acid,  besides  Phosphoric  and  Malic  Acids, 
Citrates  of  Potassium  and  of  other  bases,  etc.  Dose,  Sss-iv. 

Acidum  Citricum,  Citric  Acid,  H3C6H507.H20, — is  obtained  from  the 
juice  of  the  Lemon  or  the  Lime  by  adding  chalk  to  form  the  Citrate  of 
Calcium,  which  is  then  decomposed  by  dilute  Sulphuric  Acid.  It  occurs 
in  colorless,  rhombic  crystals  which  are  very  soluble  in  water.  A  solution 
of  gr.  xvij  in  3ss  of  water  corresponds  to  3ss  of  fresh  lemon-juice,  and 
this  quantity  of  either  will  neutralize  of  Potassium  Bicarbonate  gr.  xxv, 
of  Sodium  Bicarbonate  gr.  xx,  and  of  Ammonium  Carbonate  gr.  xivss. 
Dose,  gr.  x-xxx. 

Citrates  of  Bismuth,  Bismuth  and  Ammonium,  Iron,  Iron  and  Ammo¬ 
nium,  Iron  and  Quinine,  Iron  and  Strychnine,  Lithium,  Potassium,  eight 
in  all,  are  official.  They  are  described  under  their  respective  bases,  to 
which  rather  than  to  the  acid  their  medicinal  qualities  are  due. 

Preparations. 

Oleum  Limonis ,  Oil  of  Lemon,  C10H16, — is  the  volatile  oil,  isomeric  with  oil  of  tur¬ 
pentine,  and  extracted  from  fresh  lemon  peel  by  mechanical  means.  It  is  used  for  flavor¬ 
ing  and  is  an  ingredient  of  Spiritus  Limonis,  Spiritus  Odoratus,  and  Spiritus  Amrnoniae 
Aromaticus.  Dose,  rqj-v. 

Spiritus  Limonis ,  Essence  of  Lemon, — prepared  by  macerating  6  parts  of  the  oil  and 
4  of  the  peel  in  90  of  alcohol.  Used  for  flavoring.  Dose,  according  to  the  alcohol 
required  to  be  given. 

Syrupus  Limonis , — Lemon-juice  40,  Lemon-peel  2,  Sugar  60,  Water  q.  s.  ad  100 
parts.  Dose,  indefinite. 

Syrupus  Acidi  Citrici, — Citric  Acid  8,  Water  8,  Spirit  of  Lemon  4,  Syrup  980  parts. 
Dose,  indefinite. 


LINUM. 


267 


Physiological  Action. 

Lemon-Peel  is  bitter  and  probably  tonic  to  the  stomach,  but  is  only 
used  for  flavoring  purposes.  Lemon-Juice,  on  the  other  hand,  is  refrig¬ 
erant  and  antiscorbutic,  entering  the  blood  as  alkaline  citrates,  potassium 
salts  and  phosphoric  acid,  the  citrates  being  therein  partly  oxidized  into 
C02  and  H20,  while  the  potassium  salts  and  phosphoric  acid  probably  act 
upon  the  red  corpuscles. 

Citric  Acid  has  the  same  general  action  as  Acetic  and  the  other  vege¬ 
table  acids  (see  Acidum  Aceticum,  ante ,  page  58).  It  is  wholly  decom¬ 
posed  in  the  blood,  and  appears  to  be  non-toxic  in  man,  but  used  inter¬ 
nally  it  may  precipitate  uric  acid  and  thus  promote  the  formation  of 
calculi. 

Therapeutics. 

Lemon-juice  is  employed  largely  in  the  treatment  and  prevention  of 
scurvy,  in  which  disease  it  possesses  powers  of  specific  rank,  but  whether 
its  action  therein  is  due  to  the  citric  acid,  the  phosphoric  acid  or  the  salts 
of  potassium  is  not  known.  Lime-juice  is  equally  efficient  but  Citric 
Acid  itself  is  not  so. 

As  refrigerants  and  diuretic  mixtures  in  fevers,  Lemon-juice  and  Citric 
Acid  are  much  used,  entering  into  the  composition  of  lemonades,  efferves¬ 
cing  draughts,  etc.,  to  allay  thirst  and  subdue  restlessness,  and  to  pro¬ 
mote  the  action  of  the  skin  and  the  kidneys.  For  acidity  of  the  stomach 
they  are  efficient  if  given  in  small  doses  before  meals,  but  the  mineral 
acids  are  usually  preferred  for  this  purpose.  Long-continued  they  will 
impair  digestion  and  impoverish  the  blood.  Atheromatous  degeneration 
of  the  vessels  is  said  to  be  retarded  by  the  daily  use  of  lemon-juice,  which 
is  supposed  to  dissolve  the  excess  of  organic  matter  and  to  aid  its  excre¬ 
tion.  Obesity  may  be  reduced  by  using  the  juice  of  limes  or  lemons  in 
large  quantity,  but  it  will  be  done  at  the  expense  of  the  digestion.  Lemon- 
juice  has  been  found  of  service  in  acute  rheumatism,  probably  through  the 
alkalies  which  it  conveys  into  the  blood.  As  a  local  application  it  has 
been  found  efficient  in  pruritus  scroti,  sunburn,  post-partum  hemor¬ 
rhage,  and  as  a  gargle  in  diphtheritic  sore  throat. 


LINUM,  Flaxseed,  Linseed, — is  the  seed  of  Linum  usitatissimum 
(flax),  a  cultivated  annual  plant  of  the  nat.  ord.  Linaceae.  The  seeds  are 
small,  flattened,  oblong-ovate  bodies,  brown  and  glossy,  inodorous,  taste 
mucilaginous  and  bitter;  and  contain  15  per  cent,  of  Mucilage  in  the 
epithelium,  also  30  to  40  per  cent,  of  Fixed  Oil  in  the  embryo.  Ground 
Flaxseed  should  yield  not  less  than  25  per  cent,  of  the  fixed  oil. 

Preparations. 

Oleum  Lini ,  Linseed  Oil, — the  fixed  oil  expressed  from  flaxseed  without  the  use  of 
heat.  A  yellow,  oily  liquid,  of  slight  odor,  bland  taste,  and  neutral  reaction,  soluble  in 


268 


LITHIUM. 


5  of  absolute  alcohol  and  in  i  of  ether.  Consists  chiefly  of  the  Glyceride  of  Linoleic 
Acid  C161I2804,  which  having  a  powerful  affinity  for  oxygen  becomes  resinoid  on  expo¬ 
sure  to  the  air,  making  it  a  “  drying  oil.”  Dose,  5  ss-ij. 

Infusum  Lini,  Linseed  Tea  (Unofficial), — Flaxseed  giij,  Liquorice-root  gj,  Boiling 
Water  5  x,  infused  for  4  hours  and  strained.  Dose,  indefinite. 

Carron  Oil  (Unofficial), — is  made  by  emulsifying  equal  parts  of  Linseed  Oil  and  Lime- 
water.  The  official  Linimentum  Calcis  is  intended  for  the  same  purposes. 

Physiological  Action  and  Therapeutics. 

Flaxseed  is  demulcent,  emollient,  expectorant  and  diuretic.  The  oil  is 
laxative  in  a  dose  of  %],  and  in  smaller  doses  is  oxidized  in  the  system 
and  excreted  as  a  resinoid  body  by  the  kidneys,  which  it  stimulates 
slightly.  The  infusion  contains  the  mucilaginous  principle  and  a  small 
portion  of  the  oil,  and  is  advantageously  used  in  inflammations  of  the 
mucous  membrane  of  the  throat,  the  gastro-intestinal  tract  and  the  urin¬ 
ary  passages.  It  is  an  excellent  demulcent  in  coughs  of  various  kinds, 
and  will  be  found  very  serviceable  in  cystitis,  irritable  bladder,  renal 
colic,  strangury,  etc.  The  oil  may  be  administered  internally  as  a  laxa¬ 
tive  but  is  usually  given  as  an  enema,  and  has  considerable  reputation  as 
a  remedy  for  hemorrhoids  in  doses  of  Sij  twice  daily.  Externally  it  is  a 
favorite  application  to  burns  when  made  into  an  emulsion  with  lime- 
water.  The  ground  seed  (flaxseed  meal)  is  one  of  the  best  agents  for  use 
in  poultices,  and  is  universally  employed  for  that  purpose. 


LITHIUM,  Li  , — is  represented  in  the  Pharmacopoeia  by  five  of  its 
salts,  of  which  the  Carbonate  is  but  slightly  soluble  while  the  others  are 
readily  so.  The. low  atomic  weight  of  this  metal  (7)  makes  its  saturating 
power  greater  than  that  of  other  alkaline  metals,  hence  the  value  of 
its  salts  in  medicine. 

Salts  of  Lithium. 

Lithii  Benzoas ,  Benzoate  of  Lithium,  LiC7H502, — is  classed  with  the  Benzoates  and 
described  under  Benzoic  Acid.  (See  ante ,  page  1 29.) 

Lithii  Bromidum ,  Bromide  of  Lithium,  LiBr, — is  classed  with  the  Bromides  and 
described  under  Bromine.  (See  ante ,  page  133.) 

LAthii  Carbonas ,  Carbonate  of  Lithium,  Li2C03, — a  light,  white  powder,  permanent 
in  the  air,  odorless,  of  alkaline  taste  and  reaction,  soluble  in  1 30  of  water,  insoluble  in 
alcohol.  Dose,  gr.  ij-xv. 

Lithii  Citras ,  Citrate  of  Lithium,  Li3C6H507, — a  white,  deliquescent  powder,  odor¬ 
less,  of  faintly  alkaline  taste  and  neutral  reaction,  soluble  in  5)4  of  water,  slightly  in 
alcohol.  Dose,  gr.  v-xxx. 

Lithii  Salicylas ,  Salicylate  of  Lithium,  2LiC7H503.H20, — is  classed  with  the  Salicy¬ 
lates  and  described  under  Salix. 

Physiological  Action. 

The  Lithium  salts  have  strong  alkaline  qualities  and  act  on  the  system 
in  the  same  manner  as  other  alkalies  (see  under  Potassium).  The  high 
saturating  power  of  this  metal  makes  its  salts  more  alkaline  than  those  of 
Potassium,  Sodium  or  Calcium,  hence  more  efficient  in  alkalinizing  the 


LOBELIA. 


269 


urine.  The  Urate  of  Lithium  is  the  most  soluble  of  the  urates,  hence  the 
value  of  lithium  salts  in  the  uric  acid  diathesis.  The  Carbonate  and 
Citrate  are  the  salts  referred  to  in  this  connection,  the  others  partaking 
more  of  the  qualities  of  their  acid  factors.  Both  these  salts  are  antacid 
and  strongly  diuretic,  the  Carbonate  being  but  slightly  soluble  is  given  in 
wafer  or  in  carbonic  acid  water,  and  the  Citrate  in  solution.  The  latter 
may  be  extemporaneously  prepared  by  adding  Citric  Acid  to  an  aqueous 
solution  of  the  Carbonate,  and  in  the  organism  is  decomposed,  the  citric 
acid  being  oxidized  and  the  carbonate  formed.  Many  mineral  waters 
contain  small  quantities  of  the  carbonate,  varying  from  a  mere  trace  to 
0.0 1  grain  to  a  pint,  an  amount  so  minute  as  to  be  practically  inert  in 
comparison  with  the  much  greater  quantities  of  potassium  and  sodium 
salts  in  the  same  waters. 

Therapeutics. 

The  Carbonate  and  Citrate  of  Lithium  are  extensively  used  in  gout 
and  the  lithcemic  diathesis,  for  the  purpose  of  holding  the  uric  acid  in 
solution  as  urate  of  lithium,  and  preventing  its  deposit  in  the  tissues  as 
urate  of  sodium  which  is  less  soluble.  Their  prolonged  administration  is 
so  efficient  in  this  affection  that  they  have  been  credited  with  the  power 
of  dissolving  uric  acid  calculi  and  called  lithontriptics.  They  are  also 
highly  useful  in  the  indigestion  and  rheumatism  of  obese  subjects,  and  in 
irritable  bladder  from  excess  of  acid  in  the  urine.  Lithiated  Arsenical 
Water  has  been  lately  praised  as  a  remedy  in  diabetes. 


LOBELIA,  Indian  Tobacco, — the  leaves  and  tops  of  Lobelia 
inflata  (nat.  ord.  Lobeliacese),  collected  after  a  portion  of  the  capsules 
have  become  inflated.  The  plant  is  a  common  annual  weed  growing  on 
roadsides  throughout  the  United  States,  having  pale-green,  alternate 
leaves,  a  single,  erect  and  very  hairy  stem,  with  hairy  branches  and  small, 
pale-blue  flowers,  odor  slight  but  irritating,  taste  at  first  mild,  afterwards 
burning  and  acrid.  It  contains  gum,  resin,  fixed  oil,  wax,  lignin,  salts  of 
lime,  potassium  and  iron,  a  liquid  alkaloid  Lobeline ,  which  is  the  narcotic 
principle  of  the  plant,  also  Lobelic  Acid ,  and  an  acrid  substance  named 
Lobelacrin. 

Preparations. 

Extractum  Lobelia  Fluidum , — Dose,  rrpj-x. 

Tinctura  Lobelia , — 20  per  cent.  Dose,  npv-xxx. 

Acetum  Lobelia , — 10  per  cent.  Dose,  rrpv-^j. 

Infusum  Lobelia  (Unofficial), —  3 j  to  a  pint.  Dose,  gj-gj. 

Lobelin  (Unofficial), — an  impure  resinoid.  Dose,  gr.  ss-j. 

Physiological  Action. 

Lobelia  has  an  acrid,  nauseous  taste,  and  a  heavy,  unpleasant  odor.  It 
is  expectorant,  diaphoretic,  emetic,  purgative,  antispasmodic,  motor- 


2/0 


LYCOPODIUM. 


depressant  and  narcotic.  It  excites  an  abundant  flow  of  saliva,  much 
gastric  mucus,  profuse  urination  and  sweating,  with  nausea,  vomiting  and 
great  depression.  The  heart’s  action  is  enfeebled,  and  the  blood-pressure, 
at  first  increased,  soon  falls;  muscular  debility,  reduced  temperature  and 
coma  follow,  and  death  occurs  by  paralysis  of  the  respiratory  apparatus. 
The  drug  produces  paralysis  of  the  motor  nerve-trunks,  the  peripheral 
vagi,  and  probably  the  respiratory  and  vaso-motor  centres  also.  It 
strongly  resembles  tobacco  in  its  action,  and  is  highly  dangerous  in  full 
medicinal  doses,  having  caused  many  deaths  when  administered  thera¬ 
peutically,  the  most  important  instance  of  its  fatal  results  being  the  case 
of  Ezra  Lovett,  Jr.,  who  in  1809  was  poisoned  by  Lobelia  administered 
by  the  founder  of  the  Thomsonian  sect  of  medical  practitioners.  The 
responsible  party  escaped  conviction  on  the  plea  that  he  gave  the  drug  in 
ignorance  of  its  qualities. 

Antidotes  and  Incompatibles. 

Tannic  Acid  to  form  the  insoluble  tannate.  Strychnine,  Picrotoxine  and  Thebaine 
antagonize  its  action  on  the  nervous  system  ; — the  vaso-motor  excitants,  as  Alcohol, 
Digitalis,  Belladonna,  Ergot,  etc.,  antagonize  its  effects  on  the  circulation.  Caustic 
alkalies  are  incompatible,  decomposing  the  alkaloid. 

Therapeutics. 

Lobelia  was  a  favorite  remedy  with  the  Indians  at  the  time  of  the  first 
settlement  of  the  LTiited  States,  and  was  introduced  into  regular  practice 
as  an  anti-asthmatic,  after  having  served  as  the  main  stock-in-trade  of  the 
irregular  practitioners  for  many  years.  Its  principal  therapeutic  action  is 
that  of  an  antispasmodic,  and  in  cautious  hands  it  is  extremely  useful  in 
paroxysmal  spasmodic  asthma,  as  well  as  in  dry  cough  with  constant  tick¬ 
ling  in  the  throat.  As  an  enema  in  cases  of  strangulated  hernia  the  infu¬ 
sion  is  much  safer  than  Tobacco  and  fully  as  efficient,  and  may  overcome 
the  obstruction  in  intussusception,  while  the  tincture  in  2-drop  doses  every 
hour  will  often  relieve  a  case  of  impacted  caecum.  In  constipation  from 
atony  and  deficient  secretion  a  10-minim  dose  of  the  tincture  at  bed¬ 
time  acts  excellently,  and  in  the  poison-oak  eczema  the  infusion  is  a  good 
local  application.  As  an  emetic  it  is  entirely  too  depressant  for  child¬ 
ren’s  use. 


LYCOPODIUM  , — is  a  very  mobile,  pale-yellow,  fine  powder,  con¬ 
sisting  of  the  sporules  or  seeds  of  the  Club-moss,  Lycopodium  ciavatum, 
and  of  other  species  of  Lycopodium  (nat.  ord.  Lycopodiaceae).  The 
plant  is  a  native  of  Europe  and  the  U.  S.,  has  a  trailing  stem  several  feet 
long,  with  smooth,  deep-green,  pointed  leaves,  flowers  in  terminal  spikes, 
and  yellow  capsules  which  contain  the  seeds.  Lycopodium  is  odorless, 
tasteless,  floats  on  water,  which  does  not  wet  it,  and  burns  quickly  when 


MAGNESIUM. 


271 


thrown  on  a  flame.  It  should  be  free  from  pine-pollen,  starch,  sand  and 
other  impurities,  which  are  detected  by  means  of  the  microscope,  the 
seeds  being  about  of  an  inch  in  diameter,  four-sided  and  reticulated, 
with  short  projections  on  the  edges.  They  contain  about  47  per  cent,  of 
a  bland,  fixed  oil. 

Physiological  Actions  and  Therapeutics. 

The  plant  was  formerly  considered  to  be  diuretic  and  anti-spasmodic, 
and  was  used  in  rheumatism,  epilepsy  and  pulmonary  and  renal  disorders. 
The  powder  is  now  employed  quite  extensively  in  pharmacy  to  facilitate 
the  rolling  of  a  pill-mass  and  to  prevent  adhesion  of  pills  to  each  other. 
It  makes  an  excellent  absorbent  and  protective  powder  when  dusted  over 
an  excoriated  surface,  as  seen  between  the  thighs  of  infants. 

By  the  homoeopathic  practitioners  Lycopodium  is  elevated  to  the  rank 
of  an  active  drug  when  triturated  with  sugar  of  milk  sufficiently  long  to 
break  up  the  seeds  and  liberate  their  oily  contents.  In  their  first  centesi¬ 
mal  trituration  (yxro)  it  is  said  to  have  produced  symptoms  of  high  excite¬ 
ment  of  the  circulation  and  irritation  of  the  urinary  organs,  and  they 
profess  to  use  it  with  benefit  in  many  affections  of  the  mucous  tracts,  dys¬ 
pepsia,  pyrosis,  flatulence,  constipation,  ileo-colitis  of  infants,  hepatic 
congestion,  aneurism,  chronic  affections  of  the  lungs  and  bronchi,  diph¬ 
theria,  lithiasis,  intertrigo,  porrigo  capitis,  plica  polonica  and  pruritus 
ani,  in  all  of  which  as  an  internal  remedy  and  in  high  attenuation. 


MAGNESIUM,  Mg. — This  metal  is  represented  by  its  Oxide,  Car¬ 
bonate,  Citrate,  Sulphate  and  Sulphite,  of  which  the  Sulphate  occurs 
native  in  sea-water,  caves,  etc.,  the  others  being  prepared  from  it.  The 
first  two  are  almost  insoluble  in  water  or  alcohol.  Its  salts  are  either  white 
or  colorless,  and  those  which  are  official  are  as  follows :  — 

Official  Salts  of  Magnesium. 

Magnesia ,  Light  Magnesia,  Oxide  of  Magnesium  MgO, — made  by  heating  the  light 
carbonate  in  a  crucible  to  expel  nearly  all  the  carbonic  acid.  A  white,  light  and  very  tine 
powder,  almost  insoluble  in  water,  insoluble  in  alcohol,  and  gelatinizes  with  1 5  of  water 
after  standing  yz  hour,  having  become  hydrated.  Is  a  constitutent  of  Pulvis  Rhei  Com- 
positus,  Massa  Copaibae  and  Ferri  Oxidum  Hydratum  cum  Magnesia.  Dose,  gr.  x-t4j. 

Magnesia  Ponderosa,  Heavy  Magnesia,  Oxide  of  Magnesium,  MgO, — is  a  white,  dense 
and  very  fine  powder,  corresponding  in  other  properties  and  reactions  with  Magnesia,  ex¬ 
cept  that  it  does  not  gelatinize  with  water.  It  is  made  by  calcining  the  heavier  variety  of 
the  carbonate,  and  is  much  slower  in  action  than  the  light  magnesia.  Dose,  gr.  x-^j. 

Magnesii  Cardonas ,  Carbonate  of  Magnesium,  (MgC03)4Mgi  H0)2.5H20, — light, 
friable  masses,  or  powder,  odorless  and  tasteless,  insoluble  in  alcohol,  almost  insoluble  in 
water.  Dose,  gr.  x-^j. 

Magnesii  Sulphas,  Sulphate  of  Magnesium,  Epsom  Salt,  MgS04-7H20, — colorless 
prisms  or  acicular  needles,  slowly  efflorescent,  odorless,  of  cooling,  saline  taste,  and  neu¬ 
tral  reaction,  very  soluble  in  water,  insoluble  in  alcohol.  Is  a  constituent  of  Infusum 
Sennas  Compositum.  Dose,  3  j—  3  j. 

Magnesii  Sulphis,  Sulphite  of  Magnesium,  MgS03.6H20, — a  white,  crystalline  pow- 


272 


MAGNESIUM. 


der,  becoming  oxidized  on  exposure  to  air,  of  sulphurous  and  slightly  bitter  taste,  and 
neutral  or  slightly  alkaline  reaction,  soluble  in  20  of  water,  insoluble  in  alcohol.  Dose, 
gr.  x-xxx. 

Preparations. 

Magnesii  Citras  Granulatus,  Granulated  Citrate  of  Magnesium, — prepared  from  the 
Carbonate  with  Citric  Acid,  Sugar,  Bicarbonate  of  Sodium,  Alcohol  and  Distilled  Water. 
A  coarsely  granular,  white  salt,  deliquescent,  of  acidulous  taste  and  acid  reaction,  soluble 
with  copious  effervescence  in  2  of  water,  insoluble  in  alcohol.  Dose,  :^ij- 2-j. 

Liquor  Alagnesii  Citratis , — prepared  from  the  Carbonate  gr.  200,  Citric  Acid  gr.  400, 
Syrup  of  Citric  Acid  gr.  1200,  Potassium  Bicarbonate  gr.  30,  Water  q.  s.  ad  5  xij.  Dose, 
3  iv-vj,  repeated  for  catharsis. 

Trochisci  Magnesii , — each  troche  contains  of  Magnesia  gr.  3,  Nutmeg  gr.  0.15,  with 
Sugar  and  Mucilage  of  Tragacanth.  Dose,  indefinite. 

Mistura  Magnesice  et  Asafcetidce ,  Dewees’  Carminative, — contains  of  the  Carbonate  5 
per  cent.,  Tincture  of  Asafoetida  7,  Tincture  of  Opium  I,  Sugar  10,  and  Distilled  Water 
77.  Dose,  g  ss-iv.  Used  for  flatulent  colic  and  diarrhoea  in  infants. 


Physiological  Action. 

Magnesia  and  the  Carbonate  of  Magnesium  are  mildly  laxative  and 
antacid,  neutralizing  free  acids  in  the  stomach  and  forming  therewith  lax¬ 
ative  salts.  If  used  in  large  quantity  for  any  length  of  time  it  may 
become  hydrated  and  produce  intestinal  concretions.  The  freshly-pre¬ 
cipitated  hydrate  (see  above,  Magnesia)  is  an  antidote  to  Arsenic  in 
solution,  but  less  effective  than  the  Hydrated  Sesquioxide  of  Iron,  with 
which  it  is  combined  in  the  official  Ferri  Ox.  Hydratum  cum  Magnesia. 
(See  ante ,  page  216.)  Magnesia  may  also  be  used  in  acid  or  phosphorus¬ 
poisoning. 

The  Citrate  and  Sulphate  are  saline  cathartics,  the  latter  being  the 
most  powerful,  producing  prompt  and  free  watery  discharges,  with  but 
little  griping  or  irritation,  but  frequently  a  sense  of  coldness  and  depres¬ 
sion.  The  purgative  action  is  chiefly  due  to  increase  of  the  intestinal 
fluids  by  an  outward  osmosis  from  the  vessels,  and  not  from  increase  of 
the  secretions  of  the  glandular  appendages.  If  the  purgative  action 
should  not  take  place  a  diuretic  one  will  result,  but  to  secure  the  desired 
catharsis  the  drug  should  be  administered  in  a  considerable  quantity  of 
water.  Sulphate  of  Magnesium  is  the  principal  aperient  constituent  of 
many  of  the  popular  laxative  mineral  waters,  as  Friedrichshall,  Piillna, 
Hunyadi,  etc. 

The  Sulphite  shares  the  actions  and  uses  of  the  other  sulphites,  and  is 
more  properly  considered  with  them.  (See  ante ,  page  73.) 

Therapeutics. 

Magnesia  and  the  Carbonate  are  used  as  antacids  and  laxatives,  in  acid¬ 
ity,  sick  headache,  flatulent  colic,  etc.,  and  as  antidotes  in  poisoning  by 
acids,  arsenic,  phosphorus,  mercuric  and  cupric  salts.  The  Citrate  is  an 
agreeable  laxative,  cooling  and  acceptable  to  the  stomach.  The  Sulphate 
is  the  most  efficient  of  the  saline  cathartics  and  has  a  wide  field  of  appli¬ 
cation.  In  acute  inflammatory  conditions,  renal  and  cardiac  dropsy, 


MAGNOLIA - MALTUM. 


273 


ascites  from  obstruction  of  the  portal  circulation,  increased  blood-pressure 
within  the  cranium,  intestinal  obstruction  without  acute  inflammation,  the 
constipation  of  lead  poisoning,  and  habitual  constipation  from  deficiency 
of  the  intestinal  secretions,  this  agent  will  be  found  to  be  exceedingly 
serviceable.  Acute  dysentery  is  well  treated  by  Magnesium  Sulphate 
combined  with  diluted  Sulphuric  Acid,  and  followed  by  Opium  and  starch 
enemata.  Bleeding  from  hemorrhoids  and  uterine  hemorrhage  are  often 
relieved  by  the  same  combination  when  other  agents  fail.  The  ferro- 
saline  mixture  (see  ante ,  page  218)  is  a  very  useful  laxative  in  the  consti¬ 
pation  of  anaemic  women.  The  bitter  taste  of  Epsom  Salt  is  best  covered 
by  coffee. 


MAGNOLIA  , — is  the  bark  of  Magnolia  glauca  (Sweet  Bay,  Swamp 
Sassafras),  A/,  acuminata  (Cucumber-tree),  and  M .  tripetala  (Umbrella- 
tree),  all  of  which  belong  to  the  nat.  ord.  Magnoliaceae,  and  are  indi¬ 
genous  to  the  eastern  and  southern  States.  It  occurs  in  quilled  or  curved 
pieces,  of  orange-brown  color  externally,  whitish  or  a  pale-brown  inter¬ 
nally,  taste  astringent,  pungent  and  bitter.  It  contains  a  crystalline  prin¬ 
ciple  named  Magnolin ,  which  is  insoluble  in  water,  but  soluble  in  alcohol, 
ether,  etc.  Dose  of  the  powdered  bark,  5  ss— j .  There  are  no  official 
preparations. 

Physiological  Action  and  Therapeutics. 

Magnolia  is  an  aromatic  bitter  tonic  and  diaphoretic,  usefully  employed 
in  chronic  rheumatism,  remittent  and  intermittent  fevers.  In  the  latter 
affection  it  will  arrest  the  paroxysms  if  used  freely. 


MALTUM,  Malt  , — is  the  seed  of  Hordeum  distichum ,  Barley  (nat. 
ord.  Graminacese),  caused  to  enter  the  incipient  stage  of  germination  by 
artificial  means  and  dried.  The  germination  is  allowed  to  go  far  enough 
to  develop  the  maximum  amount  of  Diastase ,  the  peculiar  ferment  by 
which  the  starch  of  the  grain  is  converted  into  Glucose.  Malt  is  the 
source  of  beer,  ale  and  whiskey,  and  is  composed  .of  the  germinated,  dead 
grains  with  their  acrospires  and  radicles.  It  should  be  fresh,  not  darker 
in  color  than  a  pale  amber,  and  of  agreeable  odor  and  sweet  taste. 


Preparations. 

Extractum.  Malti , — a  liquid  of  the  consistence  of  thick  honey,  containing  all  the 
soluble  principles  of  malt  in  permanent  form.  It  consists  chiefly  of  diastase  and  glucose. 
Dose,  ^j-iv. 

Ilorlick' s  Food  (Unofficial), —  is  like  Mellin’s  and  many  other  foods  for  children,  a 
granulated  Extract  of  Malt.  Hoff' s  Malt  Extract  is  another  such  preparation,  contain¬ 
ing  alcohol,  and  corresponding  to  a  concentrated  beer. 

18 


MANACA - MANGANUM. 


274 


Physiological  Action  and  Therapeutics. 

Malt  Extract  is  directly  nutritive,  containing  good  food  elements,  and 
indirectly  so  from  the  presence  of  the  ferment  Diastase,  which  converts 
the  starch  of  bread  or  other  farinas  into  sugar.  It  is  usefully  employed 
in  wasting  diseases,  and  mixed  with  milk  or  oleaginous  foods  it  aids  their 
digestion  and  assimilation.  It  may  be  used  to  form  a  syrupy  mixture 
with  preparations  of  Iron  or  Cinchona. 


MANACA  (Unofficial), — is  the  root  of  Franciscea  utiiflora ,  a  shrub 
of  the  nat.  ord.  Scrophulariaceae,  indigenous  to  Brazil,  where  it  is  known 
as  Mercurio-vegetal,  or  Vegetable  Mercury,  a  name  applied  by  charlatans 
to  a  number  of  widely  differing  plants.  Very  little  is  known  about 
Manaca,  but  it  is  extensively  advertised  as  an  unfailing  remedy  for  sub¬ 
acute  and  chronic  rheumatism.  It  is  also  considered  purgative,  diuretic, 
emmenagogue  and  antisyphilitic,  being  official  in  the  Brazilian  Dispensa¬ 
tories,  and  noticed  as  follows  in  the  Diet .  de  Botan.  Brazileira. 

“  This  whole  plant,  but  especially  the  root,  excites  powerfully  the  lymphatic  system, 
eliminating  morbid  matter  by  the  skin  and  kidneys.  It  is  antisyphilitic ;  the  interior  bark 
is  nauseating  and  stimulates  the  throat.  In  small  doses  it  is  resolvent;  in  larger  purga¬ 
tive,  diuretic  and  emmenagogue.  In  large  doses  it  is  an  acrid  poison.” 

A  fluid  extract  is  on  the  market,  the  average  dose  of  which  is  14, x  three 
or  four  times  daily. 


MANGANUM,  Manganese,  Mn. — This  metal  is  represented  in 
the  Pharmacopoeia  by  two  of  its  salts,  viz. — the  native  Black  Oxide  and 
the  Sulphate,  as  follows, — 

Alangani  Oxidum  Nigrum ,  Black  Oxide  of  Manganese,  Dioxide  of  Manganese, — is 
native,  crude  Binoxide  of  Manganese,  containing  at  least  66  per  cent,  of  the  pure  Oxide, 
Mn02.  A  heavy,  grayish  black  powder,  odorless  and  tasteless,  insoluble  in  water  or  alco¬ 
hol,  giving  off  oxygen  gas  at  a  red  heat,  and  if  heated  with  hydrochloric  acid  it  causes 
the  evolution  of  chlorine  gas.  Is  used  in  preparing  Chlorine  Water.  Dose,  gr.  ij-x. 

Alangani  Sulphas ,  Sulphate  of  Manganese,  MnS04-4H20. — colorless  prisms,  of 
slightly  bitter  and  astringent  taste,  faintly  acid  reaction,  very  soluble  in  wafer,  insoluble  in 
alcohol.  Dose,  gr.  ij-v. 

Preparations. 

Potassii  Permanganas ,  Permanganate  of  Potassium,  K2Mn208, — deep,  purple-violet 
prisms,  of  sweet  and  astringent  taste,  neutral  reaction,  soluble  in  20  of  water  with  a 
scanty,  brown  residue,  decomposed  by  alcohol.  It  should  be  kept  in  well-stoppered 
bottles,  and  should  not  be  triturated  nor  combined  in  solution  with  organic  or  readily 
oxidizable  substances.  Dose,  gr.  ss-ij,  in  distilled  water. 

Syrupus  Alangani  Iodidi ,  .Syrup  of  the  Iodide  of  Manganese  (Unofficial), — contains 
about  3 j  of  the  iodide  in  each  3.  Dose,  rtpx-xxx.  For  formula  see  U.  S.  D.,  page 
1691. 

Syrupus  Ferri  et  Alangani  Iodidi ,  Syrup  of  the  Iodide  of  Iron  and  Manganese  (Un¬ 
official), — each  3  contains  gr.  50  of  the  mixed  iodides  in  the  proportion  of  3  of  the 
Iodide  of  Iron  to  1  of  that  of  Manganese.  Dose,  npx-xxx.  For  formula  see  U.  S.  D., 
page  1692. 


MANGANUM. 


275 


Fern ’  et  Mangani  Carbonas  Saccharatits ,  Saccharated  Carbonate  of  Iron  and  Man¬ 
ganese  (Unofficial), — is  a  tasteless,  reddish-brown  powder.  Dose,  gr.  v-xx.  For  formula 
see  U.  S.  D.,  page  1693. 

Physiological  Action. 

The  salts  of  Manganese  in  small  doses  improve  the  appetite  and  the 
digestion  and  stimulate  the  action  of  the  heart.  Used  in  larger  doses  and 
for  considerable  length  of  time  they  lower  the  heart’s  action,  paralyze  the 
muscular  system,  especially  the  muscular  coat  of  the  arteries,  causing  pro¬ 
gressive  wasting,  paraplegia,  and  acute  fatty  degeneration  of  the  liver. 
They  are  gastro-intestinal  irritants,  and  the  Sulphate  is  emeto -cathartic 
and  decidedly  cholagogue.  Manganese  is  closely  associated  with  Iron  in 
the  blood,  bile,  etc.,  in  the  proportion  of  about  1  to  20.  The  Black 
Oxide  is  an  efficient  emmenagogue. 

Permanganate  of  Potassium  is  an  active  oxidizer,  containing  as  it 
does  a  large  proportion  of  oxygen  which  it  yields  very  readily  in  the  form 
of  ozone,  and  then  becomes  the  binoxide  of  manganese.  This  property 
gives  it  the  qualities  of  an  antiseptic,  a  disinfectant  and  a  deodorant.  It 
is  considered  by  some  authorities  to  be  an  efficient  emmenagogue.  Used 
internally  it  must  be  instantly  decomposed  in  the  stomach,  and  probably 
is  not  absorbed  in  its  own  state. 

Therapeutics. 

The  salts  of  Manganese  are  used  by  those  practitioners  who  affect  to  see 
a  manganese-anaemia  in  cachectic  subjects,  and  they  are  always  combined 
with  ferric  preparations.  In  amenorrhoea,  gastrodynia  and  pyrosis  the 
purified  oxide  is  a  good  remedy  in  doses  of  10  to  15  grains,  and  the  same 
preparation  is  used  as  an  ointment  in  many  skin  diseases.  In  jaundice  of 
malarial  origin  or  catarrh  of  the  biliary  passages  the  sulphate  gives  good 
results. 

Permanganate  of  Potassium  is  used  as  an  antiseptic  and  oxidizing  agent 
in  diphtheria,  scarlatina,  septicaemia,  erysipelas,  etc.,  given  internally  and 
used  locally  at  the  same  time.  It  is  given  with  apparent  benefit  in  dys¬ 
pepsia,  flatulence,  lithaemia  and  obesity,  and  has  often  seemed  to  be  of 
service  in  acute  rheumatism.  In  amenorrhoea  it  is  reported  to  be  very 
efficient,  and  has  lately  been  used  with  success  as  a  remedy  for  the  bites 
of  venomous  serpents  and  for  other  animal  poisons.  Locally  it  is  fre¬ 
quently  employed  (5  j  to  the  pint)  to  correct  fetor  in  cancer,  ulcer,  caries, 
abscesses,  ozaena,  and  it  will  destroy  the  odor  of  a  foul  breath  or  that  of 
the  fetid  perspirations  of  the  feet.  It  is  used  both  as  a  test  and  as  a  cor- 
rigent  for  organic  impurities  in  drinking-water. 

Manganese  is  becoming  more  of  an  acknowledged  remedy  in  derange¬ 
ments  of  the  menstrual  function,  as  irregular  or  scanty  menstruation,  amen¬ 
orrhoea,  menorrhagia,  and  even  metrorrhagia.  By  some  authorities,  the 
emmenagogue  power  of  Potassium  Permanganate  is  ascribed  to  its  large 


276 


MANGO - MANNA. 


proportion  of  Oxygen,  which  it  is  supposed  to  give  up  to  the  uterus ;  as, 
until  recently,  Potassium  Chlorate  was  supposed  to  do  by  the  system  at 
large.  According  to  the  views  of  others  who  have  studied  its  action,  Man¬ 
ganese  should  be  classed  with  the  excito-motors ,  increasing  arterial  ten¬ 
sion,  and  specifically  acting  upon  the  uterus.  The  best  preparation  is  the 
Binoxide ,  in  freshly-made  pills  of  two  grains  each,  of  which  1  to  3  or  5 
pills  may  be  taken  twice  or  thrice  daily.  The  Permanganate  of  Potassium 
has  generally  been  the  preparation  given  when  the  effects  of  Manganese 
were  desired;  but  as  it  causes  great  gastric  irritability,  with  abdominal 
pains  and  burning  sensations,  besides  other  decidedly  unpleasant  symp¬ 
toms,  it  is  a  difficult  matter  to  get  patients  to  take  it  for  any  length  of 
time. 


MANGO  (Unofficial), — is  the  bark  of  Mangifera  indica,  an  Indian 
tree  of  the  nat.  ord.  Guttiferae.  It  is  supposed  to  be  an  astringent  with 
special  tonic  action  upon  mucous  membranes.  It  is  highly  recommended 
by  its  vendors  for  nasal  catarrh,  hemorrhages,  and  muco-purulent  dis¬ 
charges  from  the  intestines,  uterus,  vagina  and  bronchi.  A  fluid  extract 
is  sold,  which  may  be  used  in  doses  of  npx-5j. 

Mango-Fruit  or- Mangosteen,  is  the  fruit  of  Garcinia  mangostana ,  nat.  ord.  Guttiferae, 
also  from  India.  It  is  a  powerful  astringent,  and  is  used  for  nasal  catarrh,  diarrhoeas, 
dysentery,  leucorrhoea,  etc. 


MANNA  , — is  the  concrete,  saccharine  exudation  of  Fraxinus  Ornus, 
or  Flowering  Ash,  a  tree  of  the  nat.  ord.  Oleacese,  growing  in  Southern 
Europe.  Manna  is  produced  also  by  several  other  trees,  and  substances 
resembling  it  are  exuded  by  many  plants.  The  official  Manna  occurs  in 
three-edged,  fiattish  pieces,  brownish-white  and  glutinous  externally,  white 
and  crystalline  internally,  odor  honey-like,  taste  sweet,  slightly  bitter  and 
faintly  acrid.  It  contains  from  40  to  90  per  cent,  of  Mannit ,  C6Hu06, 
or  Manna-sugar,  which  does  not  undergo  vinous  fermentation,  and  is 
chemically  allied  to  the  alcohols  and  to  glycerin.  Manna  also  contains 
glucose,  mucilage,  some  acrid  resin,  and  a  small  quantity  of  the  fluores¬ 
cent  glucoside  Fraxin ,  C16H18O10.  There  are  no  official  preparations,  but 
Manna  itself  may  be  given  in  doses  of  3  j — ij. 

Physiological  Action  and  Therapeutics. 

Manna  is  a  mild  laxative,  with  some  tendency  to  produce  flatulence 
and  colic.  It  is  usually  combined  with  other  purgatives,  as  Senna,  Rhu¬ 
barb,  Magnesia,  etc.,  to  disguise  the  taste  and  increase  the  effect.  It  is 
a  constituent  of  the  official  Infusum  Sennse  Compositum.  Manna  may 
be  eaten  by  children  if  of  good  quality,  or  may  be  readily  dissolved  in 
milk  and  so  administered. 


MARRUBIUM - MASTICHE - MATICO. 


277 


MARRUBIUM,  Horehound, — the  leaves  and  tops  of  Marrubiutn 
vulgare,  a  plant  of  the  nat.  ord.  Labiatae,  native  in  Europe,  but  natural¬ 
ized  in  America.  It  contains  a  bitter  principle  named  Marrubiin ,  also  a 
volatile  oil,  resin,  tannin,  lignin,  etc.  There  are  no  official  preparations. 
Dose,  3ss-j. 

Physiological  Action  and  Therapeutics. 

Horehound  in  large  doses  is  laxative,  diuretic  and  diaphoretic,  and  in 
ordinary  dosage  it  is  a  gentle  tonic  and  stomachic.  It  is  generally  used 
in  catarrhal  states  of  the  air-passages,  over  which  it  seems  to  have  a  sooth¬ 
ing  effect,  and  is  much  employed  in  confectionery  as  an  ingredient  in 
“  cough-drops.” 


MASTICHE,  Mastic,  — is  a  concrete,  resinous  exudation  from 
Pistacia  Lentiscus ,  a  tree  of  the  nat.  ord.  Terebinthaceae,  growing  in  the 
island  of  Scio.  It  occurs  in  globular  tears,  covered  with  a  whitish  dust, 
of  weakly  resinous  odor  and  slightly  terebinthinate  taste.  Alcohol  dis¬ 
solves  about  90  per  cent,  including  the  resin  Mastichic  Acid ,  C20H32O3, 
the  remainder  consisting  of  another  resin  Mastichin ,  which  is  soluble  in 
ether  and  resembles  copal.  There  are  no  official  preparations,  but  Mastic 
is  an  ingredient  of  the  official  Pil.  Aloes  et  Mastiches  (see  ante ,  page  90). 

Physiological  Action  and  Therapeutics. 

Mastic  was  formerly  used  for  supposed  properties  analogous  to  those  of 
other  oleo-resins,  but  now  its  application  is  confined  to  dentistry,  being 
employed  as  a  temporary  filling  for  carious  teeth,  a  solution  in  ether  being 
applied  on  cotton  with  moderate  pressure,  and  remaining  as  a  firm  plug 
after  evaporation  of  the  solvent. 


MATICO, — the  leaves  of  Artanthe  elongata  (Piper  angustifolium),  a 
Peruvian  shrub  of  the  nat.  ord.  Piperaceae.  They  are  4  to  6  inches  long, 
and  prominently  venated  on  the  under  surface,  the  veins  forming  deep, 
angular  meshes.  Matico  contains  a  crystallizable  acid  named  Artanthic 
Acid ,  also  resin,  tannin,  and  a  volatile  oil.  Its  odor  is  aromatic,  and  its 
taste  astringent,  spicy  and  somewhat  bitter. 

Preparations. 

Extractum  Matico  Fluidum , — Dose,  g  ss-ij. 

Tinctura  Matico, — 10  per  cent.  Dose,  ss-ij. 

Physiological  Action  and  Therapeutics. 

Matico  is  an  aromatic  tonic  and  stimulant,  also  aphrodisiac,  vulnerary 
and  hemostatic.  It  acts,  like  cubebs,  on  the  urinary  passages,  and  is  an 
excellent  alterative  stimulant  to  mucous  membranes.  It  has  been  used 


278 


MATRICARIA - MEL. 


with  considerable  success  in  mucous  catarrhs,  as  gonorrhoea,  leucorrhcea, 
chronic  cystitis,  etc.,  also  in  epistaxis,  hemorrhoids  menorrhagia,  hemop¬ 
tysis,  hematemesis  and  other  hemorrhages.  The  under  surface  of  the  leaf 
is  so  formed  as  to  promote  coagulation  of  blood  if  applied  to  a  bleeding 
surface,  and  therefore  it  is  a  good  local  hemostatic  for  trivial  cuts  or 
wounds. 


MATRICARIA,  German  Chamomile, — the  flower-heads  of 
Matricaria  Chamomilla ,  a  European  annual  plant  of  the  nat.  ord.  Com¬ 
posite.  They  are  small,  yellow  flowers,  with  white  rav-florets,  the  recep¬ 
tacle  being  hollow,  naked  and  conical,  of  strongly  aromatic  odor  and 
bitter  taste  ;  and  contain  *^th  per  cent,  of  a  blue  Volatile  Oil  (the  color 
of  which  is  due  to  Azulen ),  also  a  bitter  extractive,  tannin,  etc.  There  are 
no  official  preparations,  but  the  flowers  maybe  eaten  or  a  decoction  or  in¬ 
fusion  used  almost  ad  libitum . 

Physiological  Action  and  Therapeutics. 

Matricaria  is  a  mild  tonic,  in  large  doses  emetic,  anthelmintic  and 
antispasmodic.  It  is  much  used  in  Germany,  and  in  this  country  is  a 
popular  domestic  remedy  among  German  people,  who  use  it  in  infusion  as 
a  diaphoretic,  etc.  This  plant  is  the  “  Chamomilla  ”  of  the  homoeopaths, 
who  find  in  it  remarkable  power  over  morbid  impressionability  of  the 
sensory  and  excito-motor  nerves,  and  administer  it  in  various  pains,  aggra¬ 
vated  at  night  and  by  warmth,  clonic  spasms  of  pregnancy,  irritability  of 
teething-children,  flatulent  colic,  etc. 


MEL,  Honey, — is  a  saccharine  secretion  deposited  in  the  honey¬ 
comb  by  Apis  mellifica ,  the  honey-bee  ;  occurring  as  a  pale-yellowish, 
syrupy  liquid,  gradually  becoming  crystalline  and  opaque,  of  peculiar  and 
heavy  odor,  and  a  very  sweet,  faintly  acrid  taste.  It  is  a  strong  aqueous 
solution  of  several  sugars  (cane  and  grape  sugar,  levulose),  with  wax- 
pollen,  coloring  and  odorous  matters,  etc.  The  sugars,  which  may  be 
resolved  into  Levulose  and  Dextrose,  amount  to  70  or  80  per  cent. 
Honey  is  frequently  adulterated  with  starch  and  artificial  glucose,  which 
maybe  detected  by  the  official  tests  (see  U.  S.  Phar.).  Dose  indefinite. 


Preparations. 

Mel  Despumatum,  Clarified  Honey, — is  honey  heated,  skimmed  and  strained.  It 
is  an  ingredient  of  Confectio  Rosie,  Mel  Rosie,  and  Massa  Ferri  Carbonatis.  Dose, 
indefinite. 

Mel  Rosa,  Honey  of  Rose, — Red  Rose  8,  Clarified  Honey  93,  Diluted  Alcohol  q.  s. 
Dose,  indefinite ;  generally  used  as  a  local  application  to  the  throat  for  its  astringency  and 
flavor,  in  combination  with  more  active  agents. 


MELISSA - MENISPERMUM - MENTHA  PIPERITA. 


279 


Physiological  Action  and  Therapeutics. 

Honey  is  emollient,  nutritive  and  laxative,  in  some  persons  giving  rise 
to  pyrosis,  flatulence  and  colic,  and  in  others  to  an  eruption  of  urticaria, 
but  generally  constituting  an  agreeable  article  of  diet.  It  is  sometimes 
actually  poisonous  from  the  presence  of  toxic  agents  extracted  by  the  bee 
from  certain  plants,  in  this  country  generally  the  Mountain  Laurel 
(. Kalmia  Latifolia).  Honey  is  chiefly  used  as  an  emollient  in  diseases  of 
the  throat,  to  relieve  dryness,  pain,  cough  and  dysphagia.  A  mixture  of 
Honey  8  parts  to  1  each  of  Acetic  Acid  and  Water  is  official  in  the  Br. 
Phar.  under  the  title  Oxymel,  and  forms  a  pleasant  addition  to  gargles  or 
a  vehicle  for  expectorant  medicines.  Honey  of  Rose  is  somewhat  astrin¬ 
gent,  and  is  used  in  gargles  for  the  throat  and  in  mouth  washes. 

MELISSA,  Balm, — the  leaves  and  tops  of  Melissa  officinalis ,  a 
European  plant  of  the  nat.  ord.  Labiatae,  growing  also  in  America.  It 
has  a  perennial  root,  which  annually  gives  forth  several  stems  from  1  to  2 
feet  high,  with  leaves  about  two  inches  long,  deeply  serrate,  hairy  and 
glandular,  and  white  or  yellowish  flowers  in  axillary  whorls  of  four  or  five 
around  half  the  stem.  It  contains  gum,  tannin,  bitter  extractive,  and  a 
fragrant  essential  oil  in  very  small  quantity  {pffi  to  per  cent.).  There 
are  no  official  preparations. 

Physiological  Action  and  Therapeutics. 

Balm  has  little  or  no  action,  except  to  flavor  hot  water  for  use  as  a 
beverage  or  a  mild  diaphoretic. 

MENISPERMUM,  — is  the  rhizome  and  rootlets  of  Menispermum 
canadense ,  or  Canadian  Moonseed,  a  woody,  climbing  plant  of  the  nat. 
ord.  Menispermaceae,  native  of  the  eastern  U.  S.,  having  peltate  three-  to 
seven-lobed  leaves,  greenish-yellow  flowers  in  small  clusters,  and  a  kidney¬ 
shaped  fruit.  The  rhizome  is  several  feet  long,  %  inch  thick,  finely 
wrinkled,  rootlets  numerous,  taste  bitter.  It  contains  starch,  Berberine, 
and  a  white  alkaloid  which  is  soluble  in  alcohol  and  in  ether.  There  are 
no  official  preparations.  Dose,  gr.  v-xx,  in  infusion. 

Physiological  Action  and  Therapeutics. 

Menispermum  is  reputed  to  have  tonic  properties,  and  is  used  in  some 
of  the  Southern  States  in  domestic  practice  as  a  substitute  for  Sarsa¬ 
parilla  in  scrofulous  conditions.  Little  is  known  about  it  of  a  definite 
character. 

MENTHA  PIPERITA,  Peppermint, — the  leaves  and  tops  of 
Mentha  piperita ,  a  perennial  herbaceous  plant,  of  the  nat.  ord.  Labiatae, 


28o 


MENTHA  PIPERITA. 


native  of  Britain,  but  largely  cultivated  elsewhere.  The  leaves  are  about 
2  inches  long,  ovate-lanceolate,  sharply  serrate,  of  aromatic  odor,  and 
pungent,  cooling  taste.  They  contain  i  to  per  cent,  of  a  Volatile 
Oil  which  is  official,  and  a  little  tannin. 


Preparations. 

Oleum  Menthce  Piperitce,  Oil  of  Peppermint, — is  the  volatile  oil  distilled  from  the  fresh 
herb  ;  a  colorless  or  pale  yellow  fluid  of  sp.  gr.  about  0.900,  having  the  odor  of  pepper¬ 
mint,  a  strongly  aromatic  taste  followed  by  a  cold  sensation  when  air  is  drawn  into  the 
mouth.  It  consists  of  a  liquid  terpene,  and  a  stearoptene  named  Menthol  or  Peppermint 
Camphor ,  C10H20O.  Dose,  rr\j-v. 

Aqua  Menthce  Piperitce ,  Peppermint  Water, — has  of  the  oil  2  parts  in  1000  of  Distilled 
Water.  Dose,  indefinite. 

Spiritus  Menthce  Piperitce ,  Essence  of  Peppermint, — is  an  alcoholic  solution  containing 
10  per  cent,  of  the  Oil  and  1  per  cent,  of  the  powdered  herb.  Is  an  ingredient  of  Mistura 
Rhei  et  Sodae.  Dose,  rtpx-xxx. 

Trochisci  Menthce  Piperitce,  Peppermint  Troches, — each  troche  contains  gr.  yLL-  of  the 
Oil,  with  Sugar  and  Mucilage  of  Tragacanth.  Dose,  indefinite. 

Menthol,  Peppermint  Camphor,  C10H20O  (Unofficial), — is  a  stearoptene  deposited  by 
Oil  of  Peppermint  on  exposure  to  cold.  Used  externally. 


Physiological  Action. 

Peppermint  is  an  aromatic  stimulant,  carminative  and  antispasmodic. 
The  oil  possesses  these  qualities  in  greater  degree  and  is  also  a  local  ano¬ 
dyne  and  anaesthetic  when  applied  locally,  especially  if  its  evaporation  be 
prevented.  The  Chinese  oil  is  particularly  anodyne  and  contains  a  large 
quantity  of  Menthol.  The  oil  is  best  administered  internally  in  its 
alcoholic  solution,  the  spirit.  Menthol  is  antiseptic  and  locally 
anaesthetic,  but  not  corrosive,  and  acts  also  as  a  vascular  stimulant  when 
applied  to  the  surface. 

Therapeutics. 

Peppermint  is  used  internally  for  the  relief  of  nausea  and  colic,  and 
to  expel  flatus  by  its  local  stimulant  and  after  sedative  action  on  the 
bowels.  It  is  an  agreeable  corrigent  for  combination  with  purgatives  to 
prevent  griping,  and  efficiently  covers  the  taste  of  many  nauseous  sub¬ 
stances.  The  spirit  is  the  best  form  for  internal  use.  The  oil  is  used 
locally  to  relieve  the  pain  of  superficial  neuralgia,  a  cloth  being  wet  with 
it,  laid  along  the  course  of  the  affected  nerve,  and  covered  with  oiled  silk 
to  restrain  evaporation.  It  is  also  efficient  in  rheumatism  as  an  anodyne 
counterirritant.  Menthol  is  highly  vaunted  as  an  external  application  in 
various  neuralgiae,  sciatica,  pleurodynia,  toothache,  etc.  For  neuralgia  it 
is  used  in  saturated  alcoholic  solution  painted  over  the  affected  nerve. 
For  toothache  a  crystal  introduced  into  the  carious  cavity  is  promptly  ano¬ 
dyne.  As  an  antiseptic  it  promises  well  as  an  application  in  parasitic  skin- 
diseases.  As  the  Chinese  have  used  their  Oil  of  Peppermint  for  ages  as  an 
application  in  neuralgiae,  and  as  this  oil  contains  a  large  quantity  of  Menthol, 
the  latter  preparation  will  probably  prove  a  very  efficient  agent  in  these  affec¬ 
tions  if  the  cupidity  of  the  manufacturers  will  allow  of  its  being  obtained  pure. 


MENTHA  VIRIDIS - MEZEREUM. 


28l 


MENTHA  VIRIDIS,  Spearmint,-  the  leaves  and  tops  of  Men¬ 
tha  viridis,  the  “mint”  of  the  kitchen  garden,  a  plant  of  the  nat.  ord. 
Labiatse,  indigenous  to  England,  but  naturalized  in  many  countries.  Its 
constituents  and  properties  are  identical  with  those  of  peppermint,  but  its 
odor  and  taste  differ  therefrom. 


Preparations . 

Oleum  Menthce  Viridis ,  Oil  of  Spearmint, — is  the  Volatile  Oil  distilled  from  the  plant. 
Dose,  rtpij-v. 

Aqua  Alenthce  Viridis,  Spearmint  Water, — has  2  parts  of  the  Oil  in  1000  of  Distilled 
Water.  Dose,  indefinite. 

Spiritus  Menthce  Viridis,  Essence  of  Spearmint, — is  an  alcoholic  solution  containing 
10  per  cent,  of  the  Oil  and  1  per  cent,  of  the  powdered  herb.  Dose,  npx-xl. 

Physiological  Action  and  Therapeutics. 

Spearmint  corresponds  in  action  to  Peppermint,  but  is  generally  less 
powerful.  It  is  usually  employed  to  correct  flatulence  and  to  relieve 
colic,  and  makes  an  agreeable  flavoring  for  many  mixtures. 


MEZEREUM,  Mezereon, — is  the  bark  of  Daphne  Mezereum  and 
of  other  species  of  Daphne,  plants  of  the  nat.  ord.  Thymelaceae,  growing 
in  mountainous  districts  of  Europe  and  Asia  and  cultivated  as  a  garden 
shrub  in  Britain.  The  bark  occurs  in  long,  thin  bands,  rolled  into  disks, 
brownish-yellow  on  the  surface,  whitish  and  silky  within,  inodorous,  very 
acrid.  It  contains  an  inert,  fixed  oil,  an  inactive  glucoside  Daphnin  and 
an  acrid  Resin,  which  is  the  anhydride  of  a  resinous  acid  named  Meze - 
reinic  Acid.  Mezereum  is  an  ingredient  of  the  compound  decoction  and 
the  compound  fluid  extract  of  Sarsaparilla.  Dose,  gr.  j-x. 

Preparations. 

Extractum  Mezerei , — is  only  used  to  prepare  the  Linimentum  Sinapis  Compositum. 

Extractum  Mezerei  Fluidum, — is  too  acrid  for  internal  use,  but  from  it  is  prepared  the 
following. 

Unguentum  Mezerei, — has  of  the  preceding  25  parts,  Lard  80,  Yellow  Wax  12.  An 
irritant  ointment. 

Physiological  Action. 

Mezereon  is  a  sialogogue,  and  an  intensely  acrid,  irritant  poison,  pro¬ 
ducing  violent  vomiting,  purging,  nephritis  and  gastro-enteritis.  In  small 
doses  it  is  laxative  and  diuretic,  and  has  had  considerable  reputation  as 
an  alterative.  Externally  the  recent  bark  is  a  powerful  local  irritant, 
speedily  producing  vesication. 

Therapeutics. 

Mezereon  is  rarely  used  internally  by  itself,  but  is  employed  in  mix¬ 
tures  with  Sarsaparilla,  etc.,  as  an  alterative  in  syphilis,  rheumatism  and 
some  skin  diseases  of  chronic  type,  but  with  doubtful  efficacy.  It  has 
been  used  with  good  effect  in  toothache  and  as  a  masticatory  in  paralysis 


282 


MORRHU/E  OLEUM. 


of  the  tongue.  Its  principal  use  is  as  a  local  irritant  to  keep  up  the  dis¬ 
charge  from  issues  or  blisters,  and  to  stimulate  indolent  ulcers. 


MORRHUiE  OLEUM,  Cod-liver  Oil, — is  a  fixed  oil  obtained 
from  the  fresh  livers  of  Gadus  Morrhua  (Cod-fish)  or  other  species  of 
Gadus.  It  is  a  colorless  or  pale  yellow,  thin,  oily  liquid,  of  slightly  fishy 
odor  and  taste,  and  faintly  acid  reaction,  soluble  in  ether;  sp.  gr.  0.920 
to  0.925.  It  consists  chiefly  of  Olein  and  Margarin ,  with  a  peculiar  prin¬ 
ciple  named  Gaduin ,  also  Trimethylamine,  free  fatty  Acids  (oleic,  pal¬ 
mitic,  stearic),  traces  of  Iodine,  Bromine,  Sulphuric  and  Phosphoric  Acids, 
the  ordinary  inorganic  salts  of  animal  tissue  and  products,  and  perhaps 
bile  constituents.  When  saponified  it  does  not  yield  Glycerin  but  Oxide 
of  Propyl.  Three  kinds  or  varieties  are  found  in  the  market,  the  pale, 
the  light-brown  and  the  dark.  The  pale  is  the  official  oil  and  the  purest. 
Dose,  3j-ij>  on  a  full  stomach,  increased  as  assimilated. 

Unofficial  Preparation. 

Glyconin  Et?mlsion  of  Cod-liver  Oil, — 01.  Morrhuse  3  iv,  Glyceritum  Vitelli  3  ix, 
Aromatic  Spirit  of  Ammonia  ^j,  Sherry  Wine  ^ij,  Diluted  Phosphoric  Acid  3 iv,  Es¬ 
sence  of  Bitter  Almond  ( 3 j  of  the  Volatile  Oil  in  Oss  Alcohol)  £ij.  The  Cod-liver  Oil 
is  to  be  added  to  the  Glyconin  very  slowly  with  brisk  stirring,  and  the  other  ingredients 
added  in  the  order  named. 

Physiological  Action. 

The  action  of  Cod-liver  Oil  is  that  of  any  other  fat,  except  that  it  is 
more  easily  assimilated  than  any  member  of  the  class.  Fats  in  small  quan¬ 
tity  are  necessary  for  the  digestion  of  nitrogenous  food,  and  form  the 
molecular  basis  of  the  chyle,  being  prepared  for  absorption  by  the  pancre¬ 
atic  juice  and  the  bile,  especially  by  the  latter.  Fat  is  an  essential  con¬ 
stituent  of  the  products  of  tissue  formation,  whether  physiological  or  path¬ 
ological,  and  is  the  principal  material  concerned  in  the  production  of 
force.  After  oxidation  it  is  excreted  as  carbonic  acid  and  water.  Lo¬ 
cally  applied  fats  reduce  the  body  temperature. 

Cod-liver  Oil  is  the  most  easily  digestible  of  fats,  penetrating  animal 
membranes  with  comparative  ease  after  being  emulsified  by  the  pancreatic 
and  biliary  secretions,  hence  entering  the  lacteal  vessels  readily  and  ap¬ 
pearing  to  bring  with  it  the  oily  and  nitrogenous  elements  of  the  food. 
The  result  is  facilitation  of  the  digestive  process,  increase  of  the  red 
blood-corpuscles  and  of  the  body-weight,  and  stimulation  of  healthy  cell- 
formation  throughout  the  tissues.  The  properties  of  this  oil  have  been 
ascribed  to  its  contained  biliary  constituent,  Iodine,  free  Oleic  Acid,  etc., 
but  no  satisfactory  explanation  has  yet  been  offered  for  the  difference  be¬ 
tween  its  action  and  that  of  other  animal  or  vegetable  oils. 

Therapeutics. 

The  use  of  Cod-liver  Oil  is  that  of  a  nutrient  wholly,  this  action  being 


MOSCHUS. 


283 


most  marked  in  wasting  diseases.  In  high  febrile  states  or  catarrhal  con¬ 
ditions  of  the  gastro-intestinal  tract  its  use  is  contraindicated,  but  in 
phthisis  a  slight  degree  of  fever  will  not  interfere  with  its  beneficial  em¬ 
ployment.  It  is  found  to  be  of  most  value  in  chronic  forms  of  phthisis, 
chronic  bronchitis  and  emphysema,  chronic  rheumatic  disorders,  atheroma 
of  the  arteries,  strumous  skin  diseases  and  diarrhoea,  syphilodermata,  neu¬ 
ralgia,  chorea  and  epilepsy.  In  many  disorders  referable  to  exhaustion 
or  debility  of  the  nervous  centres  it  is  of  great  value  as  a  nerve  tonic,  and 
in  convalescence  from  acute  diseases  it  is  of  marked  benefit.  It  should 
always  be  considered  as  a  supplementary  food,  and  if  its  use  endangers  the 
appetite  for  other  food  it  should  be  abandoned. 

The  administration  of  this  valuable  agent  is  a  serious  matter,  as  many 
patients  cannot  overcome  their  repugnance  to  its  taste  and  smell.  Various 
emulsions  are  on  the  market,  but  they  are  objectionable  because  in  no  case 
do  they  conceal  the  taste,  and  the  efficacy  of  the  oil  is  seriously  impaired 
by  the  processes  used  in  their  preparation.  Moreover,  the  temptation  is 
very  great  to  employ  an  inferior  grade  of  the  oil  or  to  adulterate  it  with 
other  fish-oils  in  the  manufacture  of  these  preparations,  and  when  the 
commercial  spirit  of  gain  is  remembered  one  can  never  be  sure  of  the 
quality  of  the  oil  so  prepared.  The  oil  itself  is  the  best  form  for  use,  in 
small  doses,  say  a  teaspoonful  thrice  daily  for  an  adult,  after  meals,  in  black 
coffee,  beer  or  lemon-juice.  The  essential  Oil  of  Eucalyptus  in  the  pro¬ 
portion  of  1  part  to  100  of  cod-liver  oil  will  effectually  extinguish  the 
odor  and  taste  to  many  persons.  Alkaline  stomachics  given  before  meals, 
the  oil  after,  and  a  teaspoonful  of  the  “  Liquor  Pancreaticus  ”  given  half 
an  hour  afterwards,  would  be  a  good  routine  in  most  cases,  the  latter  agent 
preventing  the  fishy  eructations  which  often  give  so  much  trouble.  Ex¬ 
temporaneous  emulsions  may  be  prepared  with  Glycerite  of  Yolk  of  Egg 
(see  ante ,  page  282),  White  of  Egg,  Mucilage  of  Tragacanth,  Extract  of 
Malt,  or  any  syrup,  and  flavored  with  Lemon,  Cinnamon  or  Bitter 
Almond.  The  addition  of  rr^iv  of  Ether  to  each  5  of  the  oil  promotes 
its  digestion  by  stimulating  the  pancreatic  secretion,  and  enables  a  patient 
to  take  it  with  whom  it  had  previously  disagreed. 

Inunction  by  Cod-liver  Oil  is  a  method  of  value  in  the  wasting  diseases 
of  children.  A  tablespoonful  may  be  rubbed  into  the  skin  of  the  abdo¬ 
men  twice  a  day,  and  covered  with  a  flannel  binder  with  oiled  silk  or 
mackintosh-cloth  outside.  It  readily  passes  through  the  skin  and  is  ab¬ 
sorbed,  producing  valuable  and  lasting  results. 

MOSCHUS,  Musk  , — is  the  dried  secretion  from  the  preputial 
follicles  of  Moschus  moschiferus  (the  Musk  Deer),  an  animal  inhabiting 
the  mountainous  region  of  Central  Asia.  It  occurs  in  irregular,  unctuous 
grains,  of  a  reddish-brown  color,  peculiar  and  penetrating  odor  and 


284 


MYRCI/E  OLEUM - MYRISTICA. 


bitterish  taste,  contained  in  oval  sacs  about  2  inches  in  diameter,  mem¬ 
branous  on  one  side,  hairy  on  the  other.  About  10  per  cent,  is  soluble  in 
alcohol,  50  per  cent,  in  water.  Chinese  Musk  in  the  pods  or  sacs  is  the 
most  valuable,  but  all  varieties  are  much  adulterated,  the  price  of  the 
drug  being  very  high.  The  odor  is  destroyed  by  drying,  but  returns 
again  on  the  addition  of  moisture.  Tr.ituration  with  Camphor  or  Hydro¬ 
cyanic  Acid  also  destroys  it.  The  odorous  principle  has  not  been  isolated, 
it  is  probably  a  product  of  decomposition  which  is  constantly  being 
formed.  The  constituents  of  Musk  are  a  bitter  resinous  substance, 
ammonia,  fat,  cholesterin,  etc.  Dose,  gr.  ij-x. 

Preparation. 

Tinctura  Moschi, — 10  per  cent.  Dose,  npss-  3  jss. 

Physiological  Action  and  Therapeutics. 

Musk  is  a  very  diffusible  stimulant,  acting  directly  on  the  nervous  and 
circulatory  systems,  but  without  much  energy.  It  is  also  an  antispasmodic, 
and  is  used  with  benefit  in  general  prostration  of  the  system  with  nervous 
agitation  or  irregular  muscular  action.  It  has  been  used  with  advantage 
in  laryngismus  stridulus,  insommia,  the  collapse  of  typhoid  and  typhus 
fevers,  spasmodic  affections  of  the  stomach,  obstinate  hiccough  and  con¬ 
vulsions  of  children  due  to  intestinal  spasms.  The  pure  Musk  is  very 
difficult  to  obtain,  and  its  high  price  makes  it  an  extremely  expensive 
medicine,  so  that  it  is  seldom  used  except  as  a  perfume. 

MYRCI./E  OLEUM,  Oil  of  Myrcia,  Oil  of  Bay, — is  a  volatile 

oil  distilled  from  the  leaves  of  Myrcia  acris,  or  Bayberry,  a  tree  of  the 
nat.  ord.  Myrtacese,  native  of  the  West  Indian  Islands.  It  is  a  dark- 
brown  liquid,  of  aromatic  odor,  pungent  taste,  slightly  acid  reaction,  and 
soluble  in  an  equal  weight  of  alcohol.  Sp.  gr.  about  1.040.  It  contains 
a  hydrocarbon  and  Eugenic  Acid.  Used  as  a  perfume. 

Preparation. 

Spiritus  Myrcia ,  Spirit  of  Myrciae,  Bay  Rum, — contains  in  1800  parts  Oil  of  Myrcia 
16,  Oil  of  Orange-peel  1,  Oil  of  Pimento  1,  Alcohol  1000,  Water  782  parts,  filtered 
through  Carbonate  of  Magnesium.  Used  as  a  wash  or  perfume. 

Physiological  Action  and  Therapeutics. 

The  Oil  of  Bay  is  an  agreeable  perfume  used  to  prepare  bay-rum  and 
in  other  cosmetic  preparations.  The  spirit,  known  as  “Bay-rum,”  is 
used  principally  as  a  refreshing  perfume,  and  is  thought  to  relieve  head¬ 
ache,  faintness,  etc.,  by  application  to  the  forehead  or  to  the  nostrils. 


MYRISTICA,  Nutmeg,  — is  the  kernel  of  the  seed  of  Myristica 
fragratis  deprived  of  its  testa.  The  nutmeg  tree  is  cultivated  extensively 


MYRRHA. 


285 


in  the  East  and  West  India  Islands,  belongs  to  the  nat.  ord.  Myristicaceae, 
and  is  a  native  of  the  Banda  Islands  in  the  Malayan  Archipelago.  The 
Nutmeg  is  about  an  inch  long,  oval  or  roundish-ovate,  reticulately  fur¬ 
rowed,  internally  pale-brown  or  grayish-red  with  dark-brown  veins,  hav¬ 
ing  a  strongly  aromatic  odor  and  a  somewhat  bitter  taste.  It  contains  4 
to  9  per  cent,  of  the  official  Volatile  Oil,  and  30  per  cent,  of  a  concrete 
oil,  commonly  called  “Oil  of  Mace,”  which  is  a  compound  of  fluid 
glycerides  of  Oleic  and  Butyric  Acids,  and  the  solid  glyceride  of  Myrisiic 
Acid ,  some  resin  and  volatile  oil.  Dose,  gr.  v-xx. 

Macis,  Mace, — is  the  arillus  or  fleshy  covering  of  the  fruit  of  Myristica 
fragrans ,  the  Nutmeg-tree.  It  occurs  in  narrow  bands  about  an  inch 
long,  branched  and  lobed,  of  brownish-orange  color,  fragrant  odor,  warm 
and  aromatic  taste.  It  yields  a  fixed  oil  by  pressure  and  a  volatile  oil  by 
distillation,  the  latter  being  probably  identical  with  Oil  of  Nutmeg. 

Preparations. 

Oleum  Myristicce,  Oil  of  Nutmeg, — is  the  volatile  oil,  and  consists  chiefly  of  a  terpene 
and  an  oxygenated  oil  Alyristicol.  It  is  colorless  or  pale-yellow,  of  hot,  spicy  taste  and 
neutral  reaction,  and  is  soluble  in  alcohol.  Dose,  rr\j-v. 

Spiritus  Myristicce,  Spirit  or  Essence  of  Nutmeg, — is  a  3  per  cent,  solution  of  the  oil 
in  alcohol.  Dose,  gj-ij. 

Nutmeg  is  an  ingredient  of  Acetum  Opii,  Pulvis  Aromaticus,  Tr.  Lavandulae  Co.,  Syr. 
Rhei  Aromat.,  Trochisci  Cretae,  Trochisci  Magnesiae  and  Trochisci  Sodii  Bicarbonatis. 

Physiological  Action  and  Therapeutics. 

Nutmeg  is  an  aromatic  stomachic  of  agreeable  flavor.  In  small  doses 
it  stimulates  the  production  of  gastric  juice,  and  thus  promotes  digestion 
and  increases  appetite.  It  also  relieves  intestinal  spasm  and  flatulence. 
In  large  doses  it  is  powerfully  narcotic,  acting  directly  on  the  cerebrum, 
and  producing  stupor  and  delirium.  It  is  used  chiefly  for  flavoring  pur¬ 
poses,  and  generally  in  substance,  grated  as  required,  but  has  been 
employed  as  a  carminative,  anodyne  and  astringent  in  diarrhoeas  and 
dysentery,  as  well  as  to  relieve  nausea  and  vomiting.  The  Volatile  Oil  is 
decidedly  rubefacient  when  used  externally,  and  has  narcotic  powers  if 
used  internally  in  sufficient  quantity.  It  is  occasionally  employed  as  an 
external  stimulant  in  paralysis  and  chronic  rheumatism. 

Mace  is  stimulant,  carminative  and  aromatic.  It  is  used  solely  as  a 
spice  or  condiment.  Dose,  gr.  v-xx. 


MYRRHA,  Myrrh  , — is  a  gum  resin  obtained  from  Balsamodetidron 
Myrrha ,  an  Arabian  tree  of  the  nat.  ord.  Burseraceae,  collecting  spon¬ 
taneously  upon  the  bark,  and  occurring  in  roundish  tears,  having  a  waxy 
fracture,  a  balsamic  odor,  and  an  acrid  and  bitter  taste.  Triturated  with 
water  it  yields  a  brownish-yellow  emulsion;  with  alcohol  it  yields  a 
brownish-yellow  tincture  which  turns  purple  on  the  addition  of  nitric 


286 


NAPHTHALINE. 


acid.  It  contains  60  per  cent,  of  gum,  35  per  cent,  of  Myrrhin 
a  resin,  and  about  2  per  cent,  of  an  oxygenated  ethereal  oil  Myrrhol , 
C10HnO.  Dose,  gr.  x.-xxx. 

Preparations. 

Tinctura  Myrrhce , — 20  per  cent.  Dose,  n^x-xxx. 

Myrrh  is  also  contained  in  Mist.  Ferri  Co.,  Pil.  Aloes  et  Myrrhse,  Pil.  Ferri  Co.,  Pil. 
Galbani  Co.,  Pil.  Rhei  Co.,  and  Tr.  Aloes  et  Myrrhae. 

Physiological  Action  and  Therapeutics. 

Myrrh  in  small  doses  stimulates  the  gastro-intestinal  mucous  membrane  ; 
in  large  doses  it  is  an  irritant  thereunto,  producing  vomiting  and  purging. 
It  quickens  the  action  of  the  heart  and  diminishes  the  bronchial  secretion. 
It  is  a  uterine  stimulant  and  emmenagogue,  a  stimulant  expectorant,  and  is 
thought  to  increase  the  number  of  leucocytes  in  the  blood.  Locally  it  is 
stimulant  and  disinfectant  to  mucous  membranes  and  ulcerated  surfaces. 

Myrrh  is  used  internally  in  the  various  combinations  noted  above  for 
anaemia  and  amenorrhcea,  bronchial  catarrh,  etc.  It  has  been  supposed 
to  diminish  excessive  secretion  from  the  mucous  surfaces  of  the  uterus, 
vagina,  bladder,  and  bronchi,  and  to  have  an  especially  beneficial  in¬ 
fluence  on  chronic  pharyngitis.  Locally,  the  tincture  has  a  good  tonic 
action  on  diseased  mucous  surfaces,  and  is  applied  to  spongy  gums,  relaxed 
throat,  aphthous  patches  and  unhealthy  ulcers.  The  tincture  diluted  with 
water  makes  an  excellent  disinfectant  and  stimulant  gargle  in  ulcerated 
sore-throat.  Myrrh  has  long  been  used  as  an  ingredient  of  dentifrices. 


NAPHTHALINE,  C10H8  (Unofficial), — is  one  of  the  many  products 
of  the  distillation  of  coal-tar,  and  is  one  of  the  benzene  derivatives,  being 
formed  by  the  union  of  two  benzene  groups  in  an  overlapping  ring. 
(See  ante ,  page  179.)  It  occurs  as  colorless,  micaceous  crystals,  obtained 
from  the  destructive  distillation  of  coal-tar,  having  a  peculiar  smell, — in¬ 
soluble  in  water,  dilute  acids  or  alkalies,  and  but  sparingly  so  in  alcohol. 

The  dose  of  Naphthaline  is  from  gr.  ij— gr.  viij,  up  to  gr.  lxxx  per  diem 
for  adults ; — and  for  chilren  gr.  j— gr.  iij,  every  three  hours.  Being  quite 
insoluble  in  water  it  must  be  given  in  emulsion,  or  as  a  powder  with  sugar 
in  wafers  or  capsules.  It  is  best  flavored  with  oil  of  bergamot. 

Derivatives. 

From  Naphthaline  we  have  these  unofficial  substances — 

Naphthol,  Ci0H7OH,  Beta-  or  Iso-naphthol, — one  of  several  kinds  of 
Naphthol :  is  sparingly  soluble  even  in  hot  water,  but  is  soluble  in  alco¬ 
hol,  ether,  chloroform,  olive  oil  and  vaseline.  Used  as  ointment,  1  to  5 
for  adults,  but  for  children  not  over  2  per  cent. 

Hydronaphthol,  C16H7OH, — glistening,  micaceous  scales,  sparingly 


NUX  VOMICA. 


287 


soluble  in  water,  freely  soluble  in  alcohol,  oils,  etc.  Used  as  an  anti¬ 
septic,  and  in  ointment  or  powder  locally,  diluted  with  oxide  of  zinc,  1 
to  50. 

Physiological  Actions. 

Naphthaline  is  destructive  to  all  forms  of  low  life,  and  hence  is  anti¬ 
septic  in  a  high  degree,  but  must  be  intimately  mixed  with  the  substances 
upon  which  it  is  to  act.  Internally  it  is  a  stimulant  expectorant  of  decided 
power,  and  disinfects  the  contents  of  the  intestinal  canal.  Being  so  spar¬ 
ingly  soluble,  but  little  of  it  is  absorbed,  and  hence  it  does  no  injury  to 
the  organism.  What  is  taken  up  by  the  blood  is  excreted  by  the  urine, 
partly  unchanged,  partly  as  naphthol  and  perhaps  some  as  phenol.  Naph- 
thol  is  more  easily  absorbed,  and  causes  vomiting,  hematuria,  convul¬ 
sions,  and  unconsciousness.  Hydronaphthol  is  a  powerful  and  non¬ 
irritating  antiseptic,  non-poisonous,  non-corrosive,  freely  soluble  in  alcohol, 
glycerin,  fixed  oils,  etc.,  in  cold  water,  1  to  2000;  and  in  hot  water  1 
to  100,  precipitating  as  the  water  cools,  but  leaving  a  saturated  solution 
of  1  to  1000,  which  is  perfectly  inhibitive  of  the  germs  of  putrefaction  in 
all  putrescible  fluids  (Levis.)  The  claims  made  for  it  are  that  it  is  12 
times  as  effective  as  carbolic  acid,  30  times  as  potent  as  salicylic  acid,  60 
times  as  efficient  as  boric  acid,  600  times  as  antiseptic  as  alcohol,  and  that 
it  is  entitled,  as  a  true  antiseptic,  to  stand  next  to  mercuric  chloride  in 
the  comparative  tables  (Levis.) 

Therapeutics. 

Naphthaline  is  employed  as  an  antiseptic  for  the  intestinal  canal  in 
typhoid  fever,  diarrhoea,  both  acute  and  chronic,  tubercular  diarrhoea,  etc. 
It  renders  the  urine  aseptic  and  may  be  employed  in  vesical  catarrh.  It 
is  also  used  internally  for  humoral  asthma,  verminous  affections,  and  the 
chronic  pulmonary  catarrh  of  the  aged.  Locally,  it  has  high  value  as  an 
antiseptic,  for  indolent  ulcers,  sloughing  wounds,  open  cancers,  pus  cavi¬ 
ties,  etc.  Painted  over  organic  remains  it  effectually  prevents  the  rav¬ 
ages  of  insects.  Naphthol  is  employed  like  tar  for  a  therapeutic  action 
upon  the  skin,  in  hyperidrosis,  scabies,  eczema  and  local  sweating,  in 
to  5  per  cent,  alcohol  solution,  or  as  a  10  per  cent,  ointment.  Hydro¬ 
naphthol  is  also  highly  esteemed  for  antiseptic  purposes  generally,  by 
those  who  have  used  it,  and  is  of  benefit  as  an  external  application  in 
many  skin  diseases.  Its  non-toxic  and  non-irritant  qualities  render  it  the 
most  useful  and  most  generally  available  of  the  three. 


NUX  VOMICA  , — is  the  seed  of  Strychnos  Nux-vomica ,  an  East 
India  tree  of  the  nat.  ord.  Loganiacese,  having  white,  funnel-shaped 
flowers,  and  a  fruit  about  the  size  of  an  orange,  with  many  seeds  in  a 
juicy  pulp.  The  seeds  are  flattened  and  nearly  circular,  about  one  inch  in 


288 


NUX  VOMICA. 


diameter,  ashy-gray  in  color,  covered  with  short,  satiny  hairs,  internally 
translucent,  tough  and  horny,  with  a  large  cavity,  inodorous,  taste  in¬ 
tensely  bitter.  It  contains  two  alkaloids,  Strychnine ,  0.2  to  0.5  per  cent., 
and  Brucine ,  0.1  to  1.0  per  cent.,  with  a  crystalline  acid,  Igasuric  or 
Strychnic  Acid,  and  a  yellow  coloring  matter,  a  concrete  oil,  gum,  starch, 
wax,  earthy  phosphates,  etc.  A  third  alkaloid,  Igasurine ,  is  claimed  to 
exist  by  some  authorities  and  is  denied  by  others. 


Preparations. 

Abstraction  Nucis  Vomica, — Dose,  gr.  l/2,  gradually  increased. 

Extraction  Nucis  Vomica, — Dose,  gr.  ]/%-)• 

Extraction  Nucis  Vomica  Fluidum, — Dose,  TT\j-v. 

Tinctura  Nucis  Vomica , — 20  per  cent.  Dose,  TTpv— xx. 

Strychnina ,  Strychnine,  C21H22N202, — is  an  alkaloid  prepared  from  Nux  Vomica, 
Ignatia,  and  other  plants  of  the  order  Loganiacese ;  crystalline,  intensely  bitter  even  in  I 
to  700,000  solution,  of  alkaline  reaction,  soluble  in  6  of  chloroform,  no  of  alcohol,  6700 
of  water,  almost  insoluble  in  ether.  It  is  a  constituent  of  Ferri  et  Strychninse  Citras,  and 
of  Syrupus  Ferri  Quininse  et  Strychninae  Phosphatum.  Dose,  gr.  do~do- 

Strychnina  Sulphas,  Sulphate  of  Strychnine  (C21H22N202)2H2S04.7lI20, — crys¬ 
talline,  efflorescent,  odorless,  of  intensely  bitter  taste  even  in  1  to  700,000  solution,  neu¬ 
tral  reaction,  soluble  in  10  of  water  and  60  of  alcohol  at  590  F.  Dose,  gr.  do~do' 

Brucina  Brucine,  C23FI26N204  (Unofficial), — colorless  prisms,  pearly  flakes,  or 
masses,  soluble  in  water,  less  so  in  alcohol ;  as  compared  with  Strychnine  it  is  less  bitter, 
12  times  weaker  and  three  times  slower  physiologically.  Is  thought  to  be  a  compound  of 
strychnine  and  resin,  corresponding  with  the  other  alkaloid  both  physiologically  and 
therapeutically.  Is  seldom  used.  Dose,  gr.  TL-l. 

Physiological  Action. 

The  actions  of  Nux  Vomica  are  those  of  its  alkaloid  Strychnine.  In 
small  doses,  it  acts  as  a  bitter  tonic,  stimulates  respiration,  secretion, 
appetite  and  digestion,  and  sharpens  the  vision.  It  increases  peristalsis, 
stimulates  both  the  motor  and  the  inhibitory  apparatus  of  the  heart,  and 
raises  the  arterial  tension  by  stimulating  the  vaso-motor  centres,  thus  con¬ 
tracting  the  arterioles,  though  by  full  doses  the  arterioles  are  relaxed.  By 
a  full  dose  (Strychnine,  gr.  TV),  the  pupils  are  dilated,  the  limbs  jerk, 
respiration  becomes  spasmodic  and  the  lower  jaw  stiff,  a  sensation  of 
cerebral  tension,  sudden  shuddering  and  anxiety  follow,  the  face  wearing 
an  unmeaning  smile.  A  toxic  dose  (Strychnine  gr.  y2  for  an  adult)  on 
an  empty  stomach  quickly  produces  heightened  reflexes;  tonic  spasms, 
especially  of  the  extensor  muscles,  on  the  least  irritation  quickly  succeed 
each  other  with  intervals  of  repose,  resulting  after  two  or  three  hours 
at  most  in  death  by  asphyxia,  from  tetanic  fixation  of  the  muscles  of 
respiration,  consciousness  being  preserved  until  carbonic  acid  narcosis 
sets  in. 

Strychnine  exalts  all  the  functions  of  the  spinal  cord, — reflex,  motor, 
vaso-motor  and  sensory, — the  latter  being  the  least  affected.  It  has  a 
selective  action  on  the  large  multipolar  ganglia  in  the  anterior  columns, 
which  it  first  stimulates  and  then  paralyzes  by  over-stimulation.  A  large 
dose  destroys  the  spinal  functions  as  by  one  blow.  It  does  not  affect  the 


NUX  VOMICA.  289 

brain  directly.  Thebaine,  one  of  the  alkaloids  of  Opium,  is  a  powerful 
spinal  exaltant  and  acts  very  similarly  to  Strychnine. 

From  the  spasms  of  tetanus  those  of  Strychnine  may  be  differentiated 
by  their  intermittency,  the  former  being  constant.  Moreover,  the  mean¬ 
ingless  smile,  the  less  marked  trismus,  the  absence  of  a  wound,  and  the 
rapid  course  of  the  symptoms,  all  point  to  the  action  of  Nux  vomica. 

The  excretion  of  Strychnine  takes  place  very  slowly,  and  by  the  urinary, 
salivary  and  cutaneous  channels.  Rapidly  absorbed  but  very  slowly 
excreted,  it  accumulates  in  the  system  if  even  a  small  dose  be  frequently 
repeated. 

On  the  eye  Strychnine  has  marked  effects,  augmenting  the  excitability 
of  the  retinal  elements,  increasing  the  sharpness  of  vision  and  enlarging 
the  visual  field. 

Antagonists  and  Inconipatibles. 

The  antidote  is  Tannic  Acid,  to  form  the  very  insoluble  tannate,  or  a  soluble  salt  of 
Iodine.  Then  emetics  or  the  stomach  pump,  followed  by  perfect  quiet  which  is  very  im¬ 
portant.  Antagonists  are  Chloral,  Tobacco,  Chloroform  inhalations  or  Ether,  and  Potas¬ 
sium  Bromide,  the  latter  being  almost  too  slow  of  action  to  be  of  much  use  in  practice. 
Chamomile  oil  should  antagonize  the  reflex  excitability.  The  bladder  must  be  frequently 
evacuated  to  prevent  re-absorption  of  the  poison,  and  artificial  respiration  maintained  as 
necessary. 

Incompatibles  are  Bromides,  Chlorides  and  Iodides  in  the  same  solution,  the  Strychnine 
being  precipitated  as  hydrobromate,  hydriodate,  etc. 

Therapeutics. 

Nux  Vomica  and  its  chief  alkaloid  are  used  as  a  stomachic  tonic  and 
as  a  respiratory,  cardiac,  muscular  and  nervous  stimulant.  As  the  quan¬ 
tity  of  Strychnine  in  Nux  Vomica  varies  greatly,  it  is  best  to  use  the  alka¬ 
loid  when  its  physiological  action  is  desired,  as  more  definite  dosage  may 
thus  be  obtained.  The  tincture  in  5-drop  doses  is  excellent  in  atonic 
dyspepsia  and  gastric  catarrh,  especially  in  drunkards,  and  in  constipation 
from  atony  of  the  bowels  it  may  be  given  in  io-drop  doses  with  good 
results,  not  as  a  purgative  but  to  increase  peristalsis.  The  extract  is  much 
used  in  laxative  pills  for  habitual  constipation.  In  the  vomiting  of  preg¬ 
nancy  the  tincture  is  frequently  an  efficient  remedy,  and  in  the  vomiting 
of  phthisis  Strychnine  is  one  of  the  very  best  agents.  Nux  vomica  is  a  very 
useful  remedy  in  many  nervous  derangements,  such  as  periodical  coughs, 
especially  night-coughs,  irregular  cardiac  action  and  over-action  of  the 
heart,  in  asthma,  the  nervous  movements  of  pregnancy,  hypochondriasis, 
etc.  Its  undoubted  action  upon  the  pneumogastric  makes  it  very  valuable 
in  all  sorts  of  coughs,  whether  from  bronchitis,  pneumonia,  phthisis  or  em¬ 
physema.  Epidemic  diarrhoeas  and  dysentery  are  well  treated  by  Strych¬ 
nine,  and  in  anaemia  and  chlorosis  it  is  invaluable,  combined  with  Iron 
and  Quinine.  In  neuralgiae,  especially  the  visceral,  tetanus  of  the  idio¬ 
pathic  type,  cardiac  failure  from  any  cause,  and  in  intermittents  as  an 
adjunct  in  Quinine,  it  is  always  a  useful  drug.  Local  paralyses  of  various 

19 


290 


NYMPH/EA  ODORATA - OLIVAi  OLEUM. 


forms  are  well  treated  by  injecting  Strychnine  hypodermically  into  the 
affected  muscles,  and  diphtheritic  paralyses  are  almost  invariably  cured  by 
it.  Strychnine  is  an  excellent  remedy  in  hemiplegia  when  degeneration 
has  not  yet  set  in,  and  when  the  paralyzed  muscles  are  completely  relaxed; 
but  it  is  of  no  avail  in  recent  cases,  nor  when  the  muscles  have  lost  elec¬ 
trical  contractility.  In  amaurosis  from  lead,  tobacco  or  alcohol,  it  has 
proved  remarkably  useful,  and  in  the  dyspnoea  of  pulmonary  affections  it 
may  be  employed  with  benefit  as  a  respiratory  stimulant.  Strychnine  is 
a  physiological  antagonist  to  Chloral,  Physostigmine  and  Morphine,  and 
may  be  carefully  administered  in  poisoning  by  these  substances  while  the 
ordinary  methods  are  also  employed. 

In  many  eye  diseases  Strychnine  is  injected  into  the  tissues  about  the 
temple  with  great  benefit,  especially  in  amblyopia  due  to  functional  dis¬ 
order  of  the  retina  without  lesions,  and  in  atrophy  of  the  optic  nerve. 
Used  in  the  same  manner  it  is  highly  recommended  in  infra-orbital  neu¬ 
ralgia,  and  in  other  neuralgise  characterized  by  debility  and  anaemia. 


NYMPHiEA  ODORATA,  Sweet  scented  Water-lily,  (Un¬ 
official), — is  a  well-known  American  plant  of  the  nat.  ord.  Nymphaeaceae, 
the  root  of  which  is  very  bitter  and  highly  astringent,  containing  much 
Gallic  and  Tannic  Acids,  to  which  its  actions  and  uses  are  due.  A  de¬ 
coction  of  S  j  to  the  pint  may  be  used  in  doses  of  3  ss-j,  or  a  fluid  extract 
in  doses  of  3  ss-j.  For  the  physiological  actions  and  therapeutics  of  this 
vegetable  astringent  see  Tannic  Acid,  ante  page  74. 


OLIVu®  OLEUM,  Olive  Oil,  Sweet  Oil,  Salad  Oil,— is  a  fixed 

oil  expressed  from  the  ripe  fruit  of  Olea  europcea,  the  olive  tree  (nat.  ord. 
Oleaceae),  which  is  cultivated  in  southern  Europe,  California  and  Austra¬ 
lia.  It  is  a  pale-yellow  or  greenish- yellow,  oily  liquid,  of  nutty,  oleagin¬ 
ous  taste,  and  neutral  reaction,  sparingly  soluble  in  alcohol  but  readily 
soluble  in  ether.  Sp.  gr.  about  0.916. 

Olive  Oil  consists  of  72  per  cent,  of  Olein  (a  fluid  oil)  and  28  per  cent,  of  Palmitin 
(a  solid  oil  or  stearoptene),  which  are  compounds  of  the  base  Glyceryl ,  C3H5  with  Oleic 
Acid,  Cj  9H3402,  and  Palmitic  Acid,  C17H3102,  respectively.  It  is  frequently  adul¬ 
terated  with  cheaper  fixed  oils,  especially  poppy  oil,  lard  oil,  and  cotton-seed  oil,  quan¬ 
tities  of  the  latter  being  exported  every  year  to  Italy,  whence  it  is  returned  to  us  as  Olive 
Oil  under  a  French  label.  (See  Gossypium,  ante ,  page  229.)  It  is  an  ingredient  of  Ce- 
ratum  Camphoroe,  Ceratum  Cetacei,  Emplastrum  Plumbi  and  Unguentum  Diachylon,  and 
is  the  source  of  the  official  Soap.  Dose,  5  ss-j. 

Physiological  Action. 

Externally  used  Olive  Oil  is  a  good  protective  from  the  air,  and  ren¬ 
ders  the  skin  soft  and  flexible.  If  rubbed  into  the  integument  it  is  ab¬ 
sorbed  by  the  lymphatics  and  is  directly  nutritive  in  effect.  Internally  it 


OPIUM. 


29I 


is  also  nutritious  and  mildly  laxative,  and  in  quantity  acts  as  a  protective 
to  the  mucous  membrane  against  acrid  or  poisonous  substances.  Like 
other  oils  it  is  partly  emulsified,  partly  saponified  in  the  intestines,  its  gly¬ 
cerin  being  set  free  and  its  fatty  acids  combining  with  the  free  alkalies  to 
form  soap,  which  with  the  emulsion  forms  the  molecular  basis  of  the  chyle, 
entering  the  blood  through  the  lacteals  and  being  finally  oxidized  into 
carbonic  acid  and  water,  though  an  excess  will  appear  unchanged  in  the 
urine.  Oils  are  therefore  a  food  within  certain  limits,  increase  the  fat  of 
the  tissues,  furnish  force,  and  save  the  waste  of  nitrogenous  tissue,  but  are 
unable  of  themselves  to  support  life. 

Therapeutics. 

Olive  Oil  possesses  no  very  marked  therapeutic  power  above  any  other 
bland  oil  or  fat.  It  is  a  good  laxative  for  infants  administered  internally, 
and  may  be  used  as  an  enema  followed  by  warm  water.  Its  chief  employ¬ 
ment  is  as  a  local  application.  Applied  to  burns  and  acute  inflammations 
of  the  skin  it  is  an  excellent  protective,  coating  the  surface  and  excluding 
the  air;  and  as  an  ingredient  of  liniments  it  acts  as  a  diluent  for  more 
active  agents.  It  is  used  to  facilitate  friction  over  enlarged  or  stiff  joints, 
and  in  the  desquamative  stage  of  scarlet  fever  is  a  very  useful  and  grateful 
application.  As  an  antidote  in  corrosive  poisoning  it  acts  mechanically  by 
protecting  the  mucous  membrane  of  the  stomach  and  preventing  absorp¬ 
tion.  In  pharmacy  its  bland,  unirritating  qualities  have  procured  its 
common  employment  as  an  ingredient  of  liniments,  plasters,  ointments 
and  cerates,  but  the  foreign  article  is  so  frequently  adulterated  with 
inferior  oils  that  Cotton-seed  Oil  is  now  directed  in  its  place  in  many 
official  preparations. 


OPIUM,  — is  the  concrete,  milky  exudation,  obtained  in  Asia  Minor 
by  incising  the  unripe  capsules  of  the  White  Poppy,  Papaver  somniferum , 
an  annual  herb  of  the  nat.  ord.  Papaveraceae,  indigenous  to  Western  Asia 
but  cultivated  extensively  elsewhere.  Its  capsules  are  globular,  two  or 
three  inches  in  diameter,  and  are  crowned  by  a  sessile,  stellate  stigma, 
which  distinguishes  them  from  Colocynth  and  Bael  fruits.  Opium  occurs 
in  irregular  lumps  or  cakes,  of  dark-brown  color,  sharp,  narcotic  odor, 
and  bitter  taste;  and  in  its  normal,  moist  condition  should  yield  not  less 
than  9  per  cent,  of  Morphine  when  assayed  by  the  process  official  in  the 
Pharmacopoeia. 

Composition  of  Opium. 

Opium  contains  17  alkaloids,  2  neutral  substances  and  2  organic  acids, 
together  with  sugar,  gum,  resin,  pectin,  extractives,  odorous  principles, 
water  and  other  constituents  of  plants.  Its  most  important  alkaloids  are 
the  following : 


292 


OPIUM. 


Morphine ,  C17H19N03,  5  to  20  per  cent. — the  principal  alkaloid,  occurring  in  the 
drug  in  the  form  of  the  tribasic  meconate.  Its  properties  are  anodyne,  hypnotic  and  nar¬ 
cotic.  From  it  by  a  process  of  dehydration  by  heat  and  hydrochloric  acid  is  prepared  the 
artificial  alkaloid  Apomorphine ,  a  powerful  emetic.  (See  ante ,  page  107.) 

Codeine,  C18H21N03,  0.3  to  0.5  per  cent., — is  calmative  and  when  pure  a  not  very 
active  alkaloid,  but  is  frequently  contaminated  with  other  alkaloids.  Apomorphine  may 
be  prepared  also  from  it. 

Narcotine ,  C22H23N07,  2  to  10  per  cent., — is  antiperiodic  and  a  tetanizer,  but  wholly 
devoid  of  narcotic  properties. 

Thebaine  or  Paramorphine,  C19H21N03,  0.15  to  0.20  per  cent., — is  a  powerful  spinal 
exaltant  and  tetanizer,  resembling  Strychnine  in  its  action. 

Narceine ,  C22H29N09,  0.02  per  cent., — closely  resembles  Morphine  in  action,  but  is 
probably  more  hypnotic,  and  is  not  followed  by  many  of  the  disagreeable  after-effects  of 
Morphine.  It  is  extremely  difficult  to  obtain  this  alkaloid  pure. 

Papaverine ,  C21H21N04,  1  per  cent., — is  reported  inert  on  man  by  some  observers,  a 
narcotic  and  convulsant  by  others. 

Other  Alkaloids  at  present  acknowledged  are — Cryptopine,  Pseudomorphine,  Protopine, 
Hydrocotarnine,  Laudanine,  Codamine,  Rhoeadine  Meconidine,  Laudanosine,  Lan- 
thopine  and  Gnoscopine.  Many  of  them  are  probably  to  be  regarded  as  derivatives  from 
Morphine. 

Besides  the  above-named  alkaloids  the  most  important  of  the  constitu¬ 
ents  of  Opium  are  the  following  acids  and  neutral  principles,  viz.  ; 

Acids  are — Meconic  Acid,  C.H407,  4  per  cent.,  and  Lactic  Acid ,  C3H603,  1 per 
cent.,  which  exist  in  combination  with  the  alkaloids  as  meconates,  bimeconates,  etc.  The 
second  acid  is  generally  called  Thebolactic ,  but  has  been  recently  shown  to  be  identical 
with  lactic  acid. 

Neutral  Principles  are — Meconin ,  C10H]0O4,  o.oi  per  cent. ,  white,  crystalline,  neutral, 
but  very  acrid;  Meconoiosin ,  C8H10O2,  also  crystalline,  and  Porphyroxin ,  which  is  now 
said  not  to  be  a  proximate  principle  but  a  very  complex  combination  of  several  alkaloids. 

Smyrna,  Turkey  or  Levant  Opium  is  the  best  grade.  Constantinople 
Opium  is  of  uncertain  quality,  while  of  the  other  varieties  in  the  market 
Egyptian,  Persian  and  Indian  samples  are  those  most  frequently  met  with. 
All  varieties  are  more  or  less  adulterated  with  fruits  and  leaves  of  other 
plants,  starch,  pitch,  clay,  wax,  gum,  liquorice,  etc. 

Preparations  of  Opium. 

Pulvis  Opii,  Powdered  Opium, — is  Opium  dried  at  a  temperature  not  exceeding  185° 
F.,  and  reduced  to  a  moderately  fine  powder.  It  should  contain  not  less  than  12  nor 
more  than  16  per  cent,  of  Morphine  when  assayed  by  the  official  process.  Dose,  gr. 
ss-iij,  an  average  adult  dose  being  about  one  grain. 

Opium  Denarcotisaium,  Denarcotized  Opium, — is  powdered  Opium  freed  from  the 
constituents  which  are  soluble  in  ether,  namely — the  odorous  matters  and  Narcotine, 
which  are  supposed  to  cause  the  unpleasant  after-effects  of  Opium.  It  should  yield  14 
percent,  of  Morphine,  and  therefore  is  by  no  means  “  denarcotized,”  but  is  a  good  prepa¬ 
ration,  being  a  purified  Opium  having  a  fixed  Morphine  standard.  Dose,  gr.  ss-iij,  an 
average  adult  dose  being  about  one  grain.  The  proprietary  article  named  Svapnia  is  a 
similar  preparation. 

Extraction  Opii, — an  aqueous  extract  containing  Glycerin  to  keep  it  soft,  and  freed 
from  some  disturbing  principles  which  are  insoluble  in  water.  Dose,  gr. 

Pilulce  Opii, — each  pill  containing  gr.  j  of  powdered  Opium  with  gr.  ^  of  Soap.  Dose, 

Hb-. 

Tinctura  Opii, — Laudanum, — Opium-strength  10  per  cent.,  average  Morphine- 
strength  gr.  vj,  (equaling  gr.  vijss  of  the  Sulphate)  to  the  fl  3  .  Has  about  gr.  xliv  of  Opium 
to  the  rr^xj  (gtt.  xxij)  =  gr.  j  of  Opium  or  gr.  *4  °f  Morphine  .Sulphate.  Sixty 
minims  yield  on  the  average  120  drops.  Dose,  IT^v-xx  as  per  effect  required. 

Tinctura  Opii  Deodorata,  Deodorized  Tincture  of  Opium, — an  aqueous  extract 
shaken  with  ether,  which  being  separated  the  residue  is  dissolved  in  water,  and  enough 


OPIUM. 


293 


alcohol  is  added  to  preserve  it.  An  excellent  liquid  preparation,  being  freed  from  all  the 
noxious  and  useless  ingredients  soluble  in  alcohol  and  ether.  McMunn's  Elixir  is  a 
similar  preparation,  so  also  is  a  recent  nostrum  named  Papine.  Opium-strength  10  per 
cent.,  average  Morphine-strength  gr.  vj  to  the  fl  £  .  Dose,  as  Tinct.  Opii.  Drops  of  this 
preparation  nearly  equal  minims. 

Vinurn  Opii ,  Wine  of  Opium,  Sydenham’s  Laudanum, — Opium-strength  10  per  cent., 
with  the  aromatics  Cinnamon  and  Cloves  of  each  1  per  cent.,  in  Stronger  White  Wine.  A 
vinous  tincture  decreased  somewhat  in  strength  from  the  wine  of  1870.  Dose,  as  Tinct. 
Opii.  Drops  of  this  preparation  are  larger  than  those  of  the  tincture. 

Acetum  Opii ,  Vinegar  of  Opium,  Black  Drop, — Opium-strength  10  per  cent.,  with  Nut¬ 
meg  and  Sugar  in  Dilute  Acetic  Acid.  Is  now  y  weaker  than  formerly,  having  the 
same  strength  and  dose  as  Tinct.  Opii. 

Tinctura  Opii  Camphorata ,  Camphorated  Tincture,  Paregoric, — has  of  Powdered 
Opium  4,  Benzoic  Acid  4,  Camphor  4,  Oil  of  Anise  4,  Glycerin  40,  Diluted  Alcohol  q.  s. 
ad  1000  parts.  3  ss  contains  nearly  one  grain  of  powdered  Opium,  and  is  about  ^th 
the  strength  of  Laudanum.  Dose,  for  an  infant  gtt.  v-xx,  for  an  adult  ^j-iv. 

[Note. — According  to  the  U.  S.  Pharmacopoeia  of  1880  the  official  dried  Opium  should 
contain  12  to  16  per  cent,  of  Morphine  instead  of  10  per  cent,  as  required  by  the  Pharma- 
copaeia  of  1870.  The  liquid  preparations,  except  Paregoric,  are  now  directed  to  be  of 
the  uniform  Opium- strength  of  10  per  cent,  by  weight,  making  the  Wine  less  strong  by 
2  per  cent.,  the  Acetum  fully ^3  less  in  strength,  and  the  other  liquid  preparations  stronger 
by  ]/2  in  Morphine  than  formerly.  So  that  if  the  full  anodyne  dose  of  Tincture  or  Deo¬ 
dorized  Tincture  be  taken  at  24  minims,  equalling  gr.  y  of  Morphine  Sulphate,  the  cor¬ 
responding  dose  under  the  new  system  will  be  16  minims.] 

Liquor  Opii  Compositus ,  Compound  Solution  of  Opium  (Squibb),  Unofficial, — has  the 
same  strength  as  the  official  tinctures,  namely  gr.  vj  of  Morphine,  (equalling  gr.  vijss  of  the 
Sulphate)  to  each  fluidounce.  rtbxvj  —  gr-  X  °f  Morphine  Sulphate. 

Tinctura  Opii  Composila,  Squibb’s  Diarrhoea  Mixture  (Unofficial), — has  of  Tinct.  Opii, 
Spt.  Camphorse  and  Tinct.  Capsici  of  each,  Purified  Chloroform  ^iij,  Stronger 
Alcohol  q.  s.  ad  %v.  Each  fig  or  teaspoonful  contains  about  100  drops  or  rrpxij  of  each 
of  the  first  three  ingredients  and  rrpivss  or  18  drops  of  Chloroform.  Dose,  for  infants  gtt. 
j-x,  for  children  gtt.  x-xxx,  for  adults  gj. 

Emplastrum  Opii , — Extract  of  Opium  6,  Burgundy  Pitch  18,  Lead  Plaster  76  parts. 

Pulvis  Ipecacuanhcc  et  Opii ,  Dover’s  Powder, — Ipecac  10,  Powdered  Opium  10,  Sugar 
of  Milk  80,  triturated  to  a  fine  powder.  Dose,  gr.  v-xv,  ten  grains  equalling  one  grain 
each  of  Ipecac  and  Opium. 

Tinctura  Ipecacuanhce  et  Opii , — Deodorized  Tincture  of  Opium  100  parts  evaporated 
to  85,  Fluid  Extract  of  Ipecac  10,  Diluted  Alcohol  q.  s.  ad  100.  Intended  to  represent 
Dover’s  Powder  in  a  liquid  form.  Dose,  rrpv-xv. 

Trochisci  Glycyrrhizce  et  Opii , — each  troche  contains  Extract  of  Opium  gr.  Jq  with 
Extract  of  Liquorice,  Acacia,  Sugar  and  Oil  of  Anise.  Dose,  j-iv. 


Preparations  of  Morphine. 

Morphina,  Morphine,  C17H19N03.H20, — white,  prismatic  crystals  or  a  crystalline 
powder,  odorless,  of  bitter  taste  and  alkaline  reaction,  almost  insoluble  in  water,  soluble 
in  100  of  alcohol.  Its  comparative  insolubdity  makes  the  salts  preferable  for  use,  and  as 
a  very  small  proportion  of  acid  neutralizes  it,  the  dosage  is  about  the  same  for  the  alkaloid 
and  its  salts,  viz.,  gr.  ^-gr.  j ■  Gr.  is  about  equal  to  one  grain  of  Opium  of 

medium  Morphine-strength.  [Compare  Morphince  Sulphas ,  below.] 

Alorphince  Acetas,  Acetate  of  Morphine, — a  white,  crystalline  or  amorphous  powder,  of 
faintly  acetous  odor,  bitter  taste,  neutral  or  faintly  alkaline  reaction,  soluble  when  fresh  in 
12  of  water  and  in  68  of  alcohol  at  590  F.  Dose,  gr.  ^0-j. 

Morphinoe  Ilydrochloras,  Hydrochlorate  of  Morphine, — white,  feathery  crystals  of  silky 
lustre,  of  bitter  taste  and  neutral  reaction,  soluble  in  24  of  water  and  in  63  of  alcohol  at 
590  F.  Dose,  gr.  ^-j. 

Morphince  Sulphas ,  Sulphate  of  Morphine, — white,  feathery,  acicular  crystals  of  silky 
lustre,  of  bittei  taste  and  neutral  reaction,  soluble  in  24  of  water  and  in  702  of  alcohol  at 
590  F.,  and  in  0.75  of  boiling  water.  Contains  about  80  per  cent,  of  Morphine.  Dose, 
gr.  J  5  being  a  small  dose  for  an  adult,  a  moderate  one,  a 

dose,  and  y~)  a  large  one. 

Pulvis  Morphina  Compositus ,  Tully’s  Powder, — has  of  Morphine  Sulphate  I  part  to  20 
each  of  Camphor,  Liquorice  and  Calcium  Carbonate.  A  similar  preparation  to  Dover’s 


294 


OPIUM. 


Powder  minus  the  Ipecac.  Dose,  gr.  v-xv,  ten  grains  containing  gr.  |  of  Morphine  Sul¬ 
phate. 

Trochisci  Morphines  et  Ipecacuanha, — each  troche  contains  gr.  0f  Morphine  Sul¬ 
phate  with  about  gr.  yU  of  Ipecac,  also  Sugar,  Oil  of  Gaultheria  and  Mucilage  of-  Traga- 
canth.  Dose,  one  every  hour  or  so,  cautiously  with  children. 

Injectio  Morphines  Hypodermica  (B.  P.), — is  a  solution  of  the  Acetate,  containing  gr.  j 
in  each  ten  minims,  being  thrice  as  strong  as  Magendie’s  solution.  Dose,  rt\j-iij. 

Liquor  Morphines  Sulphatis ,  Magendie’s  Solution  (Unofficial), — has  gr.  xvj  of  Mor¬ 
phine  Sulphate  in  each  fl^  ,  or  gr.  j  in  rtpxxx,  or  gr.  in  rtpvijss.  If  made  with  Benzoic 
Acid,  the  solution  will  not  spoil,  and  is  not  irritant  hypodermically.  The  same  result  is 
attained  by  adding  of  Carbolic  Acid,  rtpiij  to  the  3  . 

Tinctura  Chloroformi  ei  Morphines  (B.  P.), — a  substitute  for  Chlorodyne.  See  ante, 
page  169. 

Oleatum  Morphines,  Oleate  of  Morphine  (Unofficial), — Morphine-strength  10 per  cent, 
with  Oleic  Acid  90.  For  local  use. 

Preparations  of  Other  Alkaloids. 

Codeina,  Codeine,  C18H21N03.H20, — white  or  yellowish-white,  rhombic  prisms, 
efflorescent  in  warm  air,  of  bitter  taste  and  alkaline  reaction,  soluble  in  80  of  water  at 
590  F.  and  in  17  of  boiling  water,  very  soluble  in  alcohol,  chloroform  and  ether.  This 
alkaloid  is  official.  Dose,  gr.  ss-ij,  but  gr.  i  has  caused  alarming  symptoms  in  children. 

The  Phosphate  of  Codeine  is  sufficiently  soluble  for  hypodermic  use,  and  comparatively 
unirritant.  One  part  in  twenty  of  water  forms  the  usual  solution  for  hypodermic  employ¬ 
ment. 

Narcotines  Hydrochloras ,  Hydrochlorate  of  Narcotine  (Unofficial), — Dose,  gr.  ij-x,  as 
an  antiperiodic. 

The  Tincture  of  Opium  is  an  ingredient  of  Mistura  Magnesiae  et  Asafoetidae,  and  the 
Camphorated  Tincture  is  an  ingredient  of  Mistura  Glycyrrhizae  Composita.  (See  ante , 
pages  272,  228.) 

Children  bear  Opium  badly,  and  for  them  its  proportionate  dosage 
should  be  much  below  that  for  other  agents.  Morphine  should  not  be 
given  to  children  below  10  years  of  age,  and  never  hypodermically  to 
those  beneath  the  age  of  15.  Opium  given  to  a  nursing  mother  will 
affect  the  child,  being  partly  excreted  in  the  milk. 

Reactions  and  Incompatibles. 

An  aqueous  or  alcoholic  preparation  of  Opium  reddens  litmus  paper  (free  meconic 
acid)  ; — gives  a  deep  red  color  with  Perchloride  of  Iron  (meconic  acid) ; — forms  precipi¬ 
tates  with  Acetate  and  Subacetate  of  Lead,  Nitrate  of  Silver,  Zinc,  Copper,  and  Arsenic 
(meconates,  sulphates  and  coloring  matter); — forms  a  precipitate  with  tincture  of  Galls  or 
astringent  preparations  (tannates  of  morphine  and  codeine)  ;  and  becomes  turbid  with 
the  fixed  Alkalies,  Carbonates,  Alkaline  Earths,  and  Ammonia  (precipitated  morphine  and 
narcotine). 

Tests  for  Morphine. 

Nitric  Acid  produces  a  blood-red,  turning  orange,  then  yellow,  then  disappearing. 
Test-solution  of  P'erric  Chloride  gives  a  blue  color  changing  to  green  with  excess  of  the 
reagent,  and  destroyed  by  free  acids  or  alcohol,  but  not  by  alkalies.  Iodic  Acid  liberates 
Iodine  which  may  be  tested  by  starch. 

Physiological  Action. 

Opium  is  analgesic,  hypnotic,  antispasmodic,  diaphoretic  and  narcotic. 
It  first  stimulates  then  depresses  the  cerebrum,  heart  and  respiratory  appa¬ 
ratus,  and  is  classed  among  the  cerebral  depressants.  • 

In  medium  dose  (gr.  j)  it  arrests  all  the  secretions  except  the  milk  and 
sweat,  the  latter  being  increased  ;  producing  dryness  of  the  mouth  and 
throat,  retarded  digestion  from  stoppage  of  the  gastric  juice,  and  decided 


OPIUM. 


295 


loss  of  appetite.  The  action  of  the  heart  is  increased,  arterial  tension 
raised  and  the  pupils  slightly  contracted.  The  cerebral  faculties  are 
stimulated  by  increased  blood-supply  to  a  pleasant  activity,  ideas  follow 
each  other  rapidly  through  the  mind,  and  an  exhilaration  bordering  on 
mild  intoxication  is  experienced,  succeeded  by  a  calm  of  variable  length. 
Sleep  generally  follows,  disturbed,  however,  by  dreams,  and  after  waking 
headache,  malaise,  constipation,  digestive  disturbance  and  some  depression 
result.  The  conductivity  of  the  nerves  is  not  affected.  Frequently  the 
stage  of  mental  activity  is  absent,  but  in  persons  habituated  to  the  use  of 
Opium  it  is  usually  well  marked.  In  some  subjects  a  lengthened  period  of 
calm  repose  takes  the  place  of  sleep,  in  others  neither  calm  nor  sleep 
occurs,  but  the  stimulant  action  of  the  drug  prevails,  the  spinal  func¬ 
tions  as  well  as  the  cerebral  are  exalted,  and  great  restlessness  is  the  result. 

In  full  dose  (gr.  iij-v)  the  same  symptoms  are  produced  but  in  greater 
intensity;  the  stage  of  stimulation  is  much  shorter,  digestion  is  arrested, 
nausea  and  vomiting  produced,  also  profuse  diaphoresis.  The  conduc¬ 
tivity  of  the  nerves  is  more  or  less  impaired,  the  heart  and  circulation 
depressed,  oxidation  being  interfered  with  and  the  body-temperature 
lowered.  The  pupils  are  contracted  by  stimulation  of  the  motor  oculi 
through  the  basal  ganglia,  intense  pruritus  is  produced  especially  at  the 
nose,  and  often  spasmodic  retention  of  the  urine.  Profound  sopor  soon 
comes  on,  with  irregular  and  slow  respiration,  but  in  some  subjects  this  is 
replaced  by  coma-vigil  and  delirium.  After-effects  are  nausea,  depression, 
constipation,  racking  headache,  vertigo,  anorexia,  nasal  pruritus,  and  fetid 
pathological  secretions. 

A  toxic  dose  produces  cold  and  clammy  sweat,  very  slow  pulse,  slow 
and  stertorous  respiration  gradually  becoming  feeble  and  irregular,  cyanosed 
face,  abolished  reflexes,  coma  gradually  deepening,  the  pupils  minutely 
contracted  but  dilating  as  the  end  approaches,  and  finally  death  by 
paralysis  of  the  respiratory  centre  due  to  direct  action  on  the  medulla. 
Post-mortem  shows  only  a  wet  brain,  congested  lungs,  and  engorgement 
of  the  venous  trunks  and  of  the  right  heart. 

The  principal  action  of  Opium  is  exerted  upon  the  nervous  system, 
first  affecting  the  cerebral  convolutions  which  are  briefly  stimulated  and 
soon  depressed, — next  the  perceptive  and  sensory  centres  in  the  higher 
brain  are  more  or  less  blunted  and  the  conductivity  of  the  afferent  nerves 
impared, — soon  the  ganglia  at  the  base  of  the  brain  are  involved,  evinced 
by  the  contraction  of  the  pupils,  vomiting,  and  slowing  of  respiration, — 
the  cardiac,  vascular  and  other  centres  are  depressed  but  to  a  less  degree 
than  the  respiratory  and  perceptive, — the  gray  matter  of  the  cord,  at  first 
stimulated,  as  shown  by  the  increase  of  reflex  excitability,  is  also 
depressed,  and  locomotion  becomes  difficult,  the  motor  nerves  becoming 
paralyzed  from  the  centre  outwards,  but  muscular  irritability  is  never  lost. 


296 


OPIUM. 


Death  generally  occurs  by  paralysis  of  the  respiratory  centre  rarely  by 
sudden  cardiac  failure. 

Metabolism  is  greatly  reduced  in  activity  by  Opium,  the  quantity  of 
urea  excreted  being  markedly  lessened,  and  the  biliary  and  glycogenic 
functions  of  the  liver  being  affected,  resulting  in  whitish  stools,  perhaps 
jaundice,  and  certainly  decided  decrease  of  the  sugar  excreted  by  dia¬ 
betics,  when  given  by  the  stomach. 

On  the  uterine  and  generative  functions  Opium  exerts  a  marked  influ¬ 
ence,  stopping  menstruation  if  its  use  be  continued,  and  in  men  causing 
impotence.  Both  male  and  female  functions,  however,  return  as  soon  as 
the  drug  is  discontinued. 

The  hypnotic  action  of  Opium  is  now  believed  to  be  produced  by  a 
double  influence,  (1)  on  the  vascular  system,  causing  anaemia  of  the  brain, 
(2)  on  the  cerebral  cells,  diminishing  their  activity,  and  consequently 
lessening  their  demand  for  blood. 

Its  constipating  action  is  shown  experimentally  to  be  produced  by 
stimulation  of  the  inhibitory  nerves  of  the  intestines  through  the  splanch- 
nics. 

Morphine  acts  similarly  to  Opium  in  general,  being  the  principal  alka¬ 
loid  therein,  but  when  used  alone  its  influence  is  not  complicated  with 
that  of  the  convulsant  alkaloids  (Thebaine,  Codeine,  Narcotine),  which 
must  affect  to  a  considerable  degree  the  action  of  Opium.  Consequently, 
as  compared  with  the  latter,  Morphine  acts  more  quickly,  and  for  a 
shorter  time,  has  less  influence  on  the  intestines  and  skin,  is  less  constipa¬ 
ting,  less  stimulating,  less  convulsant  and  less  diaphoretic,  but  more  seda¬ 
tive,  more  anodyne  and  hypnotic  and  produces  more  intense  pruritus. 
Its  excretion  commences  quickly  but  may  not  be  completed  for  as  much 
as  48  hours,  and  is  affected  by  most  of  the  secretions,  especially  by  the 
urine.  It  is  probably  retained  in  the  system  when  the  action  of  the 
kidneys  is  defective,  and  hence  when  given  in  renal  disease  may  accumulate 
with  fatal  results. 

Codeine  may  chemically  be  considered  a  Methyl-morphine,  and  like 
all  methyl  compounds,  has  an  action  like  that  of  Curare,  viz., — a  motor- 
paralyzant.  It  exalts  the  spinal  cord  more  than  Morphine  and  affects  the 
cerebrum  less,  producing  muscular  tremor  in  excess  of  the  sedative  action. 
It  is  anodyne  and  analgesic, .  especially  to  abdominal  and  pelvic  pain, 
also  hypnotic  with  less  general  disturbance  than  produced  by  Morphine. 
It  markedly  reduces  the  amount  of  sugar  excreted  by  diabetics,  and  has 
a  special  sedative  influence  on  the  pneumogastric  nerve. 

Narcotine  should  be  named  Anarcotine,  as  it  has  little  or  no  narcotic 
power.  It  is  a  convulsant  in  animals  and  an  antiperiodic  in  man. 

Narceine  is  said  by  some  observers  to  be  remarkably  hypnotic,  and 
free  from  convulsant  action — by  others  equally  deserving  of  credit  it  is 


OPIUM. 


29  7 


considered  almost  inert.  This  alkaloid  is  difficult  to  obtain  pure;  hence 
the  samples  heretofore  used  have  probably  been  contaminated  with  other 
alkaloids. 

Thebaine  is  a  powerful  convulsant,  exalting  the  spinal  cord  almost  like 
Strychnine  and  Brucine.  It  is  not  used  medicinally. 

Fatal  Doses. 

In  a  child  one  day  old  npj  of  Laudanum  caused  death.  A  medicinal 
dose  given  to  a  nursing  mother  proved  fatal  to  the  infant.  A  few  drops 
of  Paregoric  have  killed  a  child  of  nine  months.  In  the  adult  gr.  ^  of 
Morphine  in  one  case,  and  gr.  iv  of  crude  Opium  in  another,  have  proved 
fatal. 

Antagonists  and  Treatment  of  Poisoning. 

Atropine  antagonizes  the  cerebral  action  of  Morphine,  also  its  action  on  the  pupils, 
respiration,  heart  and  arterial  tension,  but  if  given  too  freely  will  endanger  the  case  by 
substituting  Belladonna-narcosis  for  Opium-narcosis.  Gr.  hypodermically  every  15 
minutes  for  three  doses,  is  generally  sufficient.  Caffeine  is  also  physiologically  antago¬ 
nistic,  and  is  generally  used  in  the  form  of  strong  black  coffee  frequently  administered. 
The  chief  indications  in  Opium-poisoning  are — to  evacuate  the  stomach,  maintain  respira¬ 
tion  and  keep  up  the  circulation.  Faradization  of  the  chest  muscles,  cold  affusion,  and 
artificial  respiration  are  of  great  value,  and  evacuation  of  the  bladder  is  important.  Fla¬ 
gellation  is  a  very  dangerous  procedure,  from  the  exhaustion  which  maybe  produced; 
strong  faradic  currrents  are  much  more  efficient.  The  anode  should  be  placed  over  the 
lowest  conjoined  root  of  the  phrenic  nerve — the  cathode  three  inches  below  the  ensiform 
cartilage,  and  a  little  to  the  left  of  the  median  line. 

Strychnine  is  an  efficient  antagonist  to  the  respiratory  paralysis,  and  may  be  used  in 
lieu  of  Atropine,  or  in  connection  therewith.  Amyl  Nitrite  should  also  be  used  when 
the  heart  shows  signs  of  failure. 

Some  of  the  cerebral  effects  of  Opium,  as  vertigo  and  mental  confusion,  are  removed 
by  a  full  dose  of  Potassium  Bromide,  others  are  antagonized  by  Quinine,  and  the  general 
intra-cranial  effects  of  the  drug  are  to  some  extent  opposed  by  Digitalis  and  Tartar  Emetic. 

Atropine  may  be  advantageously  combined  with  Morphine  in  solution  for  hypodermic 
injection,  in  the  proportions  of  gr.  to  of  the  former  to  gr.  of  the  latter,  pre¬ 
venting  the  sickness  and  depression  and  many  other  unpleasant  after-effects  of  Morphine 
while  increasing  its  anodyne,  hypnotic  and  antispasmodic  powers. 

Therapeutics. 

The  chief  indications  for  the  use  of  Opium  are  (1)  to  relieve  pain  from 
any  cause  except  acute  inflammation  of  the  brain, — (2)  to  produce  sleep, 
particularly  in  the  insomnia  of  low  fevers  with  delirium,  in  which  the 
combination  of  Morphine  and  Chloral  is  very  efficient, — (3)  to  allay  irri¬ 
tation  in  the  various  forms  of  acute  nervous  erethism, — (4)  to  check  ex¬ 
cessive  secretion,  as  in  diarrhoeas,  dysentery,  diabetes,  ptyalism,  etc., — 
(5)  to  support  the  system  in  low  fevers  and  other  adynamic  conditions, 
when  sufficient  food  cannot  be  retained, — (6)  as  a  sudorific,  to  produce 
sweating  in  coryza,  etc.  It  is  considered  of  especial  value  in  any  irrita¬ 
tion  of  the  stomach,  bladder  or  bronchi,  in  severe  vomiting,  both  forms 
of  diabetes,  gastralgia,  colic  and  muscular  spasm.  In  diabetes  mellitus 
Morphine  per  orem  reduces  the  sugar  promptly,  but  when  used  hypodermi¬ 
cally  it  has  little  or  no  effect  thereon,  even  in  the  same  case.  In  perito¬ 
nitis  and  inflammations  of  other  serous  membranes,  used  freely  even  to 


298 


OPIUM. 


narcotism  it  has  often  saved  life.  In  cerebro-spinal  meningitis  it  is  the 
one  remedy  if  given  early,  before  exudation  has  set  in.  Cholera  morbus 
and  dysentery  are  efficiently  treated  by  Morphine  and  Atropine  hypoder¬ 
mically  (gr.  with  gr.  y^oO  after  the  ingesta  have  been  removed  by  purg¬ 
ing.  In  acute  uraemia  its  use  in  large  doses  is  recommended  by  Loomis 
to  control  convulsions  and  promote  diuresis,  but  here  it  is  a  dangerous 
agent.  In  muscular  rheumatism  and  acute  colds  Dover’s  powder  as  a 
diaphoretic,  conjoined  with  hot  drinks  and  foot-baths,  is  old  but  excel¬ 
lent  treatment.  In  delirium  tremens,  acute  and  chronic  mania  and  melan¬ 
cholia,  nervous  prostration  and  the  delirium  of  fevers,  Opium  is  probably 
the  best  hypnotic.  Severe  pain  from  any  cause  (except  cerebritis)  is 
relieved  by  Opium  with  an  efficiency  possessed  by  no  other  drug,  as  the 
pain  of  sciatica,  neuralgia,  lumbago,  cancer,  renal  and  hepatic  colic  from 
calculi,  etc.  Cough  of  harassing  and  frequent  character  with  but  little 
secretion  is  best  treated  by  Opium,  but  when  there  is  profuse  expectora¬ 
tion  it  should  not  be  used,  as  the  lowering  of  excitability  of  the  respira¬ 
tory  centre  which  it  produces  would  in  such  a  case  be  dangerous.  In 
nearly  all  acute  inflammations  it  is  valuable,  especially  where  it  becomes 
advisable  to  lock  up  the  bowels.  Its  tranquillizing  power  over  the  circu¬ 
lation  makes  it  invaluable  in  the  various  forms  of  hemorrhage,  while  in 
that  from  uterine  fibroids  and  cancer  the  implanting  of  the  Opium-habit 
is  deserving  of  serious  consideration  as  a  most  beneficial  measure,  as  it 
checks  and  even  stops  the  bleeding,  as  soon  as  established.  Dyspnoea 
from  any  cause  is  relieved  by  Morphine,  especially  that  of  cardiac  disease. 
“  It  gives  the  power  to  breathe  ”  (Huchard).  In  cardie  disease,  especially 
aortic  stenosis  or  insufficiency,  with  dyspnoea,  paroxyms  of  angina  pectoris, 
or  signs  of  cerebral  anaemia, — Morphine  hypodermically  presents  the  great¬ 
est  advantages. 

Applications  of  the  Various  Preparations. 

Intense  pain,  as  from  the  passage  of  calculi,  is  best  met  by  hypodermic 
injection  of  Morphine  Sulphate  in  full  doses  (gr.  with  Atropine 

Sulphate  (gr.  y-J-^).  Either  the  solution  of  Morphine  or  the  liquid  prepa¬ 
rations  of  Opium  may  be  given  by  the  mouth  in  corresponding  doses  for 
the  same  purpose.  Severe  pain  enables  the  system  to  resist  the  action  of 
Opium,  which  in  such  cases  should  be  repeated  at  short  intervals  for  effect 
regardless  of  dosage. 

Superficial  pain  is  often  alleviated  by  the  Plaster  or  by  extemporaneous 
liniments  containing  Laudanum  or  some  other  fluid  preparation.  It  is, 
however,  very  doubtful  whether  such  applications  are  of  direct  value,  as 
Morphine  is  not  absorbed  by  the  unbroken  integument ;  but  the  Oleate 
of  Morphine  is  said  to  be  very  penetrating. 

To  produce  sleep  the  most  efficient  preparations  are  the  Deodorized 


OPIUM. 


299 


Tincture,  the  Solution  of  Morphine,  Pil.  Opii  and  Dover’s  Powder,  in 
doses  corresponding  to  the  degree  of  insomnia  and  restlessness  present. 

Cough  is  relieved  by  the  two  Trochisci,  the  Deodorized  and  Camphor¬ 
ated  Tinctures,  and  by  the  Solution  of  Morphine  in  small  doses  with 
Syrup  of  Wild  Cherry  or  Syrup  of  Tolu. 

Diaphoresis  is  best  obtained  by  the  use  of  Dover’s  Powder  in  either  of 
its  three  forms. 

Sedative  action  is  obtained  by  different  preparations  for  different  organs. 
The  stomach  is  best  affected  by  the  Solution  of  Morphine  in  effervescing 
mixtures,  the  Extract  in  a  small  pill,  or  Morphine  hypodermically  over 
the  epigastrium.  The  intestines  may  be  influenced  by  Laudanum  in  a 
starch  enema,  or  internally  by  Dover’s  Powder,  Pulvis  Opii,  or  Pil.  Opii, 
especially  the  latter  with  or  without  Calomel,  as  an  astringent  when  the 
bowel  must  be  paralyzed,  as  in  peritonitis,  hernia,  intussusception,  etc. 
The  rectum  and  other  pelvic  organs  are  promptly  affected  by  a  suppository 
of  the  Extract  of  Opium,  gr.  %  with  gr.  of  the  Extract  of  Belladonna. 
The  ovaries  and  the  abdominal  and  pelvic  organs  generally  are  markedly 
susceptible  to  the  analgesic  action  of  Codeine  in  doses  of  gr.  ss  to  gr.  j  for 
an  adult  in  severe  pain. 

Administration. 

Probably  no  drug  in  the  Materia  Medica  is  so  useful  as  Opium,  or  has 
so  wide  a  range  of  application.  At  the  same  time  no  drug  requires  such 
careful  handling,  by  reason  of  the  many  influences  which  modify  its  action 
and  uses.  As  before  pointed  out,  children  are  extremely  susceptible  to  its 
narcotic  action,  and  women  are  more  easily  affected  by  it  than  men. 
Many  persons  are  found  with  idiosyncrasies  in  respect  to  Opium,  some 
being  easily  narcotized,  others  being  remarkably  insusceptible  to  its  action, 
and  many  suffer  from  a  decided  shock  after  its  hypodermic  administration, 
which  may  even  produce  alarming  symptoms  of  collapse.  In  subjects  of 
kidney  disease  it  may  accumulate  and  act  more  powerfully  than  expected, 
and  generally  it  may  be  said  to  be  contraindicated  or  to  be  used  with  great 
care  in  alcoholism,  congestion  of  the  brain,  and  advanced  disease  of  the 
respiratory  organs,  heart  and  kidneys. 

The  conjoint  administration  with  opiates,  of  the  Spiritus  zEtheris, 
Spiritus  ^Etheris  Comp.,  or  Spiritus  ^Etheris  Nitrosi,  an  equal  part  with 
Tinctura  Opii  Deodorata,  will  prevent  the  nausea  often  excited  by  the  latter, 
and  correct  the  “drying-up  ’  ’  effects  of  opium,  due  to  its  checking  secretion. 

Morphine  and  Atropine  are  sufficiently  antagonistic  to  each  other  to  make  their 
combination  extremely  valuable  as  a  therapeutic  measure,  and  their  use  as  mutual  antidotes 
in  poisoning  by  either  a  most  efficient  procedure  if  employed  with  due  precautions.  When 
Morphine  is  given  as  a  hypnotic  or  an  anodyne,  Atropine  should  always  be  administered 
at  the  same  time  in  the  proportion  of  gr.  yIo“t^o  Liter  to  gr.  %  of  the  former. 

By  this  means  the  anodyne  and  hypnotic  qualities  of  Morphine  are  increased,  while  the 
nausea  and  depression  with  the  subsequent  dyspepsia  and  constipation  due  to  it  are  avoided. 
Moreover,  as  in  the  doses  above  mentioned  Atropine  is  a  cardiac  and  respiratory  stimu¬ 
lant,  it  will  counteract  the  depressing  tendency  of  Morphine  on  the  heart  and  respiration 
in  subjects  who  have  undue  susceptibility  to  its  action. 


300 


ORIGANUM - PANCREATJNUM - PAPAIN. 


ORIGANUM,  Wild  Marj  oram, — is  the  plant  Origanum  vulgaref 
a  perennial  herb  of  the  nat.  ord.  Labiatae,  native  of  Europe  and  America, 
having  a  stem  branched  above,  petiolate  leaves  about  an  inch  long  and 
hairy  beneath,  pale  purple  flowers,  aromatic,  pungent  and  bitterish.  It 
contains  a  Volatile  Oil,  some  tannin,  resin,  and  a  bitter  principle.  The 
oil  was  formerly  much  used  and  was  official,  but  it  is  now  entirely  super¬ 
seded  by  the  Oil  of  Thyme.  Origanum  is  an  ingredient  of  Vinum  Aro- 
maticum.  There  are  no  official  preparations.  Dose,  5j-ij>  in  infusion. 

Physiological  Action  and  Therapeutics. 

Origanum  is  gently  tonic,  also  carminative,  stimulant  and  emmena- 
gogue.  It  was  formerly  much  employed  as  a  diaphoretic,  etc.,  but  is  now 
rarely  administered. 

PANCREATINUM,  Pancreatin,  (Unofficial), — is  the  juice  of  the 
pancreas,  and  consists  of  four  ferments  :  (i)  Pancreatic  Diastase ,  the 
amylolytic  ferment,  (2)  Trypsin ,  the  proteolytic  ferment,  (3)  a  fat  emulsi¬ 
fying  and  (4)  a  milk-curdling  ferment.  It  is  marketed  in  various  forms, 
named  Pancreatine,  Pancreatic  Emulsion,  and  Liquor  Pancreaticus,  of 
which  the  last-named  is  the  most  efficient  preparation. 

Liquor  Pancreaticus,  Pancreatic  Solution  (Unofficial), — prepared  by  digesting  a  finely- 
chopped  pig’s  pancreas  with  4  times  its  weight  of  dilute  alcohol.  Is  a  nearly  clear 
alcoholic  solution,  with  little  taste  or  smell.  Dose,  ^j-^ss. 

Physiological  Action  and  Therapeutics. 

Pancreatic  preparations  are  active  digestives  of  proteid  and  amyloid 
foods,  converting  proteids  into  peptones,  and  emulsifying  fats,  in  the 
presence  of  an  alkaline  solution  (Pepsin  requiring  an  acid  one).  Pan¬ 
creatin  is  digested  by  Pepsin,  and  hence  probably  never  passes  into  the 
duodenum  in  its  own  character.  Trypsin  affects  albuminoids  even  in  a 
slightly  acid  solution.  Liquor  Pancreaticus  is  used  to  partially  digest 
(peptonize)  milk,  gruel,  soups  and  other  foods,  before  their  administra¬ 
tion  in  cases  of  great  digestive  debility.  These  peptonized  foods  may  be 
administered  per  orem  vet  rectum ,  and  are  valuable  in  intestinal  dyspepsia, 
wasting  diseases,  and  convalescence  from  acute  affections.  A  teaspoon¬ 
ful  taken  after  the  administration  of  Cod-liver  Oil  will  prevent  the  dis¬ 
agreeable  eructations  which  are  so  offensive  to  some  patients,  and  will  aid 
in  the  digestion  of  the  oil. 

Trypsin,  unlike  Pepsin,  will  dissolve  mucin,  and  like  Pepsin  it  is  inert 
towards  nuclein,  horny  tissues  and  amyloid  matter.  Used  as  a  spray  on 
diphtheritic  membrane  it  has  proved  a  very  efficient  solvent. 

PAPAIN,  Papaiva  (Unofficial), — is  a  ferment  obtained  from  the 
milky  juice  of  Carica  Papaya ,  a  S.  American  fruit-tree  of  the  nat.  ord. 


PARALDEHYDE - PAREIRA. 


301 


Papayacese.  It  is  soluble  in  water  but  not  in  alcohol,  and  has  active 
digestive  powers.  It  softens  and  dissolves  fibrin  in  liquids  which  may 
be  either  acid,  or  neutral,  or  slightly  alkaline,  in  this  respect  differing 
greatly  from  Pepsin.  It  also  acts  at  higher  temperatures  and  more  rapidly 
than  Pepsin.  It  is  a  rapid  solvent  of  false  membranes  and  intestinal 
worms.  It  has  been  injected  into  tumors,  dissolving  the  tissues  in  its 
vicinity,  but  with  much  pain  and  considerable  febrile  reaction.  It  is  not 
used  internally,  as  it  is  feared  that  it  may  digest  the  gastro-intestinal 
mucous  membrane  as  well  as  its  contents. 

Papaw  Milk  is  the  milky  juice  of  the  fruit,  coagulating  into  two  parts,  a  pulpy  mass 
and  a  liquid  serum.  When  mixed  with  alcohol  an  amorphous  powder  is  precipitated, 
which  when  dried  forms  Papain. 


PARALDEHYDE,  C6H1203  (Unofficial), — is  a  polymeric  modifi¬ 
cation  of  Aldehyde,  fluid  above  510  F.,  solidifying  below  that  tempera¬ 
ture,  soluble  in  50  of  water.  Dose,  npxx-5j.  It  is  powerfully  hypnotic 
and  diuretic,  but  has  no  diaphoretic  action.  It  possesses  many  of  the 
qualities  of  Chloral  with  none  of  its  dangers,  strengthening  and  slowing 
the  heart,  instead  of  weakening  it.  A  toxic  dose  paralyzes  the  medulla 
and  the  respiratory  centre.  As  compared  with  Chloral  its  action  is 
not  so  persistent  and  it  requires  more  frequent  repetition,  but  it  is  un¬ 
questionably  safer,  As  a  hypnotic  it  has  been  used  with  great  benefit 
in  fevers,  rheumatism,  acute  mania,  hysteria,  and  insomnia  from  various 
causes.  The  above-mentioned  maximum  dose  has  frequently  been 
given  without  any  ill-effect,  and  with  no  digestive  or  cerebral  dis¬ 
turbances  afterwards. 

For  formula  see  under  Insomnia,  in  Part  III. 

PAREIRA,  Pareira  Brava,  — is  the  root  of  Chondodendron  tomen- 
tosum ,  a  climbing,  woody  vine  of  the  nat.  ord.  Menispermaceae,  with 
very  large  leaves  and  grape-like  fruit,  inhabiting  Peru  and  Brazil.  Occurs 
in  sub-cylindrical,  tortuous  pieces,  4  to  6  inches  long,  dark  brownish- 
gray  externally,  with  transverse  ridges,  fissures  and  furrows ;  internally 
pale-brown,  interior  woody,  porous,  in  concentric  circles  with  medullary 
rays.  It  contains  Pelosine  or  Cissampeline ,  an  alkaloid  identical  with  the 
Berberine  of  Nectandra  and  the  Buxine  of  Buxus  semperviretis  (Box¬ 
wood). 

Several  other  Pareiras  are  on  the  market,  that  from  the  West  Indies 
( Cissampelos  Pareira )  being  the  plant  formerly  official  in  the  Br.  Phar¬ 
macopoeia. 

Preparations. 

Extradum  Pareirce  Fluidum , — Dose,  3  ss-  3  j. 

Infusum  Pareira:  (Unofficial), —  1  in  17.  Dose,  ^j-ij. 


302 


PEPO - PEPSINUM. 


Physiological  Action  and  Therapeutics. 

Pareira  is  diuretic  and  laxative,  stimulating  peristalsis  and  the  action  of 
the  kidneys.  It  is  eliminated  by  the  renal  secretion,  and  passing  over  the 
mucous  membrane  of  the  genito-urinary  tract,  it  acts  thereon  in  a  tonic 
and  soothing  manner,  especially  on  the  bladder. 

It  is  particularly  useful  in  chronic  cystitis,  suppurative  kidney  diseases, 
gonorrhoea  and  gleet,  but  must  be  used  internally,  as  when  injected  locally 
for  gonorrhoea  and  cystitis  it  has  not  proved  successful.  Formerly  Pareira 
was  considered  an  efficient  lithontriptic,  and  in  Brazil  it  is  used  as  a  cure 
for  bites  of  poisonous  serpents,  being  employed  both  internally  and  locally 
to  the  wound. 


PEPO,  Pumpkin-seed, — is  the  seed  of  Cucurbita  Pepo,  or  common 
Pumpkin  (nat.  ord.  Cucurbitaceae),  about  inch  long,  white,  flat,  oval, 
inodorous,  bland  and  oily.  The  active  principle  is  a  resin  contained  in 
the  endopleuron  or  envelope  immediately  surrounding  the  embryo.  It 
also  contains  an  alkaloid  Cucurbitine ,  a  fixed  oil,  starch,  sugar,  etc.  There 
are  no  official  preparations.  Dose,  of  the  resin,  gr.  xv ;  of  the  seeds, 
5j-ij,  beaten  up  in  emulsion  with  sugar  and  water. 

Physiological  Action  and  Therapeutics. 

Pumpkin-seed  is  an  efficient  agent  for  the  removal  of  tapeworm  (taenia- 
fuge),  and  its  use  is  not  followed  by  unpleasant  symptoms.  The  outer 
coat  of  the  seed  should  be  removed,  and  an  emulsion  then  made  by  tritu¬ 
ration  with  sugar  and  water.  This,  if  taken  on  an  empty  stomach  and 
followed  by  a  brisk  cathartic,  will  generally  prove  effective.  Dr.  Squibb 
maintains  that  the  seeds  should  not  be  decorticated,  but  that  husks  and 
all  should  be  swallowed.  According  to  some  observers  the  expressed  oil 
is  equally  efficient  in  doses  of  ^ss  repeated  twice  or  three  times,  and  fol¬ 
lowed  by  a  cathartic. 


PEPSINUM,  Pepsin  , — is  a  hypothetical  name  for  the  digestive 
principle  of  the  gastric  juice,  and  as  a  definite  body  is  unknown,  the  vari¬ 
ous  preparations,  official  and  unofficial,  being  mere  approximations,  and 
vary  much  from  each  other.  They  are  usually  obtained  from  a  solution 
prepared  by  digesting  the  mucous  membrane  scraped  from  the  rennet-bags 
of  sheep  or  the  stomach  of  the  pig  in  acidulated  water  for  several  days. 
The  so-called  “Pepsin”  is  then  precipitated  by  Chloride  of  Sodium 
(, Scheffer ),  Acetate  of  Lead  (. Boudault ),  or  by  drying  the  peptones  on  glass 
plates  ( Beale ).  It  may  also  be  precipitated  by  alcohol.  By  Scheffer’s 
process  it  occurs  as  a  tough,  gray,  leathery  substance,  partially  soluble  in 
water,  one  grain  dissolving  3000  grains  of  albumen  in  a  few  days.  Jen- 


PEPSINUM. 


303 


sen’s  “Crystal  Pepsin,”  probably  prepared  after  Beale’s  method,  is  in 
yellowish,  translucent  scales,  soluble  in  water,  and  reputed  to  be  many 
times  stronger  than  any  other  preparation  yet  obtained. 


Preparations. 

Pepsinutn  Saccharatum ,  Saccharated  Pepsin, — is  Pespin  obtained  from  the  mucous 
membrane  of  the  hog,  and  mixed  with  powdered  Sugar  of  Milk.  One  part  dissolved  in 
500  of  water  acidulated  with  7^  of  Hydrochloric  Acid,  should  digest  at  least  50  parts  of 
hard-boiled  egg-albumen  in  5  or  6  hours  at  a  temperature  of  ioo°  to  104°  F.  Dose,  gr. 
v-^j,  soon  after  meals. 

Liquor  Pepsini,  Liquid  Pepsin, — contains  of  Saccharated  Pepsin  40  parts,  Hydrochloric 
Acid  12,  Glycerin  400,  Water  q.  s.  ad  1000  parts.  Dose,  3  ij— iv,  after  meals. 

Lactopeptine  (Unofficial), — claimed  to  contain  Pepsin,  Diastase  or  Ptyalin,  Pancreatin, 
Lactic  and  Hydrochloric  Acids,  and  that  3  j  will  digest  5  viij-x  of  albumen,  fibrin,  casein, 
or  gelatin,  will  emulsionize  3  xvj  of  cod-liver  oil,  and  convert  3  iv  of  starch  into  glucose. 
A  proprietary  preparation.  Dose,  gr.  v-xv.  Is  said  to  break  a  glass,  if  stirred  therein 
with  water. 

Ingluvin  (Unofficial), — is  a  preparation  obtained  from  the  gizzard  of  the  domestic 
fowl,  which  owes  its  activity  to  no  ferment  corresponding  to  Pepsin,  but  to  a  peculiar 
bitter  principle.  Dose,  gr.  x-xxx. 

[Every  manufacturer  has  his  own  preparation  of  Pepsin,  and  his  peculiar  name  there¬ 
for,  such  as  “  Liquid  Pancreopopsine,”  “  Lacto-peptine,”  “  Gluco-pepsine,”  “  Golden 
Scale  Pepsin,”  “  Peptogenic  Milk  Powder,”  etc.  They  vary  considerably  in  their  prop¬ 
erties,  but  all  have  the  power  in  some  degree  of  digesting  albumen  or  fibrin. 


Physiological  Action. 

Pepsin  is  not  a  solvent  but  a  ferment,  and  is  a  normal  constituent  of 
the  gastric  juice,  converting  albuminoids  (casein,  albumen,  fibrin,  etc.) 
into  peptones  for  assimilation,  with  the  aid  of  the  Lactic  and  Hydro¬ 
chloric  Acids  associated  with  it.  This  it  will  do  out  of  the  body  or  in 
cavaties  as  the  rectum,  if  warmth,  acidity  and  moisture  be  present.  Pan¬ 
creatin,  on  the  other  hand,  is  destroyed  by  acids  and  requires  an  alkaline 
medium  in  which  to  exercise  its  powers.  As  the  food  passes  out  of  the 
stomach  in  2  or  3  hours,  Pepsin  should  be  administered  within,  and  Pan¬ 
creatin  after  that  period  to  be  effective. 

Incompatibles. 

Alcohol  destroys  the  activity  of  Pepsin.  Alkalies  and  many  mineral  salts  precipitate  it. 

Therapeutics. 

Dyspepsia  in  its  various  forms  is  the  malady  for  which  Pepsin  is  chiefly 
employed,  but  it  is  also  extremely  useful  in  the  apepsia  of  infants,  gas- 
tralgia,  anaemia,  chlorosis,  gastric  ulcer  and  cancer,  the  diarrhoea  of 
infants  and  vomiting  of  pregnancy.  It  is  added  to  nutritive  enemata, 
the  rectum  not  being  a  digestive  organ,  and  is  injected  into  the  substance 
of  morbid  growths  which  are  homologous  to  the  tissues,  particularly  fatty 
tumors,  for  the  purpose  of  arresting  their  growth  and  promoting  their 
absorption.  It  has  been  injected  into  the  bladder  to  break  down  a  blood- 
clot,  and  has  been  suggested  as  an  atomized  inhalation  in  diphtheria  and 
croup  to  digest  the  membrane  without  injuring  the  living  tissues. 


304 


PETROLATUM - PHOSPHORUS. 


Ingluvin  is  particularly  useful  against  vomiting  and  has  been  found 
exceptionally  efficient  in  the  vomiting  of  pregnancy,  given  in  20-grain 
doses  before  meals.  [Compare  Pancreatin,  ante ,  page  300.] 


PETROLATUM,  Petroleum  Ointment, — is  a  semi-solid  sub¬ 
stance,  consisting  of  hydrocarbons,  obtained  from  Petroleum  by  distil¬ 
ling  off  the  lighter  portions  and  purifying  the  residue.  It  is  a  yellowish, 
fat-like  mass,  somewhat  fluorescent,  amorphous,  odorless  and  tasteless,  of 
neutral  reaction,  insoluble  in  water  or  alcohol,  soluble  in  ether,  chloro-^ 
form,  fixed  and  volatile  oils,  benzin,  etc.  Its  melting  point  is  from  104°  F. 
to  1250  F. ,  the  first  being  the  softer,  and  the  second  the  firmer  variety. 
Commercially,  it  is  known  as  Cosmoline ,  Vaseline ,  etc.,  and  is  largely 
prepared  from  residuums  or  sediments  deposited  in  tanks  containing 
crude  petroleum. 

Physiological  Action  and  Therapeutics. 

Petrolatum  is  a  valuable  protective  dressing,  and  an  excellent  basis  for 
ointments,  having  no  acridity  and  no  liability  to  become  rancid.  It  is 
readily  miscible  with  many  active  agents,  as  the  alkaloids,  phenol  com¬ 
pounds,  etc.,  but  it  does  not  penetrate  the  skin  as  readily  as  animal  fats 
and  fixed  oils.  Uncombined,  it  forms  an  excellent  bland  application  in 
all  irritated  conditions  and  injuries  of  the  skin. 


PHOSPHORUS,  Phosphites  and  Phosphates, — are  best 
studied  together,  as  the  supplying  of  the  element  Phosphorus  to  the  body 
is  the  aim  of  the  administration  of  these  agents. 

Phosphorus,  P, — is  a  non-metallic  element  obtained  from  bones, 
and  occurs  as  a  translucent,  nearly  colorless  solid,  of  waxy  lustre,  and 
usually  the  consistence  of  beeswax,  insoluble  in  water,  soluble  in  50  parts 
of  any  fatty  oil,  in  80  of  absolute  ether,  350  of  absolute  alcohol,  and 
freely  in  carbon  bisulphide.  It  has  a  disagreeable  odor  and  taste,  melts 
at  1  ii°  F.,  is  luminous  in  the  dark,  ignices  in  the  air,  and  should  be  kept 
under  water  in  a  cool  place,  protected  from  light.  It  usually  contains 
Arsenic  and  sometimes  Sulphur,  the  limits  of  which  are  fixed  by  the  phar- 
macopoeial  tests.  Dose,  gr.  yo  o~ iV,  thrice  daily. 

Preparations  of  Phosphorus. 

Pilules  Phosphoric  Pills  of  Phosphorus, —  each  contains  gr.  of  Phosphorus,  dis¬ 
solved  in  Chloroform,  mixed  with  Althaea  and  Acacia  in  Glycerin  and  Water,  and  coated 
by  shaking  with  a  solution  of  Balsam  of  Tolu  in  Ether.  Dose,  j-v. 

Oleum  Phosphoratum ,  Phosphorated  Oil, — has  of  Phosphorus  1  part,  ^Ether  Fortior 
8,  Expressed  Oil  of  Almond  q.  s.  ad  100  parts.  Dose,  j-v  thrice  daily. 

Acidicm  Phosphoricum  and  Acidum  Phosphoricum  Dilutum , — are  described  on  page 
71,  ante. 

Tinctura  Phosphori  (Thompson’s),  Unofficial. — Phosphorus  gr.  j,  Absolute  Alcohol 


PHOSPHORUS,  PHOSPHITES  AND  PHOSPHATES.  305 


£v,  Glycerin  Alcohol  3  ij,  Spt.  Menthse  Piperitse  rr^xl.  Of  this  gj  contains  gr. 

fs  of  Phosphorus. 

Tincturi  Phosphori  (Bellevue  Hospital),  Unofficial, — Phosphorus  gr.  xxxij,  Absolute 
Alcohol  ^xlvj,  Essence  of  Vanilla  Oil  of  Orange  3  iij ,  Alcohol  q.  s.  ad  3  xlviij. 
Of  this  3  j  contains  gr.  TL  of  Phosphorus. 

Zinci  Phosphidum ,  Phosphide  of  Zinc,  Zn3P2, — crystalline  fragments  or  a  gray-black 
powder,  insoluble  in  water  or  alcohol,  but  completely  soluble  in  hydrochloric  or  sulphuric 
acids  with  evolution  of  phosphoretted  hydrogen.  Is  very  irritant  to  the  stomach.  Dose, 

§r-  T)V— 2V* 

Preparations  of  Phosphites. 

Calcii  Hypophosphis,  Hypophosphite  of  Calcium,  Ca4(P02)3, — colorless  prisms,  or 
thin,  pearly  scales,  of  nauseous  taste,  soluble  in  6.8  of  water,  insoluble  in  alcohol.  Is  an 
ingredient  of  the  Syrupus  Hypophosphitum.  Dose,  gr.  x-xxx. 

Ferri  Hypophosphis,  Ferric  Hypophosphite,  Fe2(H2P02)6, — a  white  or  grayish-white 
powder,  odorless  and  tasteless,  slightly  soluble  in  water,  freely  so  in  hydrochloric  acid  or 
a  solution  of  sodium  nitrate.  Dose,  gr.  v-x.  A  ferruginous  tonic. 

Potassii  Hypophosphis ,  KH2P02, — white  masses,  or  a  white,  granular  powder,  deli¬ 
quescent,  odorless,  of  saline  taste  and  neutral  reaction.  Soluble  in  0.6  of  water  and  in 
7.3  of  alcohol  at  590  F.  Dose,  gr.  v-x. 

Sodii  Hopophosphis,  NaH2P02H20, — small  plates,  or  a  white,  granular  powder,  deli¬ 
quescent,  odorless,  of  sweetish,  saline  taste,  and  neutral  reaction.  Soluble  in  I  of  water 
and  30  of  alcohol  at  590  F.  Dose  gr.  v-x. 

Syrupus  Hypophosphitum ,  Syrup  of  Hypophosphites, — has  of  the  calcium  salt  35,  of 
the  Sodium  and  Potassium  salts  each  12,  Citric  Acid  1,  Spirit  of  Lemon  2,  Sugar  500, 
Water  q.  s.  ad  1000  parts.  Dose,  £j- i|j. 

Syrupus  Hypophosphitum  cuth  Ferro,  Syrup  of  Hypophosphites  with  Iron, — has  of  the 
preceding  99  parts  with  I  of  the  Lactate  of  Iron,  dissolved  by  trituration.  Dose,  :jj- 3  j. 


Preparations  of  Phosphates. 

Calcii  Phosphas  Prcecipitatus,  Precipitated  Phosphate  of  Calcium,  Ca3(P04)2, — a  light, 
white,  amorphous  powder,  odorless  and  tasteless,  insoluble  in  water  or  in  alcohol.  Dose, 
gr.  ij-x. 

Syrupus  Calcii  Lactophosphatis ,  has  of  the  preceding  22  parts,  Lactic  Acid  33,  Orange- 
flower  Water  80,  Sugar  600,  Hydrochloric  Acid,  Water  of  Ammonia,  Water,  aa  q.  s.  ad 
1000.  The  Phosphate  of  Calcium  is  dissolved  by  the  acid,  but  does  not  enter  into  the 
chemical  combination  suggested  by  the  title.  Dose,  ^  j—  3  j. 

Sodii  Phosphas,  Na2HP04  I2H20, — large,  monociinic  prisms,  efflorescent,  of  saline 
taste  and  alkaline  reaction.  Soluble  in  6  of  water  at  56°  F.,  insoluble  in  alcohol.  Dose, 


3i~  ,5  J- 

Sodii  Pyrophosphas ,  Na4P207. ioH20, — colorless,  monoclinic  prisms,  of  saline  taste 
and  alkaline  reaction.  Soluble  in  12  of  water  at  590  F.,  insoluble  in  alcohol.  Dose,  3  ss- 

3SS- 

Syrupus  Ferri ,  Quimnce  et  Strychnince  Phosphatum, — has  of  the  Phosphate  of  Iron 
133,  Quinine  133,  Strychnine  4,  Phosphoric  Acid  800,  Sugar  6000,  Distilled  Water  q.  s. 
ad  10,000  parts.  A  powerful  tonic.  Dose,  ^  j  — i j . 

Syrupus  Phosphatum  Compositus,  Compound  Syrup  of  Phosphates,  Parrish’s  Chemical 
Food  (Unofficial), — has  in  each  3  Phosphate  of  Iron  gr.  2^,  Phosphate  of  Calcium  gr.  j. 
Dose,  3j-ij. 

Ammonii  Phosphas ,  Fern  Phosphas  and  Ferri  Pyrophosphas  are  respectively  described 
on  pages  94  and  216. 


Physiological  Action. 

Phosphorus  in  small  doses  stimulates  the  brain  and  circulation,  the 
functions  of  the  stomach  and  the  genital  organs,  and  the  growth  of  bones. 
It  aids  digestion  by  irritating  the  end-organs  of  the  gastric  nerves,  and 
produces  eructations  of  Hydrogen  Phosphide.  Its  fumes  cause  necrosis 
of  the  upper  or  lower  maxillae,  especially  in  those  whose  teeth  are  decayed, 
but  they  may  be  prevented  by  the  inhalation  of  fumes  from  old  acid  tur¬ 
pentine.  In  poisonous  doses  it  is  a  powerful  irritant  of  the  gastro-intestinal 


20 


3°6 


PHOSPHORUS,  PHOSPHITES  AND  PHOSPHATES. 


tract,  causing  vomiting  and  purging  with  great  depression  of  the  vital 
forces.  Reaching  the  blood  as  Phosphorus,  it  is  partly  oxidized  at  the 
expense  of  the  oxygen  of  the  red  corpuscles,  causes  acute  hemorrhages 
from  fatty  degeneration  of  the  arterial  walls,  rapid  steatosis  of  the  stomach, 
liver  and  heart,  with  deep  jaundice, — then  delirium,  convulsions,  coma 
and  death  usually  from  gradual  failure  of  the  respiration  and  circulation. 
Acute  yellow  atrophy  of  the  liver  resembles  acute  phosphorus  poisoning 
so  much  that  it  is  generally  impossible  to  distinguish  between  them. 

Its  effect  on  metabolism  is  to  increase  the  nitrogenous  products,  to 
diminish  the  excretion  of  carbonic  acid,  reduce  the  glycogen  of  the  liver 
to  almost  nothing,  and  to  raise  the  temperature.  While  generally  increas¬ 
ing  metabolism  it  so  influences  that  process  as  to  arrest  it  at  the  stage  of 
conversion  of  proteids  into  urea  and  oil,  instead  of  allowing  it  to  proceed 
to  the  final  oxidation  of  oil  into  carbonic  acid  and  water,  hence  leading 
to  fatty  degeneration  of  epithelial,  glandular  and  muscular  protoplasm 
throughout  the  body. 

Phosphate  of  Calcium  is  an  essential  ingredient  of  all  the  tissues  and 
fluids  of  the  body,  and  forms  more  than  50  per  cent,  of  the  bones.  Lactic 
and  Hydrochloric  acids  dissolve  it  in  small  quantities.  It  increases  the 
alkalinity  of  the  blood  as  well  as  its  power  of  holding  Carbonic  Acid,  and 
diminishes  the  excretion  of  urea. 

Phosphate  of  Sodium  acts  on  the  blood  and  on  the  excretion  of  urea 
similarly  to  the  calcium  salt.  It  increases  secretion  generally,  especially 
of  the  bile,  being  an  excellent  cholagogue  and  thereby  aiding  in  the 
digestion  of  fats.  In  ounce  doses  it  is  laxative.  It  is  a  normal  constituent 
of  the  blood,  and  possesses  the  property  of  increasing  the  capacity  of  any 
fluid  to  hold  Carbonic  Acid  in  solution. 

The  Hypophosphites  are  generally  tonic,  and  are  supposed  to  con¬ 
stitute  a  safer  form  in  which  to  administer  Phosphorus  than  in  the  unoxid¬ 
ized  state.  They  are  probably  converted  into  phosphates  in  the  stomach. 


Antidotes  and  Antagonists. 

Antidotes  are  hydrated  magnesia,  lime-water,  powdered  charcoal,  sulphate  of  copper 
and  old  acid  turpentine.  Sulphate  of  Copper  is  the  best  emetic,  forming  a  comparatively 
insoluble  phosphide  of  copper ;  3-grain  doses  should  be  given  every  5  minutes  in  dilute 
solution  until  emesis  occurs.  Hydrated  Afagnesia  as  a  quickly-acting  purgative.  Lime- 
water  or  Charcoal  to  prevent  the  action  on  the  tissues.  Crude  French  Acid  Turpentine 
is  the  best  antidote,  which  may  be  given  rapidly  in  an  emulsion  of  gum.  Opium  to 
counteract  the  depression  of  the  heart  and  system.  Transfusion  has  proved  efficient 
where  the  blood  is  affected.  No  oils  or  fats  should  be  used,  as  they  dissolve  Phosphorus 
and  promote  its  absorption. 

Therapeutics. 

Phosphorus  is  chiefly  used  to  promote  the  nutrition  of  osseous  and 
nervous  tissue.  It  is  useful  in  chronic  nervous  exhaustion  when  the  nerve 
centres  are  implicated,  in  osteomalacia,  rachitis  and  progressive  locomotor 
ataxia.  In  threatened  cerebral  softening  it  affects  the  nerve  centres  as  no 


PHYSOSTIGMA. 


307 


other  drug  does,  and  in  paraplegia  of  myelitic  origin  from  excessive  venery 
it  is  often  very  efficient.  Progressive  pernicious  anaemia  has  sometimes 
been  arrested  by  Phosphorus  in  very  small  doses,  while  in  impotence  of 
functional  character  there  is  no  remedy  so  effective.  In  wakefulness  of  the 
aged  and  that  due  to  cerebral  anaemia  small  doses  of  the  pill  or  tincture 
are  sometimes  remarkably  beneficial.  In  certain  skin  diseases  (acne, 
psoriasis,  lupus),  it  is  an  excellent  substitute  for  Arsenic.  Neuralgia  is 
often  cured  by  Phosphorus,  but  large  doses  are  necessary,  at  least  gr.  -Jj 
every  4  hours. 

Phosphate  of  Calcium  and  the  Hypophosphites  are  used  with  benefit 
in  all  diseases  of  mal-nutrition,  and  where  the  repair  or  development  of 
the  bones  is  required.  They  are  particularly  useful  in  protracted  suppu¬ 
ration,  osteomalacia,  rachitis,  caries,  scrofulosis,  chronic  phthisis,  and  in 
the  anaemia  and  bone-softening  of  lactation.  The  Hypophosphites  are 
much  employed  in  nervous  and  general  debility  and  in  chronic  lung  dis¬ 
eases,  and  are  supposed  to  act  in  the  same  manner  as  free  Phosphorus,  but 
without  irritation.  They  are  probably  converted  into  Phosphates  in  the 
stomach,  and  hence  may  be  expected  to  promote  the  growth  and  healing 
of  bones,  to  stimulate  the  hepatic  and  intestinal  secretions,  and  to  affect 
the  lymphatic  glands  and  adenoid  tissue.  The  Compound  Syrup  of  the 
Hypophosphites  is  an  excellent  remedy  in  acne  indurata. 

Phosphate  of  Sodium  in  drachm-doses  thrice  daily  for  adults,  gr. 
x-xxx  for  children,  is  extremely  useful  as  a  laxative  in  conditions  depend¬ 
ing  on  catarrh  of  the  bile-ducts  and  duodenum,  as  headache,  jaundice, 
chalky  stools,  etc.  Gall-stones  may  be  prevented  from  forming  by 
scruple  or  drachm  doses  before  meals  for  months  at  a  time.  It  is  also 
an  efficient  agent  in  obesity,  hepatic  diabetes,  incipient  hepatic  sclerosis, 
chronic  infantile  diarrhoea,  cerebral  debility,  bilious  sick  headache,  and 
the  pasty,  white  stools  of  ill-conditioned  children.  Vichy-water  contains 
this  salt  in  the  proportion  of  gr.  to  the  pint,  and  is  considered  a  valu¬ 
able  water  in  hepatic  colic  and  kindred  conditions.  Finally  for  the  con¬ 
dition  of  the  system  producing  a  crop  of  boils,  Phosphate  of  Sodium  is 
probably  the  best  remedy. 


PHYSOSTIGMA,  Calabar  Bean, — is  the  seed  of  Physostigma 
venenosum  (nat.  ord.  Leguminosae),  a  woody  creeper  of  Calabar,  West 
Africa,  where  it  is  used  by  the  natives  as  an  ordeal  for  witches,  etc.,  vom¬ 
iting  after  its  ingestion  being  held  to  establish  the  innocence  of  the 
accused.  It  is  about  an  inch  long,  irregularly  kidney-shaped,  with  two 
flat  sides  and  a  furrow  along  its  convex  margin  ending  in  an  aperture  near 
one  end.  It  contains  an  alkaloid,  variously  named  Eserine ,  Physostig- 
mine ,  and  Calabarine ,  C15H21N;{02,  which  is  obtained  as  a  crystalline,  an 
amorphous  or  a  syrupy  body.  Some  authorities  apply  the  above  names 


3°8 


PHYSOSTIGMA. 


to  different  bodies,  but  acknowledge  that  they  agree  in  physiological  action 
though  not  in  physical  qualities. 

Preparations . 

Extraction  Physostigmatis, — an  alcoholic  extract,  of  which  the  dose  is  from  gr.  to 
Sr-  j- 

Tinctura  Physostigmatis , — strength  io  per  cent.  Dose,  TT\v-xx. 

Physostigmince  Salicylas,  Salicylate  of  Physostigmine, — colorless,  columnar  crystals,  of 
bitter  taste  and  neutral  reaction,  soluble  in  130  of  water  and  in  12  of  alcohol  at  590  F. 
Dose,  gr.  -j  ^  o~6V* 

Eserina ,  Eserine  (Unofficial), — perhaps  the  same  as  Physostigmine,  but  is  considered 
as  representing  the  powers  of  the  plant.  Dose,  gr. 

Physiological  Action. 

Physostigma  is  a  direct  spinal  paralyzer,  producing  complete  general 
paralysis,  and  abolished  reflexes,  but  not  affecting  muscular  irritability  or 
the  cerebral  functions.  It  stimulates  secretion,  excites  nausea  and  vomit¬ 
ing,  salivation  and  diaphoresis,  and  is  laxative  by  stimulating  the  muscular 
coat  of  the  intestines  to  increased  peristalsis  as  well  as  by  increasing  the 
intestinal  secretions.  If  first  lowers  then  raises  arterial  tension,  increases 
the  frequency  of  the  heart-beat,  but  depresses  the  power  of  the  cardiac 
muscle  though  not  destroying  it.  It  produces  dyspnoea  by  a  tetanic  ac¬ 
tion  on  the  respiratory  muscles,  causing  carbonic  acid  narcosis  and  death 
by  paralysis  of  respiration.  It  contracts  the  pupil  (how,  is  disputed),  and 
the  ciliary  muscle,  producing  marked  myosis.  It  is  eliminated  chiefly  by 
the  kidneys,  the  urine  of  the  animal  affected  poisoning  another. 

Antagonists  and  Incompatibles. 

Atropine  is  antagonistic  as  to  the  effects  on  the  respiration,  heart  and  pupils.  Chloral 
is  also  antagonistic  and  over  a  greater  field  of  action,  but  to  be  effective  must  be  admin¬ 
istered  before  the  ingestion  of  the  Physostigma.  The  vegetable  astringents,  tannic  acid 
and  the  caustic  alkalies  are  chemically  incompatible. 

Therapeutics. 

The  applications  of  Physostigma  are  not  many.  It  is  efficient  in  con¬ 
stipation  due  to  torpor  of  the  bowels,  in  which  condition  it  is  usually 
combined  with  Belladonna  and  Nux-vomica.  In  tetanus  it  has  been  used 
with  advantage  to  diminish  reflex  excitability  in  grain-doses  of  the  extract 
repeated  every  2  hours  and  the  dose  modified  according  to  the  effect  pro¬ 
duced.  Progressive  paralysis  of  the  insane  is  apparently  retarded  by  it, 
and  while  antagonistic  theoretically  in  atropine  and  strychnine  poisoning, 
practically  it  is  not  of  much  value. 

Eserine  is  now  used  locally  by  ophthalmologists  for  many  purposes  in 
affections  of  the  eye.  In  a  solution  of  gr.'  ij  to  the  3  of  water  dropped 
into  the  eye,  it  is  efficient  in  breaking  up  or  preventing  adhesions  of  the 
iris,  diminishes  intraocular  tension,  prevents  suppuration  after  operations, 
contracts  the  pupil,  diminishing  the  entrance  of  light  in  photophobia, 
etc.,  and  empties  the  vessels  of  the  eye.  It  is  very  useful  in  keratitis, 


PHYTOLACCA. 


309 


glaucoma,  strumous  ophthalmia,  and  neuralgia  of  the  eye-ball.  The 
salts  of  Eserine  or  Physostigmine  in  neutral  solution  may  be  used  for 
these  purposes,  as  well  as  to  counteract  the  effects  of  Atropine  on  the 
pupil.  Gelatin  disks  medicated  with  Eserine  may  be  obtained  in  the 
shops,  and  are  a  convenient  form  in  which  to  use  the  drug  for  ophthalmic 
purposes. 


PHYTOLACCA,  Poke  , — is  official  under  two  forms,  the  berry  and 
the  root  of  Phytolacca  decandi'a ,  a  plant  of  the  nat.  ord.  Phytolaccaceae, 
found  in  all  parts  of  the  United  States.  It  contains  a  neutral  principle 
Phytolaccin ,  and  an  acid  Phytolaccic  Acid ,  also  tannin,  starch,  fixed  oil, 
etc.  There  are  no  official  preparations. 

Phytolaccae  Bacca,  Poke  Berry, — dark-purple,  depressed  globular, 
about  Yi  inch  in  diameter,  composed  of  10  carpels,  each  containing  one 
black  seed  ;  juice  purplish-red,  sweet  and  slightly  acrid. 

Phytolaccae  Radix,  Poke  Root, — large,  conical,  branched,  fracture 
fibrous,  wood-bundles  in  concentric  circles,  inodorous,  sweetish  and  acrid. 
Dose,  as  emetic,  gr.  x-xxx, — as  an  alterative,  gr.  j-v. 

Preparations. 

Extractum  Phytolacca  Fluidum  (Unofficial), — Dose,  rtpv-3 j. 

Tinctura  Phytolaccae  (Unofficial), — Dose,  npx- g j. 

Physiological  Action. 

Phytolacca  is  an  emeto-cathartic,  acting  slowly  but  persistently,  with 
great  nausea  and  considerable  depression.  It  lowers  the  rate  of  respira¬ 
tion  and  of  cardiac  action,  and  is  a  motor  depressant,  paralyzing  the 
spinal  cord  and  the  medulla,  death  occurring  from  paralysis  of  respira¬ 
tion,  preceded  by  tetanic  convulsions.  Several  cases  of  poisoning  by 
this  plant  have  occurred.  Its  action  is  antagonized  by  Alcohol,  Ether, 
Opium,  Digitalis,  etc. 

Therapeutics. 

Alterative  powers  have  been  ascribed  to  Phytolacca,  and  competent 
observers  have  reported  curative  results  from  its  use  in  malignant  tumors, 
varicose  and  other  ulcers,  obstinate  eczema,  sycosis,  favus  and  other  skin 
affections,  employing  it  both  internally  and  externally.  It  is  a  very 
serviceable  remedy  in  chronic  rheumatism,  and  given  internally  has 
undoubtedly  cured  cases  of  granular  conjunctivitis.  Mastitis  is  some¬ 
times  aborted  and  suppuration  of  the  breasts  prevented  by  the  use  of  the 
fluid  extract  internally  while  a  solid  extract  is  locally  applied  to  the  seat 
of  the  impending  inflammation.  In  tonsillitis  and  diphtheritic  sore 
throat,  also  in  chronic  follicular  pharyngitis,  it  has  been  much  used  with 
good  results,  especially  when  there  is  high  fever  and  pains  in  the  head, 
back  and  limbs.  In  true  adynamic  diphtheria  it  will  do  little  good. 


3io 


PICHI - PICR0T0XINUM. 


PICHI  is  the  shrub  Fabiana  imbricata ,  a  member  of  the  nat.  ord. 
Solanaceae,  and  a  native  of  S.  America.  Among  the  Chilians  it  has  been 
much  prized  as  a  remedy  in  cystitis  with  calculi  and  gravel,  and  in 
chronic  catarrh  of  the  bladder.  It  seems  to  have  considerable  power 
over  the  hematuria  and  pain  of  renal  calculus.  It  is  also  highly  praised 
in  dyspeptic  disorders.  Its  medicinal  virtues  reside  in  oleo-resinous  con¬ 
stituents  which  are  insoluble  in  water.  An  extract  is  prepared  from  the 
leaves,  of  which  the  dose  is  gr.  v-x  in  capsules.  Dose  of  the  fluid 
extract,  5j>  but  it  should  not  be  added  to  water. 


PICROTOXINUM,  Picrotoxin,  Picrotoxic  Acid,  C9H10O4, — is 
a  poisonous,  neutral  principle  obtained  from  the  seeds  contained  in  the 
berries  ( Co c cuius  Indicus ,  Fish-berries),  of  Anamirta  paniculata  (Ana- 
mirta  Cocculus,  Menispermum  Cocculus),  a  climbing  shrub  of  the  nat.  ord. 
Menispermaceae,  a  native  of  the  East  Indies.  The  berries  are  somewhat 
kidney-shaped,  of  blackish-brown  color,  wrinkled,  brittle,  inodorous  and 
nearly  tasteless,  except  the  shrivelled  embryo  which  is  bitter.  They  con¬ 
tain,  besides  Picrotoxin,  a  large  quantity  of  fixed  oil  and  other  substances 
of  less  interest.  In  the  shell  are  found  Menispertnin ,  an  alkaline  princi¬ 
ple,  Paramenispermin ,  which  is  neutral  and  crystalline,  and  Hypopicrotoxic 
A  cid. 

Picrotoxin  occurs  in  colorless,  flexible  crystals,  of  prismatic  form, 
bitter  taste  and  neutral  reaction,  soluble  in  150  of  water  and  in  10  of 
alcohol  at  590  F.,  also  in  acids  and  in  alkaline  solutions.  Dose  by  the 
stomach,  gr.  cautiously.  For  hypodermic  use  a  solution  in  water 

of  gr.  ij  in  5j  may  be  used,  in  doses  of  gr.  of  the  principle,  npiv 

equalling  gr.  ¥V 

Unofficial  Preparations  of  Cocculus. 

Tinctura  Cocculi,  —  1  in  8.  Dose,  rtpij-xv. 

Extraction  Cocculi  Fluidum, — Dose,  tT\j-iij. 

Planat's  Tincture  of  Cocculus , — I  in  4.  Dose,  TT\ j — v. 

Physiological  Action. 

Picrotoxin  is  a  cerebro-spinal  exaltant,  affecting  especially  the  centres 
in  the  medulla  oblongata,  and  in  its  action  representing  the  combined 
actions  of  Belladonna  and  Nux-vomica.  It  stimulates  all  the  secretions, 
especially  the  cutaneous,  the  salivary  and  intestinal  ;  produces  nausea  and 
vomiting,  and  slows  the  heart  and  the  respiration  after  transiently  ac¬ 
celerating  both.  It  causes  muscular  twitching,  incoordination,  stupor, 
delirium,  epileptiform  convulsions,  tonic  spasms  of  the  flexor  muscles 
alternating  with  clonic  ones,  exalted  reflexes  and  trembling, — then  coma, 
insensibility  and  death  by  paralysis  of  the  heart,  which  is  arrested  in  dias¬ 
tole.  The  action  of  the  drug  is  on  the  spasm  and  vagus  centres  in  the 
medulla,  and  on  Setchenow’s  inhibitory  centre,  as  well  as  on  the  cere- 


PILOCARPUS. 


31 1 

bellum  and  spinal  cord,  paralyzing  the  first-named  centres  and  stimulating 
the  reflex  centres  in  the  cord.  It  is  eliminated  by  all  the  excretory  chan¬ 
nels,  chiefly  by  the  kidneys. 

The  spasms  caused  by  Picrotoxin  are  choreic  and  chiefly  affect  the  flexor 
muscles, — those  from  Strychnine  are  tetanic,  affecting  principally  the 
extensors.  The  order,  succession  and  character  of  the  phenomena  pro¬ 
duced  by  Picrotoxin  resemble  in  marked  degree  those  of  the  epileptic 
paroxysms. 

Cocculus  berries  are  used  to  stupefy  fish,  being  thrown  into  ponds  con¬ 
taining  them.  They  are  also  employed  to  adulterate  beer  and  porter  in 
order  to  make  these  drinks  more  intoxicating. 


Antagonists. 

Chloral  is  antagonistic  to  its  cerebral  and  spinal  actions,  but  synergistic  to  its  depressant 
power  over  the  heart  and  the  respiration.  Acetic  Acid  gives  relief  in  overdosing,  and 
may  have  some  antidotal  power.  Ancesthetics  antagonize  its  spasm-producing  action. 

Therapeutics. 

Picrotoxin  is  used  chiefly  in  nervous  diseases.  Epilepsy  is  amenable  to 
it,  especially  when  the  attacks  are  nocturnal,  and  in  anaemic  cases  and 
those  attributable  to  onanism.  Paralyses  of  several  forms  have  been 
greatly  benefited  by  it,  especially  paralysis  of  the  sphincters,  hemiplegia 
from  cold,  glosso-labio-laryngeal  paralysis,  and  paralysis  agitans.  Chorea 
is  well  treated  by  it  but  requires  full  doses.  It  is  remarkably  efficient  in 
controlling  the  night  sweats  of  phthisis,  and  in  flatulent  colic,  also  in  dys¬ 
pepsia  with  flatulence  and  severe  epigastric  pain,  and  in  vomiting  with 
giddiness,  headache  and  intolerance  of  light  and  sound.  Dysmen- 
orrhoea  is  often  benefited  by  Cocculus  administered  for  two  days  before 
the  period ;  and  leucorrhoea,  when  the  discharge  is  sero-purulent  with 
lumbar  pains,  is  frequently  controlled  by  it.  Parasitic  skin  diseases  are 
well  treated  by  an  ointment  of  Picrotoxin  (gr.  x  to  the  5)>  which  will 
also  kill  pediculi,  but  it  must  be  used  cautiously  and  with  special  care  to 
avoid  an  abraded  surface.  The  tincture  of  Cocculus  may  be  used  as  a 
wash  to  kill  body-lice,  undiluted. 


PILOCARPUS,  Jaborandi  , — the  leaflets  of  Pilocarpus pennatifo- 
lius,  a  Brazilian  plant  of  the  nat.  ord.  Rutacese.  They  are  about  4  inches 
long,  ovate-oblong,  coriaceous,  pellucid-punctate,  mostly  smooth,  some¬ 
what  pungent  and  bitter.  It  contains  two  alkaloids, — Pilocarpine ,  Cu 
HiGN202,  soft  and  viscous,  slightly  soluble  in  water  but  soluble  in  alco¬ 
hol,  ether  and  chloroform  ;  Jaborine ,  isomeric  with  Pilocarpine,  to  which 
it  is  antagonistic  in  action  ;  also  a  Volatile  Oil  and  probably  a  peculiar 
acid. 


312 


PILOCARPUS. 


Preparations. 

Ext r actum  Pilocarpi  Fluidum , — Dose,  upv- 3  j. 

Pilocarpines  Hydrochloras , — minute,  white,  deliquescent  crystals,  very  soluble  in  water 
and  in  alcohol,  almost  insoluble  in  ether  or  chloroform.  Dose,  gr. 

Physiological  Action. 

Pilocarpus  is  a  paralyzer  of  the  vaso-motor  system,  and  a  stimulant  of 
the  peripheral  terminations  of  nerves  supplying  glands  and  involuntary 
muscular  fibre,  subsequently  paralyzing  the  latter.  It  is  therefore  a  power¬ 
ful  diaphoretic  and  sialogogue,  a  cardiac  depressant  by  stimulation  of  the 
vagus  ends, — also  myotic,  emetic,  and  under  some  circumstances  aborti- 
facient.  Its  taste  is  hot  and  pungent.  It  causes  prompt  and  profuse 
perspiration  (Six-xv,  in  quantity)  and  salivation  (3x-xxvij),  after  a  pre¬ 
liminary  flushing  of  the  skin.  The  nasal,  bronchial  and  lachrymal  secre¬ 
tions  are  much  increased  ;  sometimes  watery  diarrhoea  occurs ;  the  action 
of  the  heart,  at  first  increased,  is  afterwards  lowered,  the  arterial  tension 
is  reduced,  and  the  temperature  falls  from  i°  to  40.  Drowsiness,  pallor, 
chilliness  and  debility  succeed,  and  last  several  hours ;  the  pupil  is  con¬ 
tracted  and  accommodation  impaired.  The  elimination  of  urea  is  greatly 
increased,  but  not  the  quantity  of  urine.  The  respiratory  power  is  low¬ 
ered,  and  apnoea  may  occur,  from  increase  of  the  bronchial  mucus. 

Pilocarpus  is  rapidly  diffused,  and  is  eliminated  by  the  skin  and  the 
salivary  glands.  Its  effects  pass  off  usually  in  from  three  to  six  hours. 
Children  are  less  affected  than  adults,  by  proportionate  doses.  It  causes 
contractions  of  the  bladder,  uterus  and  spleen,  in  the  latter  case  whether 
the  organ  is  enlarged  or  of  normal  size. 

Pilocarpine  is  the  principle  to  which  the  foregoing  actions  are  due, 
but  Jaborine,  though  chemically  identical,  is  perfectly  antagonistic 
thereto  in  its  effects  on  the  heart,  pupils,  lungs  and  salivary  glands,  acting 
precisely  like  Atropine  on  these  organs.  The  difference  is  probably  due 
to  a  different  molecular  arrangement. 

Antagonists  and  Inco??ipatibles. 

Atropine  is  the  antagonist  to  Pilocarpine  in  dose  of  gr.  Tl^  for  gr.  L  of  the  latter.  The 
antagonism  between  these  two  alkaloids  extends  over  the  whole  range  of  their  action, 
and  is  the  most  complete  known  to  physiological  experimentation.  Conversely  Pilocar¬ 
pine  is  exactly  antagonistic  to  Atropine,  but  Jaborine  acts  similarly  to  the  latter  drug. 
Morphine  controls  the  nausea  and  vomiting.  Caustic  alkalies,  the  persalts  of  Iron  and 
salts  of  the  metals  generally,  are  chemically  incompatible. 

Therapeutics. 

Jaborandi  is  used  with  great  benefit  in  dropsies,  especially  the  renal 
form,  also  in  eclampsia  of  renal  origin,  in  uraemia,  pleuritis,  meningitis 
and  other  inflammations  of  serous  membranes,  but  it  is  contraindicated 
when  from  any  cause  there  is  weak  heart.  In  diabetes  insipidus  it  reduces 
the  quantity  of  urine  remarkably,  relieving  the  kidneys  by  throwing  the 


PIMENTA - PIPER. 


313 


work  on  the  skin.  In  the  acute  and  chronic  forms  of  Bright’s  disease  it 
has  been  used  with  great  advantage,  but  being  so  depressant  it  must  be 
employed  with  great  caution  in  this  disorder.  For  alopecia  it  is  the  most 
efficient  remedy  known,  stimulating  the  skin  and  improving  the  color 
and  condition  of  the  hair.  In  agalactia  it  stimulates  the  secretion  of  the 
milk,  and  it  often  gives  prompt  relief  in  parotitis.  Ptyalism  is  frequently 
relieved  by  minute  doses  of  Pilocarpine  (gr.  -fa),  which  acting  on  the 
same  gland  antagonizes  the  morbid  action  ;  and  similar  doses  used  thrice 
daily  will  check  profuse  perspiration.  The  hypodermic  use  of  Pilocar¬ 
pine  will  arrest  a  paroxysm  of  spasmodic  asthma,  and  is  equally  efficient 
in  hiccough.  Atropine-poisoning  is  best  combated  by  the  use  of  Pilo¬ 
carpine  hypodermically. 

Ophthalmologists  employ  Pilocarpine  with  most  excellent  results  in  the 
amblyopia  of  alcoholism  and  that  from  the  abuse  of  tobacco,  in  detach¬ 
ment  of  the  retina,  chronic  iritis,  keratitis,  glaucoma,  hemorrhage  into 
the  vitreous,  atrophic  choroiditis,  white  atrophy,  to  promote  resolution 
and  absorption  in  inflammatory  conditions  with  exudation,  and  instead 
of  Eserine  as  a  myositic. 

Erysipelas  and  diphtheria  are  diseases  in  which  Pilocarpine  has  recently 
proved  very  efficient,  but  its  depressant  action  on  the  heart  and  respira¬ 
tion  must  not  be  lost  sight  of.  In  the  writer’s  experience  the  fluid  extract 
is  one  of  the  best  agents  for  breaking  up  a  common  cold.  It  may  be 
given  in  doses  of  trpx-3j,  according  to  age,  at  bedtime.  Children  bear 
the  drug  well  in  respect  to  all  its  physiological  actions. 


PIMENTA,  Allspice  , — is  the  nearly  ripe  fruit  ot  Eugenia  Pimenta , 
a  West  Indian  tree  of  the  nat.  ord.  Myrtaceae.  The  berries  are  nearly 
globular,  about  ]/^  inch  in  diameter,  crowned  with  the  remnants  of  the 
calyx,  two-celled,  each  cell  containing  one  reniform  seed,  odor  and  taste 
pungent  and  aromatic.  They  contain  a  Volatile  Oil  which  is  official, 
a  green  fixed  oil,  fat,  tannin,  gum,  resin,  etc.  Dose,  gr.  x-xl. 

Oleum  Pivientce,  the  volatile  oil,  colorless  or  pale-yellow,  of  aromatic  odor,  pungent 
taste  and  slightly  acid  reaction.  Is  a  constituent  of  Bay  Rum  (Spt.  Myrcise).  Dose, 

"Vj-d- 

Physiological  Action  and  Therapeutics. 

Allspice  is  a  warm,  aromatic  stimulant,  very  useful  as  a  condiment,  im¬ 
proving  digestion  by  increasing  the  vascularity  of  the  gastric  mucous  mem¬ 
brane  and  by  stimulating  the  salivary  secretion.  The  oil  is  an  agreeable 
remedy  for  flatulence,  nausea  and  intestinal  colic,  and  is  used  to  prevent 
the  griping  of  purgatives  and  to  cover  the  taste  of  nauseous  medicines. 

PIPER,  Pepper,  Black  Pepper, — is  the  unripe  fruit  of  Piper 
nigrum ,  or  Pepper-vine,  a  perennial  plant  of  the  nat.  ord.  Piperaceas,  grow- 


3H 


PISCIDIA. 


ing  in  India,  Siam,  Java,  Borneo,  etc.  It  is  about  inch  in  diameter, 
of  globular  shape,  reticulately  wrinkled,  aromatic,  of  pungent,  spicy  taste, 
and  contains  an  alkaloid,  Piperine ,  which  is  official,  also  a  green,  acrid 
concrete  oil,  a  balsamic  volatile  oil,  starch,  lignin,  gum,  extractive,  etc. 
Dose,  gr.  v-xx. 

Preparations. 

Oleoresina  Piperis ,  Oleoresin  of  Pepper, — contains  almost  all  the  volatile  oil  and  acrid 
resin  extracted  by  ether,  with  little  of  the  Piperine.  Dose, 

Piperina ,  Piperine,  CnH19N03, — a  proximate  principle  of  feeble  alkaloidal  power, 
prepared  from  Pepper,  and  occurring  also  in  other  plants  of  the  natural  order  Piperacese. 
Occurs  in  colorless  or  pale-yellowish  prisms,  of  neutral  reaction,  almost  insoluble  in  water, 
slightly  so  in  ether,  but  soluble  in  30  of  alcohol  at  590  F.  Dose,  gr.  j-x. 

Physiological  Action  and  Therapeutics. 

Pepper  when  applied  to  the  skin  acts  as  an  irritant ;  internally  its  effects 
are  similar  to  those  of  other  aromatics,  being  a  warm  carminative  and 
stimulant,  increasing  slightly  the  action  of  the  heart,  stimulating  the  kid¬ 
neys  somewhat,  and  toning  up  the  mucous  membrane  of  the  urinary  and 
intestinal  passages,  by  which  channels  it  is  eliminated.  It  has  been 
thought  to  possess  antiperiodic  powers,  and  was  formerly  much  employed 
in  intermittents.  Its  chief  medical  use  is  to  correct  flatulence,  and  to 
excite  action  of  the  stomach,  being  very  commonly  taken  as  a  condiment 
with  food.  It  is  occasionally  employed  in  gleet,  but  more  extensively  in 
hemorrhoids  and  other  diseases  of  the  rectum.  Its  active  constituents  are 
the  concrete  oil  of  resin  and  the  volatile  oil,  the  alkaloid  having  very 
slight  action  on  the  system,  except  as  an  antiperiodic  and  antipyretic, 
qualities  which  it  certainly  possesses. 


PISCIDIA,  J  amaica  Dogwood  (Unofficial),  is  the  bark  of  the  root 
of  Piscidia  eryihrina ,  a  tree  of  the  nat.  ord.  Leguminosae  growing  in  the 
West  Indies.  It  occurs  as  a  tough,  fibrous  bark,  externally  blackish,  in¬ 
ternally  greenish,  of  a  heavy,  narcotic  odor,  and  a  bitter,  acrid  and  astrin¬ 
gent  taste,  containing  a  yellowish,  resinoid  substance  named  Piscidin. 
Its  active  principle  has  not  yet  been  isolated.  A  fluid  extract  is  on  the 
market,  of  which  the  dose  is  3 ss— j ,  carefully  increased. 

Physiological  Action. 

Piscidia  has  a  narcotic  effect  on  many  animals,  and  has  been  used  in 
Jamaica  for  many  years  to  stupefy  fish,  that  they  may  be  easily  taken.  It 
produces  muscular  relaxation,  incoordination  of  movement,  lowered  sensi¬ 
bility,  increased  action  of  the  heart  and  increase  of  the  arterial  tension  by 
stimulation  of  the  vaso-motor  centre.  Soon,  however,  the  heart  is  weak¬ 
ened,  vascular  tension  falls,  and  a  tetanoid  state  results  from  stimulation 
of  the  spinal  cord,  with  reduced  reflex  action.  On  the  brain  its  effects 
resemble  those  of  Opium,  causing  deep  sleep  without  any  unpleasant  after 


PIX. 


315 


results.  It  relieves  pain  in  less  degree,  however,  than  Opium  does,  but  its 
hypnotic  action  is  greater.  It  also  relieves  cough  and  spasm,  produces 
diaphoresis  and  salivation,  and  dilates  the  pupil.  From  toxic  doses  death 
occurs  by  asphyxia.  In  man  it  probably  causes  the  same  effects  but  in 
decidedly  less  marked  degree. 

Therapeutics. 

Jamaica  Dogwood  is  used  chiefly  as  a  general  nervous  sedative.  Its 
hypnotic  and  anodyne  powers  are  somewhat  uncertain,  but  have  in  many 
cases  been  very  decided.  It  is  useful  in  whooping-cough  and  spasm,  and 
has  proved  almost  specific  in  many  cases  of  neuralgia,  while  in  others  it 
has  caused  great  gastric  distress  without  the  least  anodyne  effect. 


PIX,  Pitch  , — is  a  resinous  exudation  from  the  stem  of  certain  trees 
of  the  genera  Pinus  (Pines)  and  Abies  (Firs  and  Spruces)  ;  and  may  also 
be  obtained  by  the  evaporation  of  wood-tar.  [See  Pix  Liquida  below.] 
The  following  varieties  are  official,  viz.  : 

Pix  Burgundica,  Burgundy  Pitch, — the  prepared,  resinous  exudation 
of  Abies  excelsa  or  Norway  Spruce  (nat.  ord.  Coniferae),  a  native  of 
Europe  and  Northern  Asia.  Occurs  in  hard,  brittle,  opaque  or  translu¬ 
cent  mass,  with  a  shining,  conchoidal  fracture,  reddish-brown  color, 
aromatic  and  somewhat  empyreumatic,  not  bitter,  almost  entirely  soluble 
in  glacial  acetic  acid.  It  is  very  fusible,  and  at  the  body-heat  it  softens 
and  becomes  adhesive.  Used  for  plasters. 

Pix  Canadensis,  Canada  or  Hemlock  Pitch, — the  prepared  resinous 
exudation  of  Abies  canadensis  (nat.  ord.  Coniferae),  the  Hemlock  Spruce 
of  the  U.  S.  and  Canada.  Its  properties  are  much  the  same  as  those  of 
the  preceding. 

Pix  Liquida,  Tar, — is  an  empyreumatic  oleo-resin  obtained  by  the 
destructive  distillation  of  the  wood  of  Pinus  palustris  and  other  species 
of  Pinus  (nat.  ord.  Coniferae).  Is  thick,  viscid,  semi-fluid,  blackish- 
brown,  of  acid  reaction,  terebinthinate  odor,  and  sharp,  empyreumatic 
taste,  slightly  soluble  in  water,  soluble  in  alcohol,  oils,  and  in  solution  of 
potassa  or  of  soda.  By  distillation  it  yields  an  acid  liquor  named  Pyro¬ 
ligneous  Acid  and  an  empyreumatic  oil  called  Oil  of  Tar  (see  Ol.  Picis 
Liquids,  below),  the  residue  being  pitch.  Its  granular  appearance  is 
due  to  crystals  of  Pyrocatechin ,  C6H4(OH)2,  which  occur  either  in  the 
Pyroligneous  Acid  or  in  the  tarry  mixture.  Dose,  3j~ij  daily,  in  ten- 
grain  doses. 

Preparations. 

Oleum  Picis  Liquidce ,  Oil  of  Tar, — a  volatile  oil  distilled  from  Tar.  Dark,  reddish- 
brown  (almost  colorless  when  fresh),  of  tarry  odor  and  taste  and  acid  reaction,  readily 
soluble  in  alcohol.  Contains  a  great  variety  of  compounds,  including  Hydrocarbons, 
Phenols,  Paraffin,  etc.,  among  the  phenols  being  Creasote  and  Carbolic  Acid.  Is  used 
locally  and  as  an  atomized  inhalation. 


316 


PIX. 


Syrupus  Picis  Liquid#,  Syrup  of  Tar, — has  of  Tar  6  per  cent.,  and  is  a  sweetened 
Tar- water.  Dose,  ^ij-^ss. 

Unguentum  Picis  Liquid#,  Tar  Ointment, — contains  equal  parts  of  Tar  and  Suet. 

Emplastrum  Picis  Burgundic#,  Burgundy  Pitch  Plaster, — has  of  Burgundy  Pitch  90, 
Yellow  Wax  10  parts. 

Emplastrum  Picis  Canadensis,  Canada  Pitch  Plaster, — has  of  Canada  Pitch  90,  Yel¬ 
low  Wax  10  parts. 

Emplastrum  Picis  cum  Cantharide,  Warming  Plaster, — has  of  Burgundy  Pitch  92, 
Cerate  of  Cantharides  8  parts. 

Lnfusum  Picis  Liquid#,  Tax  Water  (Unofficial), — made  by  shaking  Tar  I  with  Water 
4  frequently  during  24  hours,  decanting  and  filtering.  Is  stimulant  and  diuretic.  Dose, 
Oj-ij  daily. 

Vinum  Picis  Liquid #,  Wine  of  Tar  (Unofficial), — Tar  ^xvj,  Glycerin,  White  Wine, 
Honey,  aa  ^  viij,  Acetic  Acid  j,  Boiling  Water  Ovj,  shaken  together  and  digested  in  a 
close  vessel  for  two  hours  at  150°  to  160°,  then  macerated  for  a  few  days,  frequently 
shaken,  strained  and  filtered. 

Oleum  Pini  Sylvestris,  Oil  of  Scotch  Fir  (Unofficial), — a  colorless,  fragrant  oil,  dis¬ 
tilled  from  the  leaves  of  Pinus  sylvestris,  resembling  Turpentine  in  action.  Used  by 
inhalation  (  g  ss  to  Oj  of  boiling  water),  or  locally. 

Concentrated  Extract  of  Pinus  Canadensis  (Unofficial), — is  an  aqueous,  non-irritant 
astringent,  prepared  from  the  Abies  Canadensis  ox  Hemlock  Spruce.  It  is  said  to  have  a 
specific  tonic  action  upon  mucous  membranes.  Two  kinds  are  sold,  one  being  called 
the  “  White  ”  Extract. — in  reality  a  golden  yellow, — and  the  other  the  “  Dark”  Extract, 
— the  former  intended  for  use  when  it  is  desirable  to  avoid  staining  the  linen.  This 
preparation  received  the  endorsement  of  Dr.  J.  Marion  Sims,  and  has  been  extensively 
employed  both  locally  and  internally,  as  a  topical  application  in  uterine  and  vaginal 
catarrhs,  and  as  a  systemic  remedy  in  catarrhal  inflammation  of  the  gastro-intestinal  and 
broncho-pulmonary  mucous  membranes. 


Physiological  Action  and  Therapeutics. 

Pitch  is  a  gentle  rubefacient  when  applied  to  the  skin,  but  in  some 
constitutions  the  Burgundy  variety  causes  a  vesicular  and  pustular  inflam¬ 
mation  if  used  extensively.  It  is  generally  employed  as  a  basis  for 
plasters,  and  is  of  benefit  in  lumbago,  rheumatism,  chronic  pleurisy,  pain¬ 
ful  joints,  superficial  neuralgise,  etc.,  protecting  the  part  from  variations 
of  temperature,  and  perhaps  by  the  gentle  pressure  exercised  stimulating 
the  lymphatics  and  promoting  absorption.  It  is  supposed  to  have  a 
special  influence  on  the  rectum,  and  in  pill  with  Tar  has  been  employed 
as  a  remedy  for  hemorrhoids.  In  applying  adhesive  plasters  the  hair 
should  first  be  shaved  off,  and  when  about  to  be  removed  the  plaster 
should  be  warmed,  and  a  little  Oil  of  Turpentine  inserted  between  its 
edge  and  the  skin. 

Canada  Pitch  is  too  soft  for  plasters,  but  is  employed  for  the  same 
purposes  as  the  preceding.  A  volatile  oil  obtained  from  the  same  tree 
(Oil  of  Spruce,  Oil  of  Hemlock)  has  been  used  for  abortifacient  pur¬ 
poses,  endangering  the  life  of  the  subject. 

Tar  is  a  complex  mixture  of  resins  and  hydrocarbons,  containing 
Creasote  and  Carbolic  Acid  which  give  to  it  irritant  qualities.  Internally 
it  is  expectorant  and  produces  gastro-intestinal  irritation,  sometimes 
severe  headache,  giddiness  and  febrile  phenomena.  It  is  eliminated  by 
tlue  kidneys  chiefly,  which  it  stimulates,  and  may  cause  their  congestion 
and  increased  diuresis.  Externally  it  is  a  decided  stimulant  to  the  skin, 


PLANTAGO - PLUMBUM.  3  I  / 

often  giving  rise  to  considerable  irritation  and  pain.  It  is  also  antiseptic, 
and  in  most  of  its  effects  it  resembles  the  turpentines. 

Tar  is  used  as  a  local  application  in  chronic  scaly  skin  diseases, 
especially  psoriasis  and  chronic  eczema.  As  an  atomized  inhalation  it  is 
of  decided  benefit  in  bronchitis,  pharyngitis,  laryngitis  and  winter  cough. 
Internally  it  may  be  employed  with  advantage  in  these  affections,  in 
hemorrhoids,  bronchial  catarrh,  and  phthisis.  The  best  preparation  for 
internal  administration  is  the  syrup,  which  is  a  sweetened  tar- water,  the 
sugar  forming  with  the  Tar  a  soluble  compound. 


PLANTAGO,  Plantain  (Unofficial)  , — is  the  leaf  of  Plantago  major , 
and  Plantago  lane eo lata  (nat.  ord.  Plantaginacese),  the  common  “  Ribbed 
Grass.”  The  pounded  leaves  applied  as  a  paste,  or  the  dry  leaf  powdered, 
are  actively  hemostatic,  stopping  hemorrhages  speedily.  Among  the 
ancients  it  had  a  good  reputation  as  a  remedy  for  toothache  and  earache, 
which  still  adheres  to  it  in  Switzerland  and  many  other  parts  of  Europe. 
In  many  other  painful  affections  it  is  extremely  efficient,  especially  in 
mastitis,  rhus-poisoning,  erysipelas,  burns,  scalds,  wounds  and  bruises.  A 
poultice  of  the  leaves  may  be  applied  to  the  affected  part,  and  an  infusion 
administered  internally.  A  fluid  extract  is  sold  in  the  shops,  of  which 
the  dose  is  rrpv-xv. 


PLUMBUM,  Lead,  Pb  , — is  not  official,  but  several  of  its  salts  are, 
namely, — the  Acetate,  Carbonate,  Iodide,  Nitrate  and  Oxide,  of  which 
the  Acetate  is  the  only  one  administered  internally,  the  solutions  of  the 
Subacetate  are  the  only  liquid  preparations,  the  Oxide  (Litharge)  is  used 
as  Emplastrum  Plumbi,  the  Nitrate  is  used  as  a  local  stimulant  or  escha- 
rotic,  the  Iodide  as  an  ointment  for  absorbent  purposes,  and  the  Carbonate 
as  an  astringent  locally  to  inflamed  surfaces.  The  metal  occurs  in  nature 
chiefly  as  a  Sulphide  named  Galena ,  also  as  an  Oxide  rarely,  and  in  various 
saline  combinations. 

Official  Salts  of  Lead. 

Pluvibi  Acetas ,  Acetate  of  Lead,  Sugar  of  Lead,  Pb(C2Fl302)2.3Fr20, — colorless, 
shining,  prismatic  crystals  or  scales,  efflorescent,  of  faintly  acetous  odor  and  acid  reaction, 
and  a  sweetish,  astringent  and  metallic  taste.  Soluble  in  1.8  of  water  and  in  8  of  alcohol 
at  590  F.,  in  0.5  of  boiling  water  and  in  1  of  boding  alcohol.  Dose,  gr.  ss-v. 

Plumbi  Carbonas ,  Carbonate  of  Lead,  White  Lead,  (PbC03)2Pb( HO)2, — a  heavy, 
white,  opaque  powder,  odorless,  tasteless  and  insoluble  in  water  or  alcohol,  but  soluble 
with  effervescence  in  dilute  nitric  acid.  Used  locally  as  ointment,  powder,  or  white  paint. 

Plumbi Iodidum,  Iodide  of  Lead,  Pbl2, — a  heavy,  bright  citron-yellow  powder,  odor¬ 
less  and  tasteless,  fusible  and  volatilizable  by  heat,  soluble  in  about  2000  of  water  at  590 
I'.,  and  in  about  200  of  boiling  water.  Used  externally  as  an  ointment.  May  be  given 
internally  in  doses  of  gr.  I  twice  daily. 

Plumbi  Nitras ,  Nitrate  of  Lead,  PbfN03)2, — colorless,  opaque,  octahedral  crystals, 
odorless,  of  sweetish,  astringent  and  metallic  taste  and  acid  reaction,  soluble  in  2  of  water 
at  590  F.,  almost  insoluble  in  alcohol.  Used  locally  as  an  astringent  and  deodorizer  in 
solutions  up  to  1  per  cent.,  also  as  an  escharotic  and  a  disinfectant. 


318 


PLUMBUM. 


Plumbi  Oxidum ,  Oxide  of  Lead,  Litharge,  PbO, — a  heavy,  yellowish  or  reddish-yellow 
powder,  odorless,  tasteless  and  insoluble  in  water  or  alcohol,  but  almost  wholly  soluble 
with  slight  effervescence  in  dilute  nitric  acid.  When  heated  in  contact  with  charcoal  it  is 
reduced  to  metallic  lead.  Used  as  Lead- Plaster  and  sometimes  with  oil  as  an  external 
application. 

Preparations. 

Liquor  Plumbi  Subacetatis,  Solution  of  Subacetate  of  Lead,  Goulard’s  Extract, — an 
aqueous  solution  containing  about  25  per  cent,  of  the  salt,  prepared  from  Acetate  of  Lead 
170,  Oxide  of  Lead  120,  and  Distilled  water  q.  s.  ad  1000  parts.  It  is  a  clear,  colorless 
liquid,  of  sweetish,  astringent  taste  and  alkaline  reaction,  of  sp.  gr.  1.228,  and  when  added 
to  a  solution  of  acacia  it  produces  a  dense,  white  precipitate.  Used  locally  as  an  astrin¬ 
gent  and  cooling  lotion,  diluted  usually  with  an  equal  quantity  of  water. 

Liquor  Plumbi  Subacetatis  Dilutus ,  Lead  Water, — has  of  the  preceding  3  parts  to  97 
of  Distilled  Water.  Used  locally  as  a  mild  astringent  and  cooling  lotion. 

Linimentum  Plumbi  Subacetatis , — contains  of  Liquor  Plumbi  Subacetatis  40  parts  to 
60  of  Cotton-seed  Oil.  Used  as  an  anodyne  application  for  itching,  etc. 

Ceratum  Plumbi  Subacetatis ,  Goulard’s  Cerate, — has  of  the  same  solution  20  parts  with 
80  of  Camphor  Cerate,  freshly  prepared,  as  it  becomes  rancid  easily.  Used  as  an  astrin¬ 
gent  and  protective  application. 

Etnplastrum  Plumbi,  Lead-plaster,  Diachylon  Plaster, — Oxide  of  Lead  32,  Olive  Oil 
60,  rubbed  together  and  boiled  with  10  parts  of  water.  Is  white,  pliable  and  tenacious, 
free  from  greasiness  or  stickiness,  and  should  be  entirely  soluble  in  warm  oil  of  turpentine. 
A  good  protective  in  abrasions  and  bed-sores,  and  the  basis  of  many  other  plasters. 

Unguentum  Diachylon,  Diachylon  Ointment, — has  of  Lead  Plaster  60,  Olive  Oil  39, 
Oil  of  Lavender  1.  Used  locally  in  eczema  and  other  cutaneous  disorders. 

Unguentum  Plumbi  Carbonatis , — has  of  the  Carbonate  in  very  fine  powder  10,  Benzo- 
inated  Lard  90.  Used  as  a  dressing  for  burns. 

Unguentum  Plumbi  Lodide, — has  of  the  Iodide  in  very  fine  powder  10,  Benzoinated 
Lard  90.  Used  locally  to  promote  absorption  of  glandular  tumors. 

Oleation  Plumbi,  Oleate  of  Lead  (Unofficial), — a  20  per  cent,  solution  of  Oxide  of  Lead 
in  Oleic  Acid.  A  soft,  yellowish  ointment,  for  local  use. 

Physiological  Actions. 

Lead-salts  are  all  more  or  less  poisonous,  but  metallic  Lead  is  inert 
until  converted  into  a  soluble  salt  by  the  acids  of  the  stomach.  The 
Acetate  in  large  doses  is  emetic,  so  that  acute  lead-poisoning  is  rare.  Its 
chief  phenomena  are  intense  gastro-intestinal  irritation,  vomiting,  paraly¬ 
sis,  coma  and  collapse. 

Chronic  lead-poisoning  (plumbism)  has  its  principal  sources  in  pure 
water  conveyed  by  leaden  pipes,  the  use  of  hair-dyes,  handling  of  print¬ 
ing-type,  working  in  the  smelting  of  lead  ores,  etc.  It  produces  loss  of 
appetite,  emaciation,  pallor  and  constipation,  followed  by  slowing  of  the 
heart’s  action,  and  accompanied  by  violent  colic  (enteralgia),  muscular 
impairment  evinced  by  paralysis  of  the  extensor  muscles  of  the  forearm 
(drop-wrist),  impaired  sensibility  and  albuminuria.  Occasionally  apho¬ 
nia,  vertigo,  gastralgia,  headache,  stupor  and  convulsions  are  manifested. 
Rheumatism  without  fever  or  tenderness  in  the  joints,  which  however  are 
red  and  swollen,  is  a  frequent  symptom.  A  blue  line  (sulphide)  is  seen 
along  the  margin  of  the  gums  in  those  who  do  not  clean  their  teeth. 
Neuralgic  troubles  may  arise,  and  amaurosis  often  occurs  from  impairment 
of  the  optic  nerve.  The  metal  becomes  deposited  in  the  affected  muscles 
and  other  tissues,  and  probably  acts  by  impairing  the  isolating  power  of 
the  nerve-fibres,  thus  enfeebling  the  nerve-currents.  It  also  produces  con- 


PLUMBUM. 


319 


traction  of  the  smaller  vessels,  and  may  affect  any  muscles  of  the  body, 
also  the  brain,  producing  delirium,  coma  and  convulsions.  Abortion  is 
a  frequent  result,  either  through  an  influence  on  the  muscular  tissue  of  the 
uterus,  or  from  a  toxic  action  on  the  foetus.  Death  may  occur  from  ex¬ 
tension  of  the  paresis  to  the  muscles  of  respiration,  from  gradual  impair¬ 
ment  of  nutrition,  or  from  convulsions  and  coma,  a  form  of  disease  known 
as  Lead-encephalopathy. 

Astringency  is  the  chief  quality  of  the  lead  salts  ;  they  lessen  secretion, 
contract  muscular  tissue  and  then  destroy  its  contractile  power,  slow  both 
the  heart  and  the  respiration,  and  in  time  destroy  the  red  blood-corpus¬ 
cles.  Lead  enters  the  blood  as  an  albuminate,  in  which  form  also  it  is 
retained  by  the  tissues.  It  is  slowly  excreted  by  the  liver,  kidneys,  skin 
and  mammary  glands.  That  which  escapes  by  the  bile  is  reabsorbed  by 
the  bowel,  is  again  excreted  by  the  intestinal  glands,  escaping  with  the 
faeces  as  a  sulphide.  It  lessens  the  excretion  of  uric  acid. 

Antidotes  and  Inconipatibles: 

In  acute  poisoning,  as  by  the  Acetate,  the  antidotes  are  Sulphate  of  Sodium  or  of  Mag¬ 
nesium,  and  Phosphate  of  Sodium.  The  stomach  should  be  evacuated,  and  albuminous 
drinks  and  Opium  given  to  allay  irritation.  Chronic  poisoning  is  best  treated  by  Iodides 
to  saturation  of  the  system.  Sulphurated  Potassa  baths  (^j  or  more  in  water)  are  also 
very  useful.  Incompatibles  are  mineral  acids  and  salts,  vegetable  acids,  alkalies,  vege¬ 
table  astringents,  Iodide  of  Potassium,  albuminous  solutions,  Opium,  and  all  natural  waters 
containing  lime,  sulphates,  carbonates  and  Carbonic  Acid. 

Therapeutics. 

Lead  salts  are  chiefly  used  as  astringents  and  hemostatics.  The  solu¬ 
tion  of  the  Subacetate  diluted  with  4  parts  of  glycerin  and  water  is  locally 
employed  in  many  skin-diseases,  especially  in  eczema,  lichen,  impetigo 
and  erythema ;  also  in  catarrhal  discharges  of  muco-purulent  character 
from  the  ear,  vagina  and  the  urethra,  particularly  in  gonorrhoea  and  leu- 
corrhoea.  Inflammations  of  external  parts  are  constantly  treated  by  the 
lotion  of  “  Lead  water  and  Laudanum”  (Liquor  Plumbi  Subacetatis  Di- 
lutus,  7  parts  to  1  of  Tinctura  Opii).  Though  the  constituents  of  this 
lotion  are  chemically  incompatible,  it  is  a  valuable  sedative  and  astringent. 
The  Acetate,  in  5 -grain  doses  every  three  hours,  is  an  efficient  internal 
styptic  in  various  hemorrhages,  particularly  in  hemoptysis,  hematemesis 
and  gastric  ulcer,  lowering  the  action  of  the  heart  and  constringing  the 
vessels.  Its  astringent  action  is  well  manifested  in  bronchorrhoea  and 
other  pulmonary  affections  with  excessive  secretion.  It  is  well  used  in 
diarrhoeas,  gr.  ij  with  gr.  j  of  pulverized  Opium  in  choleraic  diarrhoea, 
and  smaller  doses  for  the  summer  complaint  of  children.  In  caseous 
pneumonia  the  Acetate  is  highly  recommended  as  the  best  remedial  agent, 
combined  with  Opium  and  Digitalis ;  and  in  cardiac  hypertrophy  it  may 
be  often  used  to  lower  the  action  of  the  heart.  It  is  also  serviceable  in 
whooping-cough  with  profuse  bronchial  secretion,  and  in  humid  asthma. 


PODOPHYLLUM. 


320 

Carbonate  of  Lead  is  only  used  externally  to  protect  irritated  sur¬ 
faces,  as  erythema,  erysipelas,  intertrigo,  etc.,  in  which  it  may  be  dusted 
over  the  surface  if  unbroken.  The  official  ointment,  or  white  paint  mixed 
with  linseed  oil,  is  an  excellent  application  to  burns  or  scalds,  but  if  ap¬ 
plied  on  the  broken  cuticle  it  may  prove  rapidly  poisonous. 

The  Iodide  is  employed  externally  as  an  ointment  to  enlarged  lym¬ 
phatic  glands  and  enlarged  spleen,  also  to  chronic  eczema  and  psoriasis. 
It  has  been  used  internally  to  reduce  a  malarial  spleen. 

The  Nitrate  is  an  efficient  application  to  fissured  nipples,  gr.  x  to  5j 
of  glycerin.  In  powder,  dusted  over  unhealthy  granulations,  and  sani- 
ous  ulcers  resulting  from  onychia,  it  gives  prompt  relief  after  a  brief  period 
of  pain.  It  is  said  to  have  cured  cases  of  epithelioma  when  used  in  the 
same  manner.  In  solution  (gr.  x  to  the  3)  it  is  a  most  efficient  deodor¬ 
izer  against  the  fetor  from  gangrenous  sores,  ozsena  and  other  offen¬ 
sive  discharges.  Pharmaceutically  it  is  used  in  the  preparation  of  the 
Iodide. 

The  Oxide  is  used  in  the  preparation  of  plasters,  most  of  the  other 
salts  of  lead,  and  Digitalin.  It  is  not  employed  internally,  but  may  be 
used  as  an  external  application  mixed  with  sweet  oil  in  superficial  burns, 
but  care  should  be  taken  that  it  is  only  applied  to  the  unbroken  skin. 


PODOPHYLLUM,  May  Apple,  — is  the  rhizome  and  rootlets  of 
Podophyllu??i  peltatum  (Mandrake),  an  herbaceous  perennial  of  the  nat. 
ord.  Berberidaceae,  growing  in  the  woodlands  of  Canada  and  the  U.  S., 
having  a  pale-green  stem  about  a  foot  high,  with  a  single  white  flower  at 
its  summit.  The  rhizome  is  horizontal,  -J-  inch  thick,  consisting  of  joints 
about  2  inches  long,  of  orange-brown  color  externally,  white  and  mealy 
internally,  inodorous,  taste  bitter  and  acrid.  Its  active  principle  is  a 
Resin  which  is  official,  and  is  a  compound  of  several  resins.  It  probably 
contains  the  alkaloid  Berberine ,  which  is  also  found  in  Berberis,  Hydrastis 
and  several  other  plants.  Dose,  gr.  v-xx. 

Preparations. 

Abstraction  Podophylli, — Dose,  gr.  %-). 

Extraction  Podophylli , — Dose,  gr.  v-x. 

Extraction  Podophylli  Fluidum, — Dose,  TTjJ-xxx. 

Resina  Podophylli ,  Podophyllin, — is  precipitated  from  a  concentrated  tincture  by  acidu¬ 
lated  water.  Soluble  in  alkaline  liquids  and  partly  so  in  ether.  Contains  Podophyllotoxin , 
Picropodophyllin ,  Podophyllinic  and  Protocatechuic  Acids.  Dose,  gr.  )/%-],  in  pill. 

Physiological  Action  and  Therapeutics. 

Podophyllum  is  a  tonic-astringent  and  resin-bearing  purgative,  having 
an  action  similar  to  that  of  Jalap  but  slower,  like  Calomel,  taking  6  to  10 
hours  to  produce  its  cathartic  effect.  It  increases  the  intestinal  secretions 
and  the  flow  of  bile,  causing  copious  watery  stools,  with  considerable 


POLYGONUM  HYDROPIPEROIDES - PONGAMIA.  32  I 

griping  pain  and  some  nausea.  The  powder  is  irritant  to  the  respiratory 
passages  and  the  skin. 

Resina  Podophylli  is  an  excellent  purgative  in  cases  of  habitual  con¬ 
stipation  or  portal  congestion,  and  is  a  useful  cholagogue.  Laxative 
effects  are  produced  by  small  doses  (gr.  but  grain-doses  are 

necessary  for  its  full  action.  It  should  be  combined  with  Hyoscyamus, 
Belladonna  or  Cannabis  Indica,  in  order  to  counteract  its  griping  ten¬ 
dency.  It  is  an  efficient  derivative  in  cases  of  catarrhal  or  malarial  jaun¬ 
dice,  and  is  recommended  in  very  small  doses  for  prolapse  of  the  rectum, 
remittent  fevers  of  children,  dyspepsia,  hepatic  derangement,  bilious 
vomiting  and  headache,  and  in  the  vomiting  and  diarrhoea  of  gastro¬ 
enteritis. 


POLYGONUM  HYDROPIPEROIDES,  Water  -  pepper, 
Smart-weed  (Unofficial), — is  a  plant  of  the  nat.  ord.  Polygonaceae, 
indigenous  to  the  U.  S.,  having  narrow,  lanceolated  leaves  and  slender 
spikes  of  whitish  flowers.  It  contains  Tannin  and  an  active  principle, 
Polygonic  Acid ,  which  is  green,  crystallizable,  insoluble  in  water,  but 
soluble  in  alcohol,  ether,  and  chloroform. 

Preparations. 

Extraction  Polygoni  Fluidum  (Unofficial), — Dose,  TT^x- ^  j. 

Extraction  Polygoni  (Unofficial), — Dose,  gr.  j-v. 

Physiological  Action  and  Therapeutics. 

Smart-weed  has  a  pungent,  acrid  taste,  producing  a  sensation  of  heat 
in  the  stomach,  and  a  peculiar  tingling  throughout  the  system.  It  stimu¬ 
lates  the  action  of  the  heart,  raises  the  arterial  tension,  increases  the 
warmth  of  the  surface,  promotes  the  cutaneous,  bronchial  and  renal  secre¬ 
tions  and  the  menstrual  flow.  It  is  an  efficient  diuretic,  emmenagogue 
and  aphrodisiac.  The  juice  applied  to  the  skin  excites  inflammation  and 
vesication. 

Amenorrhoea  from  functional  inactivity  of  the  uterine  system  is  remark¬ 
ably  benefited  by  this  remedy  in  5ss  doses  of  the  fluid  extract  four  times 
daily  for  a  week  before  the  expected  period.  It  has  considerable  influ¬ 
ence  over  functional  impotence,  but  produces  aching  pains  in  the  hips  and 
loins,  and  a  sense  of  weight  and  fullness  within  the  pelvis.  It  has  also 
been  used  with  benefit  in  diarrhoea,  dysentery,  gravel,  and  locally  in  mer¬ 
curial  salivation  and  the  sore  mouth  of  nursing  women. 


PONGAMIA,  Kurung  Oil  (Unofficial),  is  a  yellow  oil  expressed 
from  the  seeds  of  Pongatnia  glabra ,  an  Indian  tree  of  the  nat.  ord.  Legu- 
minosse.  It  has  been  used  for  many  years  in  India  for  skin  affections, 


POTASSIUM. 


322 

and  in  professional  hands  has  proven  an  excellent  application  in  pityriasis 
versicolor,  rubbed  in  twice  daily.  It  promises  to  be  a  valuable  remedy 
in  parasitic  diseases  of  the  skin,  is  not  irritating  and  does  not  discolor  the 
surface  to  which  it  is  applied. 


POTASSIUM,  Kalium,  K, — is  represented  by  a  number  of  official 
salts,  which  are  colorless  or  white,  sometimes  anhydrous,  and  generally 
readily  soluble  in  water.  The  metal  itself  is  not  official.  The  chief 
source  of  its  salts  is  the  ash  remaining  after  the  combustion  of  plants  or 
trees,  which  contains  the  Carbonate,  from  which  most  of  the  others  are 
prepared.  There  are  also  two  subsidiary  sources,  viz. — the  Nitrate, 
which  is  found  native ;  and  the  Bitartrate,  which,  under  the  name  of 
Crude  Tartar  or  Argol,  is  deposited  during  the  fermentation  of  wine.  It 
is  distinguished  from  all  other  bases  (except  Magnesium,  Sodium  and 
Ammonium)  by  not  being  precipitated  by  Ammonium  Sulphide  or  Am¬ 
monium  Carbonate.  It  is  positively  known  by  the  violet  color  it  imparts 
to  flame,  by  its  very  sparing  solubility  when  converted  into  the  Bitartrate, 
and  by  its  precipitation  by  Platinum  Perchloride. 

Potassium  Compounds  and  their  Preparations. 

Poiassa,  Potassium  Hydrate,  Caustic  Potash,  KHO, — a  very  deliquescent,  white,  hard 
and  dry  solid,  of  very  acrid  and  caustic  taste  and  strongly  alkaline  reaction,  soluble  in 
0.5  of  water  and  in  2  of  alcohol.  It  is  a  powerful  and  deeply-acting  escharotic,  and 
should  be  kept  in  well-stoppered  bottles  made  of  hard  glass. 

Potassa  cum  Calce ,  Potassa  with  Lime,  Vienna  Paste, — a  grayish- white,  deliquescent 
powder,  consisting  of  equal  parts  of  Potassa  and  Lime  rubbed  together.  A  milder  and 
more  manageable  caustic  than  the  preceding. 

Liquor  Potassce ,  Solution  of  Potassa, — contains  about  5  per  cent,  of  Potassium  Hy¬ 
drate,  and  is  prepared  by  dissolving  90  parts  of  Potassium  Bicarbonate  in  400  of  Dis¬ 
tilled  Water,  40  of  Lime  in  the  same  quantity  of  Distilled  Water,  boiling,  mixing  the 
solutions  gradually,  again  boiling,  and  when  cold  adding  Water  up  to  1000  parts,  strain¬ 
ing,  settling,  and  decanting  the  clear  solution.  Or,  by  dissolving  56  of  Potassa  in  944  of 
Distilled  Water.  Is  a  clear,  colorless,  odorless  liquid  of  acrid  and.  caustic  taste,  and 
strongly  alkaline  reaction.  Dose,  rrpv-^ss,  well  diluted  with  water. 

Potassii  Ace/as,  Acetate  of  Potassium,  KC2H302, — a  white,  satiny,  crystalline  mass, 
or  a  granular  powder,  very  deliquescent,  odorless,  of  pungent,  saline  taste,  and  a  neutral 
or  faintly  alkaline  reaction,  soluble  in  0.4  of  water  and  in  2.5  of  alcohol  at  590  F.  Dose, 

sr-v-3i\ 

Potassii  Carbonas,  Carbonate  of  Potassium,  (K2C03)2.3H20, — a  white,  crystalline  or 
granular  powder,  very  deliquescent,  odorless,  of  alkaline  taste  and  reaction,  soluble  in 
1  of  water  at  590  F.,  insoluble  in  alcohol.  It  is  a  constituent  of  Unguentum  Sulphuris 
Alkalinum.  Dose,  gr.  ij-xx. 

Potassii  Bicarbonas,  Bicarbonate  of  Potassium,  KHC03, — colorless  prisms  of  saline 
and  alkaline  taste  and  alkaline  reaction,  soluble  in  3.2  of  water  at  590  F.,  decomposed  by 
boiling  water,  almost  insoluble  in  alcohol.  Dose,  gr.  v-xxx. 

Potassii  Chloras ,  Chlorate  of  Potassium,  KC102, — colorless  prisms  or  plates,  of  pearly 
lustre,  of  cooling,  saline  taste  and  neutral  reaction,  soluble  in  16.5  of  water  at  590  F.  and 
in  2  of  boiling  water;  slightly  soluble  in  alcohol.  It  should  not  be  triturated  with 
readily  oxidizable  or  combustible  substances,  nor  combined  with  glycerin  in  the  presence 
of  a  free  acid.  Dose,  gr.  v-xx. 

Trochisci  Potassii  Chloratis , — each  troche  contains  gr.  v  of  Potassium  Chlorate,  with 
Sugar,  Tragacanth  and  Spirit  of  Lemon.  Dose,  j-iij,  slowly  dissolved  in  the  mouth. 

Potassii  Citras ,  Citrate  of  Potassium,  K3C6H507.H20, — a  white,  granular,  deliques- 


POTASSIUM.  323 

cent  powder,  of  cooling,  alkaline  taste,  and  a  neutral  or  faintly  alkaline  reaction,  soluble 
in  0.6  of  water  at  590  F.,  slightly  soluble  in  alcohol.  Dose,  gr.  x-xxx. 

Liquor  Potassii  Citratis, — contains  about  9  per  cent,  of  the  salt,  with  some  free  Citric 
Acid  and  Carbonic  Acid  gas.  Prepared  by  dissolving  6  of  Citric  Acid  and  8  of  Potas¬ 
sium  Bicarbonate  each  in  40  of  water,  filtering  and  adding  to  the  filters  in  each  case 
enough  water  to  bring  to  50  parts,  then  mixing  the  two  solutions.  Dose,  ^ss- ^j. 

Mistura  Potassii  Citratis ,  Neutral  mixture, —  Lemon-juice,  fresh  and  strained  100,  Bi¬ 
carbonate  of  Potassium  about  10  parts  or  enough  to  neutralize  the  Lemon-juice.  Should 
be  freshly  made.  Dose,  j^ss-^j. 

Potassii  Nilras,  Nitrate  of  Potassium,  Saltpetre,  Nitre,  KNOs, —  colorless,  transparent 
prisms  or  a  crystalline  powder,  of  pungent,  cooling  and  saline  taste  and  neutral  reaction  ; 
soluble  in  4  of  water  at  590  F.  and  in  0.4  of  boiling  water;  almost  insoluble  in  alcohol. 
Is  a  constituent  of  Argenti  Nitras  Dilutus.  Dose,  gr.  v-xx,  well  diluted. 

Charta  Potassii  Niiratis,  Nitrate  of  Potassium  Paper, — is  unsized  paper  immersed  in 
a  solution  of  20  parts  of  the  salt  in  80  of  distilled  water,  and  dried.  Used  for  inhalation, 
the  fumes  from  the  burning  paper  being  inhaled  in  asthma. 

Potassii  Sulphas ,  Sulphate  of  Potassium,  K2S04, — colorless,  hard,  rhombic  prisms,  of 
sharp,  saline  and  bitter  taste  and  neutral  reaction,  soluble  in  9  of  water  at  590  F.,  and  in 
4  of  boiling  water,  insoluble  in  alcohol.  Dose,  gr.  xx-^ss,  well  diluted. 

Potassii  Tartras ,  Tartrate  of  Potassium  (K2C4H406)2.H20, — small,  transparent 
crystals,  or  a  white  powder,  somewhat  deliquescent,  of  saline,  bitter  taste,  and  neutral 
reaction,  soluble  in  0.7  of  water,  almost  insoluble  in  alcohol.  Dose,  gr.  xx-^ss. 

Potassii  Bitartras,  Bitartrate  of  Potassium,  Acid  Tartrate  of  Potash,  Creamor  Tartar 
Cream  of  Tartar,  KHC4H406, — colorless  rhombic  crystals,  or  a  white,  gritty  powder,  of 
acidulous  taste  and  acid  reaction;  soluble  in  210  of  water  at  590  F.,  and  in  15  of  boiling 
water,  very  slightly  soluble  in  alcohol.  Is  a  constituent  of  Pulvis  Jalapae  Compositus. 
Dose,  gr.  xx-3  ss. 

Potassii  et  Sodii  Tartras,  Tartrate  of  Potassium  and  Sodium,  Rochelle  Salt, — 
KNaC4H406.4H20, — colorless,  rhombic  crystals,  or  a  white  powder,  of  cooling  and 
slightly  saline  and  bitter  taste,  and  neutral  reaction;  soluble  in  2.5  of  water  at  590  F., 
very  soluble  in  boiling  water,  almost  insoluble  in  alcohol.  Is  a  constituent  of  the  follow¬ 
ing  preparation.  Dose,  5  ss-j- 

Pulvis  Effervescens  Compositus ,  Compound  Effervescing  Powder,  Seidlitz  Powder, — 
each  has  of  the  preceding  salt  120  grains,  of  Sodium  Bicarbonate  40  grains,  mixed  in 
one  paper ;  and  of  Tartaric  Acid  35  grains  in  another  paper.  Dose,  1  or  2  pair,  dissolved 
separately  in  water  and  the  solutions  poured  together. 

Potassii  Silicas,  Silicate  of  Potassium,  Soluble  Glass,  Iv2Si03  (Unofficial), — is  used 
in  solution  of  a  syrupy  consistence  for  the  preparation  of  immovable  dressings  for  frac¬ 
tured  limbs,  etc.  (See  under  Silicates.) 

[The  Arsenite  of  Potassium  is  described  under  Arsenic,  page  1 16; — the  Bromide 
under  Bromum,  page  1 33  ; — th z  Bichromate  under  Acidum  Chromicum,  page  62; — 
the  Iodide  under  Iodum,  page  252  ; — the  Cyanide  and  Ferrocyanide  under  Acidum 
Hydrocyanicum,  page  67  ; — the  Hypophosphite  under  Phosphorus,  page  305, — the 
Permanganate  under  Manganum,  page  274 ; — the  Sulphite  under  Acidum  Sulphu- 
ROSUM,  page  73; — the  Nitrite  under  Amyl  Nitris,  page  98; — and  Sulphurated 
Potassa  under  Sulphur.] 

Physiological  Action. 

Caustic  Potash,  like  other  caustic  alkalies,  destroys  the  tissues  by 
combining  with  their  water,  dissolving  the  albumen  and  saponifying  the 
fats,  and  converting  the  tissue  to  which  it  is  applied  into  a  moist,  gray 
slough,  with  considerable  surrounding  inflammation.  Internally  it  acts  as 
a  powerful  corrosive  poison,  destroying  the  mucous  membrane  of  the  parts 
with  which  it  comes  in  contact,  and  giving  rise  to  intense  pain,  diarrhoea, 
convulsions  and  delirium.  Unless  speedily  rejected  or  neutralized  it 
causes  death  from  inflammation  of  the  larynx,  the  gastro-intestinal  lesions, 
or  after  some  time  from  stricture  of  the  oesophagus.  Liquor  Potass^e, 
containing  over  5  per  cent,  of  the  pure  Potash,  possesses  in  a  degree  the 


324 


POTASSIUM. 


same  caustic  properties,  and  should  never  be  administered  undiluted.  It 
neutralizes  the  acids  in  the  stomach,  and  in  the  blood  exists  chiefly  as  the- 
Carbonate,  being  eliminated  with  the  urine,  which  it  renders  alkaline.  If 
its  use  be  continued  too  long  it  impairs  the  blood,  and  renders  the  subject 
anaemic. 

Potassium  Salts  in  large  doses  are  cardiac  poisons,  muscular  para- 
lyzers,  poisonous  to  protoplasm,  especially  nerve-tissue,  and  destructive  to 
the  ozonizing  function  of  the  blood.  They  increase  the  saliva,  promote 
oxidation  and  stimulate  retrograde  metamorphosis ;  and  are  therefore 
waste-producers.  In  small  doses  on  an  empty  stomach  they  promote  the 
formation  of  acid  gastric  juice  by  favoring  the  outward  osmosis  of  its  con¬ 
stituents  from  the  blood  ;  in  larger  doses  they  act  chemically  on  the 
stomach  contents,  neutralizing  its  free  acids,  and  disordering  digestion. 
The  Bicarbonate,  given  on  an  empty  stomach,  enters  the  blood  unchanged, 
meets  the  neutral  phosphate  of  sodium  and  is  decomposed,  acid  phosphate 
of  sodium  being  formed,  which  renders  the  urine  more  acid.  On  a  full 
stomach  it  is  decomposed  by  the  acids  of  the  gastric  juice,  increases  the 
alkalinity  of  the  blood  and  makes  the  urine  less  acid.  The  Salts  of 
Potassium  with  Vegetable  Acids  (Acetate,  Citrate,  Tartrate,  etc.) 
enter  the  blood  in  their  own  form,  are  there  decomposed,  forming  free 
C02,  and  are  converted  into  alkaline  carbonates,  in  which  form  they  are 
eliminated,  alkalinizing  the  blood  and  the  urine.  They  are  diuretics  also, 
increasing  the  urinary  water  and  solids,  but  decreasing  the  uric  acid  by 
causing  increased  oxidation.  The  Mineral  Salts  (Nitrate,  Chlorate, 
etc.)  are  not  decomposed  in  the  blood,  but  are  eliminated  in  their  own 
form,  the  Nitrate  being  a  most  active  diuretic,  the  Chlorate  irritating  the 
kidneys,  depressing  the  heart,  causing  albuminuria,  and  impairing  the 
ozonizing  function  of  the  blood.  In  large  doses  these  salts  decompose 
the  red  blood-corpuscles  and  paralyze  the  motor  ganglia  of  the  heart. 
The  Chlorate  does  not  part  with  its  oxygen  in  the  system,  as  generally 
believed.  The  Sulphate  is  chiefly  purgative  in  its  action,  but  acts 
harshly,  and  in  overdoses  has  caused  death. 

[The  action  of  the  remaining  Potassium  salts  is  described  under  the 
titles  of  their  acid  and  other  constituents,  to  which  their  effects  are  chiefly 
referable.] 

Antago7iists  and  Incompatibles. 

Poisoning  by  caustic  alkalies  is  treated  by  the  dilute  Vegetable  Acids,  as  vinegar,  cider, 
lemon-juice ; — then  demulcent  drinks  and  oils  to  protect  the  mucous  membrane,  and  the 
usual  measures  to  support  vitality.  The  alkalies  and  their  carbonates  are  incompatible 
with  the  acids  and  also  with  metallic  salts,  and  the  caustic  alkalies  decompose  most  of  the 
alkaloids. 

Therapeutics. 

Caustic  Potash  is  used  locally  to  destroy  morbid  or  cicatrical  tissue, 
to  cauterize  the  wounds  resulting  from  bites  of  animals  or  stings  of  insects, 
to  form  issues  or  to  open  deep-seated  abscesses,  and  to  destroy  chancres, 


POTASSIUM. 


325 


malignant  pustules,  naevi,  warts,  etc.  Its  action  is  deep  and  severe,  and 
it  is  best  employed  in  the  form  of  Potassa  cum  Calce,  which  is  far  more 
manageable. 

Liquor  Potass/E  is  used  internally  as  a  free  alkali  to  neutralize  excess 
of  acid  in  the  stomach,  blood  and  secretions,  as  an  an tilithic  in  the  uric 
acid  diathesis,  also  for  acne,  boils,  and  obesity.  Locally  it  is  employed 
to  soften  the  nail  in  in-growing  toe-nail,  and  diluted  to  relieve  pruritus 
and  remove  scales  in  various  skin-diseases.  In  small  doses  with  a  vegetable 
bitter  tonic  before  meals  it  acts  well  in  atonic  dyspepsia,  increasing  the 
flow  of  the  gastric  juice  by  direct  stimulation  of  the  gastric  mucous  mem¬ 
brane.  If  given  after  meals  in  acid  dyspepsia  large  doses  are  necessary 
for  temporary  alleviation  by  neutralizing  the  food  acids.  These  remarks 
concerning  acidity  and  dyspepsia  apply  equally  well  to  the  Bicarbonate, 
which  is  used  for  the  same  purpose,  and  while  possessing  all  the  virtues  of 
the  potassium  salts,  is  without  any  corrosive  or  irritant  action.  It  is  also 
useful  in  simple  gastralgia  or  cardialgia;  and  in  cystitis,  gonorrhoea,  etc., 
where  there  is  acid  urine,  it  renders  the  urine  less  irritating  and  soothes 
the  inflamed  surfaces.  Acute  and  chronic  rheumatism  and  rheumatoid 
arthritis  are  much  benefited  by  an  alkaline  treatment  in  patients  of  suffi¬ 
cient  bodily  vigor  to  sjtand  its  lowering  effects.  The  Bicarbonate  is  also 
used  to  alkalinize  the  blood  and  secretions  in  lithaemia,  jaundice,  many 
cutaneous  eruptions,  and  in  diabetes  ;  also  locally  as  a  lotion  for  fetid 
perspiration  of  the  feet  and  axillae,  acne  and  acute  eczema.  The  Car¬ 
bonate  is  diuretic,  antacid  and  antilithic,  but  is  seldom  used  internally, 
being  too  irritant,  and  the  Bicarbonate  having  all  its  virtues  without  its 
objectionable  qualities.  Locally  a  solution  (5j  to  the  5)  is  said  to  be 
effectual  as  a  remedy  for  pruritus  vulvae,  and  one  of  half  the  above  strength 
is  used  in  freckles,  sunburn  and  tan  of  the  epidermis,  in  moist  eczema  and 
the  itching  of  urticaria. 

The  Acetate,  Citrate  and  Tartrate  are  good  purgatives  in  doses  of 
5ij  to  £iv,  and  in  smaller  doses  are  much  employed  as  alkalinizers  of  the 
blood  and  urine,  diuretics,  etc.  Of  these  vegetable  potassium  salts  the 
Acetate  is  the  most  certain  diuretic,  the  Bitartrate  is  the  most  active  ca¬ 
thartic,  while  the  Citrate  is  the  most  reliable  diaphoretic  and  the  best 
agent  to  use  to  alkalinize  the  urine  for  any  length  of  time,  it  having  the 
least  injurious  effect  on  the  blood  or  on  the  digestion.  In  lithaemia  these 
salts  are  given  to  promote  oxidation,  and  by  keeping  the  urine  alkaline 
they  may  reduce  small  calculi  of  the  uric  acid  variety.  In  acute  rheuma¬ 
tism  and  fevers  they  act  as  antacids  in  the  blood,  as  febrifuges  by  promot¬ 
ing  diaphoresis,  and  as  sedatives  to  the  general  nervous  system.  As  an 
agreeable  laxative  no  preparation  surpasses  the  Bitartrate  in  2  to  4  drachm 
doses  made  into  a  paste  with  orange  marmalade  or  any  other  conserve. 
It  is  also  used  in  Infusion  of  Juniper  as  a  diuretic  in  general  cardiac  dropsy, 
and  without  the  Juniper  in  acute  desquamative  nephritis. 


326 


POTASSIUM. 


Potassium  Chlorate  is  much  employed  locally  in  solution  (5ss  to  the  3) 
as  a  deodorizer  and  detergent  wash  in  inflamed,  ulcerated  and  aphthous 
conditions  of  the  mouth.  On  unhealthy  mucous  membranes  generally  it 
exercises  an  alterative  action  for  the  better,  but  if  too  long  used  it  will 
keep  up  a  state  of  chronic  irritation.  In  mercurial  salivation  it  is  of  great 
benefit,  and  in  dilute  solution  (gr.x  to  the  3)  it  is  an  efficient  application 
to  unhealthy  sores  and  ulcers,  as  a  wash  for  foul  sinuses  or  cavities,  and  as 
an  injection  in  chronic  affections  of  the  bladder.  The  powdered  salt  may 
be  applied  to  aphthae,  and  dusted  over  epithelioma  will  alter  the  action, 
diminish  the  pain,  check  the  growth  and  promote  cicatrization.  Inter¬ 
nally  this  salt  has  been  administered  in  the  mistaken  idea  that  it  parts 
with  its  oxygen  in  the  system,  but  it  is  now  shown  that  it  is  excreted  un¬ 
changed.  Setting  up  congestion  and  irritation  of  the  kidneys  it  is  highly 
dangerous  in  large  doses  or  if  used  for  any  length  of  time,  but  is  constantly 
administered  in  diphtheria,  chronic  bronchitis,  purpura,  hematuria,  ova¬ 
rian  tumor,  pseudo-membranous  laryngitis,  scarlatina,  typhoid  fever, 
chronic  cystitis,  etc.  When  used  internally  it  should  be  given  in  small 
doses  (gr.  xx  in  24  hours  for  an  infant,  gr.  xxx  in  24  hours  for  a  child  of 

2  to  4  years,  and  5iss  for  an  adult  in  the  same  time),  and  the  action  of 
the  heart  and  the  kidneys  should  be  carefully  watched.  It  should  never 
be  prescribed  with  the  Iodide  of  Potassium  lest  the  poisonous  Iodate  be 
formed,  nor  with  the  Syrup  of  the  Iodide  of  Iron,  lest  it  liberate  the 
Iodine,  and  cause  severe  gastritis.  Strong  acids  and  acid  sulphates  de¬ 
compose  it,  and  it  forms  explosive  compounds  with  easily  oxidizable  sub¬ 
stances  as  Sugar,  Sulphur,  Tannin,  Sodium  or  Potassium  Hypophosphites, 
Catechu,  Glycerin,  etc. 

For  the  combination  of  the  Chlorate  of  Potassium  with  the  Tincture  of 
the  Chloride  of  Iron,  as  a  gargle,  see  ante ,  page  173,  under  Chlorum. 

Potassium  Nitrate  has  been  much  employed  as  a  refrigerant  diapho¬ 
retic  and  diuretic,  in  febrile  and  inflammatory  affections,  especially  in 
inflammation  of  the  trachea  and  bronchi,  pneumonia  and  rheumatism,  but 
its  action  is  uncertain  and  it  is  now  giving  place  in  these  disorders  to  more 
efficient  agents.  The  fumes  of  burning  nitre  paper  (Charta  Potassii  Ni- 
tratis)  are  a  useful  inhalation  in  some  forms  of  spasmodic  asthma. 

Potassium  Sulphate  is  used  in  teaspoonful  doses  in  water  as  an  hepatic 
stimulant  and  a  mild  cathartic,  increasing  the  secretions  of  the  intestinal 
glandular  apparatus.  Its  action  is  sometimes  harsh,  and  death  has  resulted 
from  overdoses. 

The  Tartrate  of  Potassium  and  Sodium,  or  Rochelle  Salt,  is  the 
chief  aperient  agent  in  Seidlitz  Powders.  In  doses  of  3ss-j  it  is  a  gentle 
and  cooling  laxative,  and  in  drachm  doses  frequently  repeated  it  is  used 
to  render  the  urine  alkaline,  and  as  an  antilithic. 

[The  uses  of  the  other  Potassium  Salts  are  described  as  noted  on  page 

3  23- ] 


PRINOS — PRUNUM — PRUNUS  VIRGINIANA. 


327 


PRINOS,  Black  Alder, — is  the  bark  of  Pidnos  verticillatus  or  Win¬ 
ter-berry,  a  shrub  of  the  nat.  ord.  Aquifoliaceae,  indigenous  in  Canada  and 
the  U.  S.,  having  small,  white  flowers,  and  a  globose,  six-seeded,  bright- 
red  berry,  which  grows  in  clusters  and  is  persistent  all  winter.  The  bark 
occurs  in  thin,  slender  fragments,  of  a  brownish-ash  color  externally,  and 
a  pale-green  or  yellow  internally ;  taste  bitter  and  slightly  astringent.  It 
contains  an  amorphous,  yellow  and  bitter  principle,  also  tannin,  sugar, 
starch,  wax,  resin,  etc.  There  are  no  official  preparations,  but  the  bark 
may  be  given  in  substance  in  doses  of  5ss,  or  a  decoction  (3ij  in  Oiij 
boiled  to  a  quart)  in  doses  of  Sj-ij- 

Physiological  Action  and  Therapeutics. 

Black  Alder  is  astringent  and  tonic,  and  has  been  used  in  intermittent 
fever,  diarrhoea,  and  chronic  cutaneous  diseases.  In  the  latter  class  of 
disorders  it  may  be  applied  locally. 


PRUNUM,  Prune  , — is  the  fruit  of  Prunus  domestica ,  the  Plum 
tree  (nat.  ord.  Rosaceae),  indigenous  to  Western  Asia,  but  cultivated  in 
most  countries  of  temperate  climate.  The  dried  fruit  (Prune)  is  oblong, 
shrivelled,  of  blackish-blue  color,  having  an  almond-shaped  seed.  Prunes 
contain  sugar,  pectin,  albumen,  malic  acid  and  salts.  They  are  a  constitu¬ 
ent  of  Confectio  Sennse. 

Physiological  Action  and  Therapeutics. 

Prunes  are  laxative  and  nutritious,  and  are  freely  used  as  a  food  and 
sweetmeat,  but  in  excess  may  give  rise  to  flatulent  colic  from  the  indiges¬ 
tibility  of  their  skins.  Stewed  Prunes  is  an  excellent  dish  for  constipation 
in  children,  and  may  be  made  more  effective  by  the  addition  of  a  little 
Senna. 

PRUNUS  VIRGINIANA,  Wild  Cherry,— is  the  bark  of 
Primus  serotina ,  or  Wild  Cherry,  a  large  forest  tree  of  the  nat.  ord. 
Rosaceae,  growing  in  Canada  and  the  U.  S.  The  bark  should  be  col¬ 
lected  in  autumn  from  the  large  branches  only,  and  comes  in  curved 
pieces  inch  or  more  thick,  of  greenish  or  yellowish-brown  color  exter¬ 
nally,  and  astringent,  aromatic  and  bitter  taste.  On  maceration  in  water 
it  develops  a  distinct  odor  of  bitter  almonds.  It  contains  tannin,  gallic 
acid,  resin,  starch,  etc.,  also  Amygdalin  and  Emulsin ,  which  by  their 
mutual  reaction  in  the  presence  of  water,  produce  Hydrocyanic  Acid  and 
a  Volatile  Oil  resembling  that  of  Bitter  Almond.  [See  arite,  Amygdala, 
page  97,  and  Acidum  Hydrocyanicum,  page  67.]  Dose  of  the  powdered 
bark,  3 ss— j . 


328 


PULSATILLA. 


Preparations. 

Extraction  Pruni  Virginians  Fluidion, — Dose,  3  ss-j . 

Infusion  Pruni  Virginians, — 4  per  cent.  Dose,  3  ss-ij.  Should  be  made  with 
cold  water. 

Syrupus  Pruni  Virginians , — 12  per  cent.  Dose,  3  j-iv. 

Physiological  Action. 

Wild  Cherry  is  an  aromatic  bitter  tonic,  increases  appetite,  aiding 
digestion,  and  thus  promoting  constructive  metamorphosis.  The  presence 
of  a  volatile  oil  gives  it  a  local  stimulating  action  on  the  alimentary 
canal  in  common  with  Serpentaria,  Cascarilla  and  other  members  of  the 
same  class.  Hydrocyanic  Acid  being  yielded  by  it  in  the  presence  of 
cold  water,  results  in  imparting  a  sedative  action  to  its  preparations,  calm¬ 
ing  irritation  and  diminishing  nervous  excitability.  Very  large  doses 
reduce  the  action  of  the  heart. 

Therapeutics. 

The  preparations  of  Wild  Cherry  are  used  in  catarrhal  conditions  of 
the  bronchial  mucous  membrane,  in  the  hectic  of  phthisis  and  scrofula, 
palpitation  of  the  heart,  and  debilitated  stomach,  a  collection  of  symp¬ 
toms  often  observed  in  consumptive  subjects,  to  whom  it  is  a  very  useful 
palliative.  Cough  is  supposed  to  be  especially  amenable  to  its  influence, 
and  hence  it  has  become  a  matter  of  daily  routine  to  prescribe  the  syrup 
as  an  ingredient  of  cough-mixtures.  The  infusion  is  an  excellent  stom¬ 
achic  tonic,  and  may  be  administered  with  great  benefit  in  dyspepsia  and 
in  convalescence  from  acute  disease. 


PULSATILLA,  Pasque-flower,  Meadow  Anemone, — is  the 

herb,  collected  soon  after  flowering,  of  Anemone  Pulsatilla  and  Anemone 
pratensis  (Pulsatilla  nigricans),  and  of  Anemone  patens  (Pulsatilla  Nuttal- 
liana),  small  herbal  plants  of  the  same  natural  order  (Ranunculaceae)  to 
which  Aconite  belongs.  The  first-named  species  inhabit  Europe  and 
Siberia,  and  have  large,  purple  flowers;  the  last-named  is  an  inhabitant 
of  the  United  States,  and  sometimes  has  whitish-colored  flowers;  all  are 
inodorous  and  very  acrid.  Pulsatilla  contains  a  very  acrid  yellow  oil, 
which  in  the  presence  of  water  is  gradually  changed  to  Anemonin ,  C15H1206, 
a  volatile,  crystallizable,  camphoraceous  principle,  soluble  in  chloroform, 
nearly  insoluble  in  ether  or  water;  and  Anemotiic  Acid ,  C15Hu07,  a 
white,  crystalline,  tasteless  powder,  which  may  be  formed  also  by  the 
action  of  alkalies  on  Anemonin. 

There  are  no  official  preparations,  but  a  tincture  may  be  made  according  to  the  phar- 
macopoeial  directions  for  Tinctune  Herbarum  Recentium  (1  in  2),  of  which  the  dose  is 
rrLTL-rrpx.  The  imported  homoeopathic  tincture  has  equal  parts  of  the  expressed  juice 
and  alcohol,  and  is  generally  a  very  good  preparation. 

Anemoninum,  Anemonin  (Unofficial), — the  active  principle.  Dose,  gr.  y^-ij  in  pill. 


PULSATILLA. 


329 


Physiological  Action. 

Pulsatilla  is  a  local  irritant,  the  fresh  juice  producing  numbness  and 
tingling  in  the  part  to  which  it  is  applied,  and  may  excite  violent  inflam¬ 
mation  of  the  skin  with  vesicular  or  pustular  eruption,  and  if  swallowed 
severe  irritation  of  the  gastro-intestinal  mucous  membrane.  On  the 
tongue  it  produces  symptoms  like  those  from  Aconite,  viz. — tingling  and 
burning,  followed  by  numbness.  Internally  it  lowers  the  heart  and 
arterial  tension,  reduces  respiration  and  temperature,  dilates  the  pupils, 
produces  nausea  and  vomiting,  diaphoresis  and  diuresis,  and  paralyzes 
motion  and  sensibility.  Stupor,  coma  and  convulsions  may  be  caused  by 
a  toxic  dose.  Most  of  these  effects  have  been  observed  on  rabbits.  The 
active  principle  (Anemonin)  is  volatile,  hence  the  herb  must  be  fresh  to 
be  suitable  for  medicinal  use. 

Antagonists  and  Incompatibles. 

Alcohol,  Opium  and  Digitalis  are  the  physiological  antagonists.  Incompatibles  are 
the  caustic  alkalies,  Tannic  Acid  and  the  metallic  salts. 

Therapeutics. 

Pulsatilla  is  a  very  efficient  remedy  if  a  fresh  preparation  be  employed. 
It  was  highly  praised  by  Storck  for  amenorrhoea,  corneal  opacities,  cata¬ 
ract,  paralyses,  rheumatism,  old  ulcers,  constitutional  syphilis  and  scaly 
skin  diseases.  On  the  generative  organs  it  seems  to  have  a  specific  action, 
and  is  an  excellent  remedy  in  functional  amenorrhoea,  dysmenorrhoea, 
menstrual  suppression  from  fright  or  chill,  leucorrhoeal  discharges  with 
back-pains  and  nervous  depression.  Epididymitis  and  orchitis  are  often 
controlled  and  even  dissipated  by  very  small  doses  (tip  )  every  2 

hours.  It  quickly  relieves  dyspepsia  or  subacute  gastritis,  with  white- 
coated  tongue,  no  taste  or  a  greasy  sensation  in  the  palate,  nausea,  flatu¬ 
lence,  heartburn,  etc.  Many  acute  inflammations  of  mucous  surfaces 
with  mucous  or  muco-purulent  discharges,  as  coryza,  otitis  (externa  and 
interna),  rhinitis,  bronchitis,  conjunctivitis,  etc.,  are  greatly  benefited  by 
5  to  io-drop  doses  every  4  hours  and  locally  5j~ij  of  tincture  to  5  iv 
water  as  a  lotion.  A  similar  use  of  this  remedy  has  proven  of  great  bene¬ 
fit  in  many  cutaneous  affections,  especially  eczematous  eruptions,  syphil- 
ides,  and  ulcers  of  indolent  character.  It  is  also  said  to  be  efficiently 
employed  in  acute  cerebral  and  spinal  meningitis,  subacute  rheumatism 
of  the  small  joints,  rheumatic  gout,  chronic  vesical  and  nasal  catarrhs, 
gastro-enteric  symptoms  of  remittent  fever  and  measles,  ophthalmia  neona¬ 
torum,  strumous  ophthalmia  with  profuse  but  bland  discharge,  acute  and 
subacute  inflammations  of  the  middle  ear,  and  in  left-sided  clavus,  hemi- 
crania  and  infra-mammary  pain.  An  extract  of  the  root  has  proved  effi¬ 
cient  against  tapeworm. 

Coughs  which  are  loose  by  day  but  dry  and  tickling  on  lying  down  at 


330 


PYRETH  RUM - QUASSIA. 


night  are  greatly  benefited  by  Pulsatilla,  and  Anemonin  in  doses  of  gr. 
y2- )  has  been  found  extremely  useful  in  whooping-cough  and  other  coughs 
of  irritative  character. 


PYRETHRUM,  Pellitory, — is  the  root  of  Anacyclus  Pyrethrum, 
a  plant  of  the  nat.  ord.  Compositae,  native  of  Northern  Africa,  but  culti¬ 
vated  in  Europe.  The  root  is  2  to  4  inches  long,  y2  inch  thick,  annu¬ 
late  above,  wrinkled  below,  externally  a  dark  grayish-brown,  internally 
brownish-white;  the  bark  thick,  containing  two  circles  of  resin-cells  sur¬ 
rounding  slender  wood-bundles  and  medullary  rays ;  inodorous,  pungent 
and  acrid.  It  contains  an  alkaloid  Pyrethrine ,  also  inulin,  tannin,  mucil¬ 
age,  etc.,  with  a  brown  Resin  and  two  fixed  oils.  Dose,  as  a  mastica¬ 
tory,  5  ss-j. 

Pyrethrum  Roseum,  Persian  Pellitory  (Unofficial), — is  indigenous  to 
Western  Asia,  and  resembles  Chamomile  in  appearance.  The  flower- 
heads  are  used  in  powder  to  kill  insects,  4  grains  killing  a  fly  in  a  vial  in 
2  or  3  minutes. 

Preparation . 

Tinctnra  Pyrethri , — 20  per  cent.  Not  used  internally. 

Physiological  Action. 

Pellitory  is  an  irritant  sialogogue.  When  chewed  it  causes  a  pricking 
sensation  in  the  tongue  and  fauces  with  heat,  acridity,  pungency  and  a 
copious  flow  of  saliva  and  buccal  mucus.  Large  doses  may  cause  bloody 
diarrhoea,  tetanoid  spasms,  accelerated  pulse,  and  profound  stupor.  Ap¬ 
plied  to  the  skin  it  acts  as  a  rubefacient,  the  powder  inhaled  as  a  sternuta¬ 
tory.  It  stimulates  the  local  nerves  and  vessels  of  the  mouth  and  salivary 
glands  by  direct  irritant  action,  but  soon  depresses  the  nerves  and  blunts 
their  sensibility. 

Therapeutics. 

Pellitory  is  chewed  as  a  masticatory  and  sialogogue  in  paralysis  of  the 
tongue,  rheumatic  and  neuralgic  affections  of  the  head  and  face,  and  pain 
from  carious  teeth.  Its  powder  has  been  recommended  as  a  sternutatory 
in  chronic  catarrh  of  the  frontal  sinuses.  As  a  gargle  or  lotion  (5iij  to 
Oj)  it  is  very  useful  for  relaxed  uvula  and  as  a  mouth-wash.  When  used 
for  toothache  a  few  drops  of  the  tincture  should  be  inserted  into  the 
cavity  on  cotton  or  wool.  Used  as  a  sialogogue  it  is  an  efficient  agent 
to  secure  the  rapid  elimination  of  Iodine  from  the  system  in  chronic  poi¬ 
soning  thereby. 


QUASSIA  , — is  the  wood  of  Picrcena  excelsa,  a  large  tree  of  the  nat. 
ord.  Simarubacese,  indigenous  to  Jamaica  and  other  West  Indian  islands. 
Surinam  Quassia,  used  in  Europe,  is  the  wood  of  Quassia  amara.  Both 


QUEBRACHO. 


331 


varieties,  as  met  with  in  the  shops,  are  in  the  form  of  chips  or  raspings, 
of  a  yellowish-white  color,  inodorous  but  of  intensely  bitter  taste.  The 
wood  is  also  turned  into  cups,  which  are  sold  under  the  name  of  quassia- 
or  bitter-cups.  It  contains  a  bitter  principle,  Quasstn,  C31H4209,  which  is 
crystalline,  soluble  in  hot  alcohol  and  in  chloroform,  slowly  in  cold  water, 
faster  in  alkaline  or  acidulated  water.  Dose  of  the  powdered  wood,  gr. 
xx-xxx. 

Preparations. 

Extraction  Quassice, — aqueous.  Dose,  gr.  j  — i i j . 

Extraction  Quassice  Fluidum , — Dose,  3  ss-j. 

Tinctura  Quassice , — strength  10  per  cent.  Dose,  nqv-^j. 

Infusum  Quassice  (Unofficial), — made  with  cold  water  5  x,  Quassia  chips  3  j,  macerated 
for  yz  hour  and  strained.  Or  water  poured  into  a  quassia-cup  and  left  standing  will  give 
a  good  infusion.  Dose,  ^j-iij. 

Physiological  Action. 

Quassia  is  a  simple  bitter,  having  no  flavor,  but  is  intensely  bitter  and 
less  agreeable  than  either  Gentian  or  Chiretta.  It  is  fatal  to  flies  and  fish, 
and  makes  an  excellent  anthelmintic  enema  against  the  thread-worm.  A 
concentrated  preparation  is  poisonous  to  rabbits  and  dogs,  and  has  pro¬ 
duced  very  alarming  narcotic  symptoms  in  a  four-year  old  child.  As  usually 
administered  its  action  is  that  of  a  bitter  stomachic  tonic,  as  described 
under  Calumba  (see  ante ,  page  145). 

Therapeutics. 

The  preparations  of  Quassia  contain  no  tannin  and  hence  may  be  pre¬ 
scribed  with  salts  of  Iron.  It  is  chiefly  employed  in  atonic  dyspepsia  with 
pain  after  eating,  and  vomiting  or  regurgitation  of  food,  also  in  atonic 
diarrhoea  depending  on  indigestion  or  an  irritable  condition  of  the  intesti¬ 
nal  mucous  membrane.  It  is  useful  in  convalescence  to  promote  the 
appetite  and  digestion,  and  with  Sodium  Bicarbonate  in  gastric  vertigo. 
As  an  enema  the  strong  infusion  is  an  effective  remedy  for  ascarides  of  the 
rectum.  It  has  been  used  as  a  feeble  antiperiodic,  and  in  hysteria  its 
repulsiveness  is  an  aid  to  its  medicinal  action. 


QUEBRACHO  (Unofficial),— is  the  bark  of  Aspidosperma  Que¬ 
bracho ,  a  large  evergreen  tree  of  the  nat.  ord.  Apocynaceae,  growing  in 
Chili  and  the  Argentine  Republic.  The  name  is  one  given  in  S.  America 
to  any  very  hard  wood  ( quebrar  hacho ,  to  break  the  axe),  and  the  par¬ 
ticular  tree  above  named  is  known  as  Quebracho  bianco ,  from  the  white 
color  of  its  wood.  It  contains  several  alkaloids,  no  one  of  which  repre¬ 
sents  the  action  of  the  bark  itself;  the  most  important  being  Aspidosper- 
mine ,  C22H30N2O2,  and  Quebrachine ,  C21H26N203.  Several  false  Quebrachos 
are  found  on  the  market,  that  most  frequently  seen  being  the  bark  of 


332 


OUERCUS  ALBA. 


Loxopterygium  lorentzii ,  or  Quebracho  Colorado ,  an  Argentine  tree  of  the 
order  Terebinthaceae. 

Preparations. 

Tinctura  Quebracho  (Unofficial), — 20  per  cent.  Dose,  sQ-^ss. 

Extractum  Quebracho  Fluidum  (Unofficial), — Dose,  rr^v-^j. 

Vinum  Quebracho  (Unofficial), — Quebracho  1,  Alcohol  2,  White  Wine  16  parts.  Dose, 

3K?j- 

Extractum  Quebracho  (Unofficial), — Dose,  gr.  ij-viij. 


Physiological  x4ction. 

Quebracho  is  a  bitter  tonic  of  disagreeable  taste,  promoting  appetite 
and  increasing  digestion.  It  lowers  the  action  of  the  heart,  reduces  arte¬ 
rial  tension,  and  slows  respiration,  also  decreasing  the  sensation  of  need 
of  air  after  active  exercise.  In  large  doses  it  causes  severe  salivation, 
nausea,  vomiting,  vertigo  and  headache.  In  animals  it  paralyzes  the  motor 
nervous  system  and  lowers  the  reflexes,  producing  great  dyspnoea  and 
finally  death  apparently  from  asphyxia. 

Aspidospermine  is  actively  poisonous  to  the  respiratory  apparatus  and 
circulation  in  both  cold-  and  warm-blooded  animals,  in  the  former  the 
respiration  being  chiefly  affected,  in  the  latter  the  motor  ganglia  of  the 
heart.  Lowered  temperature,  dyspnoea,  stupor  and  convulsions  occur 
before  death. 

Therapeutics. 

Quebracho  has  long  been  used  in  Chili  as  an  antiperiodic,  a  stomachic 
tonic,  and  a  remedy  for  dyspnoea.  In  the  latter  condition  it  is  reported 
to  be  remarkably  palliative,  especially  when  due  to  emphysema,  uraemic 
and  spasmodic  asthma,  spasmodic  cough  and  chronic  bronchitis.  It  is 
not  efficient  in  dyspnoea  from  organic  disease  of  the  heart,  nor  in  that  of 
aged  subjects  of  atheroma. 

Aspidospermine  has  been  used  as  an  antipyretic,  also  in  cardiac  neu¬ 
roses  and  in  asthma.  Its  salts  are  freely  soluble  in  water,  but  the  alkaloid 
itself  is  only  soluble  in  oils  and  fats,  6  to  8  parts  being  readily  incorpo¬ 
rated  with  100  of  cod-liver  oil  by  the  aid  of  heat.  Its  average  dose  is 

gr-  j-ij. 


QUERCUS  ALBA,  White  Oak, — is  the  bark  of  Quercus  alba , 
the  White-oak  tree  (nat.  ord.  Cupuliferae),  and  occurs  in  nearly  flat  pieces 
deprived  of  the  corky  layer,  of  pale-brown  color,  tan-like  odor,  and 
strongly  astringent  taste  ;  or  as  a  coarse,  fibrous  powder,  which  does  not 
tinge  the  saliva  yellow.  It  contains  a  variety  of  Tannin  named  Querci- 
tannic  Acid ,  C28H24012,  also  Pectin  and  a  bitter  principle  named  Quercin , 
but  no  Gallic  Acid.  There  are  no  official  preparations,  but  a  decoction 
(Sj  ad  Oj)  may  be  used  in  doses  of  5ss-j. 


QUILLAIA. 


333 


Quercus  Tinctoria ,  Black  Oak  Bark, — was  formerly  official.  It  contains  a  coloring 
principle  Quercitrin ,  which  stains  the  saliva  yellow  when  the  bark  is  chewed,  also  Quer- 
citannic  Acid,  etc. 

Quercus  Lusitanica  is  the  source  of  Galls  (see  ante,  Galla,  page  223). 

Physiological  Action  and  Therapeutics. 

Oak-bark  is  astringent  and  tonic,  but  is  seldom  used  internally.  Its 
action  and  uses  are  those  of  Tannic  Acid  (see  ante,  page  74).  The  decoc¬ 
tion  is  much  used  in  country  practice  as  a  cheap  astringent  application  for 
injection  in  leucorrhoea,  prolapsus  ani,  hemorrhoids,  etc.,  and  as  a  gargle 
in  faucial  inflammation  and  prolapsed  uvula.  It  has  also  been  used  as  an 
injection  into  dropsical  cysts,  and  as  a  lotion  for  flabby  ulcers  and  suppu¬ 
rating  wounds.  The  powdered  bark  as  a  poultice  has  proved  an  excellent 
application  in  gangrene,  and  in  finely  pulverized  state  it  is  a  useful  ingre¬ 
dient  of  tooth-powders.  A  concentrated  fluid  extract  is  used  in  the  Hea- 
ton-Warren  operation  for  the  radical  cure  of  hernia,  by  injection  into  the 
tissues  around  the  margin  of  the  ring,  with  the  object  of  exciting  inflam¬ 
mation  and  occlusion  of  the  opening. 


QUILLAIA,  Soap-Bark, — is  the  inner  bark  of  Quillaia  Saponaria, 
a  tree  of  the  nat.  ord.  Rosaceae,  indigenous  to  Peru  and  Chili.  It  occurs 
in  large,  flat  pieces,  about  -J-  inch  thick,  of  a  brownish-white  color  exter¬ 
nally,  very  acrid  and  sternutatory,  but  inodorous.  It  contains  Calcium 
Sulphate  crystals,  starch,  and  the  glucoside,  Saponin ,  C3.2H54018,  a  white, 
amorphous,  sternutatory  powder,  soluble  in  water  and  in  dilute  alcohol. 
There  are  no  official  preparations,  but  a  tincture  may  be  prepared  by  ex¬ 
hausting  one  part  of  the  bark  with  sufficient  dilute  alcohol  to  make  5  parts 
of  tincture. 

Physiological  Action  and  Therapeutics. 

Quillaia  in  powder  is  sternutatory  and  causes  the  water  in  which  it  is 
macerated  to  froth,  making  emulsions  of  oils,  and  being  used  instead  of 
soap  for  washing  purposes  in  various  affections  of  the  skin,  and  to  stimu¬ 
late  the  growth  of  the  hair  in  alopecia.  Its  properties  are  due  to  the  glu¬ 
coside  Saponin,  which  is  found  also  in  Senega  and  in  a  number  of  other 
plants,  and  is  a  violent  irritant  of  the  respiratory  passages,  a  local  anaes¬ 
thetic,  an  antipyretic,  a  powerful  paralyzant  of  the  heart  and  respiration, 
and  a  poison  to  the  voluntary  muscles.  It  has  not  been  made  use  of  in 
practical  medicine. 

A  decoction  of  the  bark  (5  to  200)  has  been  employed  in  doses  of  5j-ij 
according  to  age,  as  a  substitute  for  Senega  in  the  treatment  of  diseases  of 
the  respiratory  organs  where  a  pleasant  expectorant  is  indicated.  Its  ex¬ 
pectorant  properties  are  well  established,  and  children  take  it  readily.  It 
does  not  provoke  diarrhoea  or  vomiting,  and  has  a  sweetish,  agreeable 
taste. 


334 


RESINA — RESORCINUM. 


RESINA,  Resin,  Rosin,  Colophony,  C44H6204, — is  the  residue 
left  after  distilling  off  the  volatile  oil  from  Turpentine.  It  is  a  transparent, 
amber-colored  substance,  of  sp.  gr.  1.070  to  1.080,  hard  and  brittle,  with 
a  glossy  and  shallow  conchoidal  fracture,  and  a  faintly  terebinthinate  odor 
and  taste,  soluble  in  alcohol,  ether,  fixed  or  volatile  oils,  and  in  its  own 
weight  of  oil  of  turpentine.  Chemically  it  is  considered  as  the  Anhydride 
of  Abietic  Acid,  C44H6405,  into  which  acid  it  is  converted  by  agitation  with 
warm  diluted  alcohol.  Silvic,  Pinic  and  Palmaric  Acids  are  decomposi¬ 
tion  products,  not  constituents  of  the  resin  as  formerly  taught.  Other 
official  resins  are  Resina  Copaiba,  Resina  Jalap^e,  Resina  Podophylli 
and  Resina  Scammonii,  which  are  severally  described  under  the  titles  of 
the  plants  forming  their  respective  sources. 

Preparations. 

Ceraium  Resince,  Resin  Cerate,  Basilicon  Ointment, — consists  of  Resin  35,  Yellow  Wax 
15,  and  Lard  50  parts.  It  forms  65  per  cent,  of  Turpentine  Liniment,  and  is  a  constitu¬ 
ent  of  Savine  Cerate. 

E7iiplastrum  Resince ,  Resin  Plaster,  Adhesive  Plaster, — consists  of  Resin  14,  Lead 
Plaster  80,  Yellow  Wax  6  parts.  Is  the  common  adhesive  plaster  of  surgery,  and  an 
ingredient  of  the  official  Arnica,  Belladonna  and  Capsicum  Plasters. 

Resin  itself  is  an  ingredient  of  Mercurial  Plaster,  Cantharides  Cerate,  and  Cerate  of 
the  Extract  of  Cantharides. 

Physiological  Action  and  Therapeutics. 

Resin  gives  consistence  and  adhesiveness  to  plasters  and  cerates,  and 
generally  acts  as  a  mild  local  stimulant,  but  the  writer  has  seen  persons 
with  so  susceptible  a  skin  that  the  ordinary  adhesive  plaster  would  pro¬ 
duce  on  them  a  high  degree  of  cutaneous  irritation.  It  is  never  employed 
internally,  but  in  chronic  bronchial  catarrh  the  fumes  from  boiling  resin 
are  inhaled  with  considerable  advantage.  Resin  Cerate  is  one  of  the 
most  commonly  used  applications  to  promote  the  healing  of  indolent 
ulcers,  blistered  surfaces,  burns,  scalds,  chilblains,  etc. 


RESORCINUM,  Resorcin,  Meta  -  di  -  hydroxy  -  benzene,  C6H4- 
(HO)2  (Unofficial), — is  a  diatomic  phenol,  isometric  with  Pyrocatecliin 
and  Hydroquinone  (see  ante ,  page  180),  obtained  by  fusing  certain  resins 
with  a  caustic  alkali,  but  best  prepared  by  fusing  Potassium  Benzol-disul- 
phonate  with  Caustic  Potassa,  the  salt  being  decomposed  into  Potassium 
Sulphite  and  Resorcin.  It  crystallizes  in  colorless,  rhombic  prisms  or 
plates  of  neutral  reaction,  odorless,  and  of  sweetish,  acrid  taste,  soluble 
in  of  water,  also  in  alcohol,  ether,  etc.  Dose,  gr.  v-xv  ; — as  an  anti- 
pyretic  5j>  not  repeated  for  several  hours,  or  gr.  v  every  2  hours. 

Physiological  Action. 

Resorcin  is  closely  allied  to  Carbolic  Acid,  but  possesses  the  advantage 
over  the  latter  in  that  it  is  odorless,  more  soluble  and  almost  non-irritant. 


RESORCINUM. 


335 


It  is  equally  powerful  as  an  antiseptic  and  antiferment,  arresting  decom¬ 
position  and  destroying  low  organisms.  Injected  beneath  the  integu¬ 
ment  in  solution  it  produces  very  little  irritation,  and  never  causes 
inflammation  or  abscess.  Vesication  results  from  its  application  to  the 
mucous  membrane.  Internally  a  30-  to  60-grain  dose  causes  a  sense  of 
heat,  discomfort  and  oppression,  followed  by  profuse  perspiration  and 
languor ;  if  fever  be  present  the  temperature  of  the  body  is  lowered  sev¬ 
eral  degrees,  but  rises  again  after  a  rigor  in  from  2  to  4  hours.  Larger 
doses  (150  grains)  have  produced  deafness,  dizziness,  salivation,  confused 
vision,  vertigo,  unconsciousness,  general  clonic  convulsions,  and  tetanic 
rigidity  of  the  muscles  of  the  neck,  with  no  decline  of  temperature  in 
feverless  subjects.  Toxic  doses  (gr.  xv  to  each  5xxxv  of  weight)  cause 
in  animals  trembling  succeeded  by  epileptiform  convulsions,  which 
increase  in  severity  and  then  decline,  the  respiration  is  quickened  and 
enfeebled,  the  heart’s  action  becomes  rapid,  weak,  and  irregular,  and 
death  results  from  paralysis  of  respiration,  the  drug  paralyzing  the  motor 
tracts  in  the  spinal  cord,  but  not  affecting  the  general  sensibility.  It  is 
eliminated  chiefly  by  the  urine,  which  it  colors  a  bluish-violet  hue  and 
with  great  rapidity,  about  one  hour  serving  for  its  excretion.  The  best 
test  of  its  presence  is  the  solution  of  the  Perchloride  of  iron,  which 
produces  with  it  a  dark-violet,  almost  black  color. 

Antagonists. 

Atropine  and  other  cardiac  and  respiratory  stimulants,  cerebral  excitants  and  agents 
which  raise  the  arterial  tension  are  physiologically  antagonistic. 


Therapeutics. 

Resorcin  is  employed  as  an  antipyretic  and  antiseptic,  being  preferred 
to  Carbolic  Acid  for  internal  and  subcutaneous  use.  A  3  per  cent,  solu¬ 
tion  gives  good  results  in  stomach  complaints,  as  gastralgia,  gastric  catarrh, 
gastric  ulcer,  fermentative  indigestion,  etc.  It  has  given  great  satisfac¬ 
tion  to  some  observers  in  intermittent  fevers  and  malarial  diseases  gener¬ 
ally,  while  others  have  been  much  disappointed  with  its  action  therein. 
As  an  antipyretic  it  has  been  used  in  erysipelas,  puerperal  fever,  septicae¬ 
mia  and  diphtheria,  and  in  the  latter  disease  it  has  been  employed  locally 
in  crystals  with  decided  benefit.  A  2  per  cent,  solution  has  given  great 
satisfaction  as  a  local  antiseptic  application  to  wounds,  parasitic  skin  dis¬ 
eases,  cystitis,  gonorrhoea,  anthrax,  and  spyhilitic  sores  of  unhealthy 
character.  As  spray  a  similar  solution  is  well  applied  to  catarrhal  or  ulcer¬ 
ative  affections  of  the  respiratory  passages.  As  a  caustic  it  may  be  applied 
in  undiluted  form  to  chancres,  papillomata,  carbuncles,  etc.  A  saturated 
ethereal  solution  is  a  good  application  where  the  caustic  action  of  the 
drug  is  required. 


RHEUM. 


336 

RHEUM,  Rhubarb  , — is  the  root  of  Rheum  officinale ,  a  perennial 
plant  of  the  nat.  ord.  Polygonacese,  a  native  of  Thibet,  and  of  other 
undetermined  species  of  Rheum ,  many  of  which  are  cultivated  in  Europe 
and  America,  their  leaf-stalks  being  used  as  a  fruit.  The  commonly 
accepted  medicinal  Rhubarb  is  the  Chinese  variety,  and  is  imported  from 
Shanghai  and  Canton.  It  occurs  in  cylindrical  or  conical  segments, 
sometimes  flattened  and  bored  with  a  hole,  of  a  dirty-brown-yellow  color 
externally,  internally  marbled  with  fine  waving  lines,  of  peculiar  odor, 
gritty  between  the  teeth,  and  of  a  bitter  astringent  taste.  It  imparts  its 
virtues  to  water  and  alcohol,  and  contains  several  substances  of  greater 
or  less  activity,  the  least  important  being  Phceoretin ,  C32H32014,  the  rhu¬ 
barb-resin, — Erythroretin ,  C38H36014,  and  Chrysophan ,  C27H30O14,  the  latter 
of  which  is  split  by  acids  into  Sugar  and  Chrysophanic  Acid.  (See  ante , 
Chrysarobinum,  page  174.)  It  also  contains  Rheo-tannic  Acid,  C52H52028, 
Rheumic  Acid,  C40H32O18,  and  probably  a  principle  which  is  identical 
with  Cathartic  Acid  (see  Senna),  on  which  its  purgative  activity  may 
depend.  Dose  of  Rhubarb  as  a  stomachic,  gr.  j-v;  as  a  purgative,  gr. 
x-xx. 

Preparations. 

Extraction  Rhei , — Dose,  gr.  x-xv. 

Extraction  Rhei  Fluidum, — Dose,  3  ss-ij. 

Pilules  Rhei , — composed  of  Rhubarb  3,  Soap  1  ;  each  pill  containing  gr.  iij  of  pow¬ 
dered  Rhubarb.  Dose,  j-iij. 

Piluhs  Rhei  Composites , — each  contains  of  Rhubarb  gr.  ij,  Aloes  gr.  \]/2,  Myrrh  gr.  j, 
Oil  of  Peppermint  gr.  TC.  Dose,  ij-v.  A  safe  and  efficient  laxative. 

Tinctura  Rhei , — has  of  Rhubarb  12,  Cardamom  2,  with  diluted  Alcohol  to  100  parts. 
Dose,  gj-^ss. 

Tinctura  Rhei  Aromatica, — has  of  Rhubarb  20,  Cinnamom  4,  Cloves  4,  Nutmeg  2, 
Diluted  Alcohol  to  100  parts.  Dose,  gj-giij. 

Tinctura  Rhei  Dulcis, — has  of  Rhubarb  8,  Licorice  4,  Anise  4,  Cardamom  1,  Diluted 
Alcohol  to  100  parts.  Dose,  5  ss-^  ij. 

Syrupus  Rhei , — has  of  Rhubarb  90,  Cinnamon  18,  Potassium  Carbonate  6,  Sugar  600, 
Water  to  1000  parts.  Or,  it  may  be  made  extemporaneously  thus : — Fluid  Extract  5  iij, 
Simple  Syrup  3  xxix.  Dose  for  an  infant  ^j;  for  older  children  ^  ij—  3  ss. 

Syrupus  Rhei  Aromaticus , — has  of  the  Aromatic  Tincture  10,  Syrup  90  parts.  Dose, 
as  the  Syrup. 

Vinum  Rhei, — has  of  Rhubarb  10,  Calamus  1,  Stronger  White  Wine  to  100  parts. 
Dose,  £  j~3  ss. 

Pulvis  Rhei  Compositus, — has  of  Rhubarb  25,  Magnesia  65,  Ginger  10.  Dose,  a  tea¬ 
spoonful. 

Mistura  Rhei  et  Sodcs , — Sodium  Bicarbonate  30,  Fluid  Extract  of  Rhubarb  30,  Spirit 
of  Peppermint  30,  Water  to  1000  parts.  Dose,  3  ij — ^ij. 


Physiological  Action. 

Rhubarb  is  classed  among  the  tonic-astringent  and  resin-bearing  pur¬ 
gatives,  which  increase  the  secretions  of  the  glandular  appendages  of  the 
intestinal  canal,  and  stimulate  the  muscular  layer  of  the  bowel.  In  small 
doses  (gr.  j-v)  its  action  is  that  of  a  stomachic  and  intestinal  astringent, 
the  influence  of  the  bitter  principle  and  the  rheo-tannic  acid  probably 
predominating.  In  larger  doses  (gr.  xxx-lx),  its  cathartic  action  prevails, 


RHINACANTHUS - RHUS  AROMATICA. 


337 


producing  in  6  to  8  hours  copious  yellow,  pultaceous  stools,  with  some 
griping  and  considerable  hepatic  stimulation.  After  the  cathartic  prin¬ 
ciple  is  expelled,  the  astringent  quality  of  its  tannin  asserts  itself  and 
constipation  is  likely  to  result.  The  yellow  color  of  the  stools  is  partly 
due  to  the  rhubarb  pigment  and  partly  to  excess  of  bile,  the  drug  having 
marked  cholagogue  properties,  in  all  probability  due  to  its  resin,  Phaeore- 
tin.  Its  pigment  stains  the  milk,  urine  and  sweat,  the  milk  acquiring  a 
bitter  taste  and  purgative  properties.  The  cathartic  action  of  Rhubarb 
may  be  obtained  from  its  application  locally  to  ulcers,  by  being  rubbed 
into  the  moist  skin,  or  applied  to  the  abdomen  as  a  poultice. 

Therapeutics. 

Rhubarb  is  highly  esteemed  as  a  cathartic  for  children,  from  the  mild¬ 
ness  of  its  action,  as,  though  occasionally  producing  quite  severe  griping, 
it  never  inflames  the  gastro-enteric  mucous  membrane.  Its  tonic  and 
astringent  action  following  its  catharsis  makes  it  a  valuable  agent  in 
diarrhoeas  due  to  the  presence  of  irritating  matter  in  the  bowel,  and  to 
correct  atonic  indigestion  accompanied  by  diarrhoea.  For  hemorrhoids 
with  constipation  its  gentle  action  makes  it  peculiarly  suitable,  its  astrin¬ 
gent  after-effect  being  entirely  overcome  by  2  to  4  drachm  doses  of  olive 
oil  nightly.  It  may  be  combined  with  a  mercurial  or  with  Bicarbonate 
of  Sodium,  the  latter  being  supposed  to  overcome  its  astringent  action 
and  to  disguise  its  taste  in  some  degree.  In  small  doses  the  tincture  is 
a  very  efficient  stomachic  tonic,  improving  appetite,  increasing  the  flow 
of  the  gastric  juice,  assisting  digestion,  and  promoting  the  action  of  the 
liver  without  producing  any  cathartic  results.  The  preparations  most  in 
use  for  children  are  the  Aromatic  Syrup  and  the  Mistura  Rhei  et  Sodae. 


RHINACANTHUS  (Unofficial), — the  leaves  and  root  of  Rhina- 
canthus  communis ,  a  shrub  of  the  nat.  ord.  Acanthaceae,  indigenous  to 
India  and  China.  The  root  contains  a  quinone-like  body  named  Rhina- 
canthin ,  CUH1804,  which  forms  with  alkalies  intensely  red  compounds 
which  are  decomposed  by  benzin.  It  is  known  in  China  as  Hong-Pang- 
Chong,  and  is  employed  as  a  local  remedy  for  ringworm  and  parasitic 
skin  diseases,  the  leaves  being  bruised  and  mixed  with  lime-juice.  Used 
internally  a  tincture  of  the  root  has  some  reputation  as  a  feeble  tonic  and 
antiperiodic.  The  same  preparation  is  applied  locally  in  chronic  eczema, 
tinea  and  psoriasis. 


RHUS  AROMATICA,  Sweet  Sumach  (Unofficial), — is  an  in¬ 
digenous  shrub  of  the  nat.  ord.  Terebinthaceae,  growing  about  5  feet 
high,  and  having  yellow  flowers  in  spikes.  The  root-bark  contains  a 


333 


RHUS  GLABRA - RHUS  TOXICODENDRON. 


volatile  oil,  several  resins,  fat,  tannin,  etc.  A  fluid  extract  is  prepared 
from  the  bark  of  the  root  according  to  the  general  pharmacopoeial  rule, 
and  may  be  given  in  doses  of  trpx-xxx,  every  2  or  3  hours. 

Physiological  Action  and  Therapeutics. 

Rhus  Aromatica  has  astringent  properties,  and  seems  to  possess  a  selec¬ 
tive  action  upon  the  urinary  tract.  Its  action  is  not  yet  clearly  made  out. 
Therapeutically  it  has  been  used  with  advantage  in  cystitis,  night-sweats, 
hematuria,  menorrhagia,  diabetes  insipidus,  diarrhoea  and  dysentery.  As 
a  remedy  for  incontinence  of  urine  in  children  it  has  attracted  consider¬ 
able  attention,  having  been  extremely  efficient  in  doses  of  npxv  of  a  good 
fluid  extract  four  times  daily,  administered  in  glycerin  and  water,  or  any 
other  suitable  excipient.  It  is  reported  to  be  equally  effective  in  hysteri¬ 
cal  enuresis  of  adults,  but  larger  doses  (rrpxx-xxx  several  times  a  day)  are 
required.  Diabetes  insipidus  is  remarkably  benefited  by  its  continued 
use,  and  even  in  diabetes  mellitus  its  employment  has  occasionally  seemed 
to  have  been  followed  by  curative  results. 


RHUS  GLABRA,  Smooth  Sumach, — is  the  fruit  of  Rhus 
glabra ,  an  indigenous  shrub  of  the  nat.  ord.  Terebinthaceae,  growing  in 
rocky  and  barren  soil  to  a  height  of  8  to  12  feet.  The  berries  are  about 
yi  inch  in  diameter,  subglobular,  densely  hairy,  of  crimson  color  and 
acidulous  taste,  but  inodorous.  The  leaves  and  bark  have  an  astringent 
and  bitter  taste,  and  are  also  used  medicinally.  It  contains  tannin,  col¬ 
oring  matter,  potassium  and  calcium  malates. 

Preparation. 

Extraction  Rhois  Glabrce  Flnidum, — Dose,  3  i-ij. 

Physiological  Action  and  Therapeutics. 

Sumach-berries  form  a  useful  acidulous  and  astringent  drink  or  gargle 
in  catarrhal  pharyngitis,  stomatitis,  aphthae,  etc.  An  infusion  (3j  to  the 
pint)  may  be  used,  or  the  official  fluid  extract  as  a  wash  and  dressing  for 
ulcers  and  wounds.  Internally  they  are  useful  remedies  for  mild  catarrhal 
affections  of  the  stomach  and  bowels. 


RHUS  TOXICODENDRON,  Poison  Sumach,— is  the  fresh 
leaf  of  Rhus  Toxicodendron ,  the  poison  Oak,  and  of  Rhus  radicans,  the 
Poison  Ivy,  shrubs  of  the  nat.  ord.  Terebinthaceae,  indigenous  to  Canada 
and  the  greater  part  of  the  United  States  east  of  the  Rocky  Mountains. 
The  climbing  plant  (R.  radicans)  is  not  a  distinct  species,  but  a  variety 
of  the  erect  form,  both  when  wounded  exuding  a  poisonous,  acrid,  milky 
juice  which  turns  dark  on  exposure.  The  leaves  are  trifoliate,  on  peti- 


RHUS  TOXICODENDRON. 


339 


oles  4  or  5  inches  long,  the  lateral  leaflets  sessile,  entire  and  glabrous  in 
R.  radicans  (or  variously  notched,  toothed  or  lobed,  downy  beneath,  in 
R.  Tox.J,  inodorous,  astringent  and  acrid.  They  may  be  confounded 
with  the  leaves  of  the  hop-tree,  Ptelea  trifoliata ,  which  are  quite  similiar 
in  appearance,  but  all  its  leaflets  are  sessile.  The  poisonous  principle  of 
the  plant  is  Toxicodendric  Acid,  which  is  volatile,  and  also  exists  in  Rhus 
venenata  or  Swamp  sumach,  Rhus  pumila ,  and  Rhus  diversiloba ,  the 
former  of  which  is  probably  the  most  poisonous  of  the  four  species.  Dose 
of  the  leaves  is  generally  placed  at  gr.  j-iv,  but  if  old  and  dry  they  will 
generally  prove  to  be  inert.  There  are  no  official  preparations. 

Preparations. 

Tinctura  Rhois  Toxicodendri  (Unofficial), — maybe  prepared  according  to  the  formula 
of  the  Pharmacopoeia  for  Tincturae  Herbarum  Recentium  (Tinctures  of  Fresh  Herbs),  one 
part  of  the  fresh  leaves  to  two  of  Alcohol.  Dose, 

Extractum  Rhois  Toxicodendri , — has  been  used  in  France  in  large  doses.  It  is  prob¬ 
ably  inert. 

Physiological  Action. 

The  effects  of  Rhus  Toxicodendron  upon  the  skin  are  familiar  to  all 
who  have  suffered  from  contact  with  poison-oak  or  ivy.  Some  persons 
are  so  susceptible  to  the  poison  that  the  exhalations  from  the  plant  will 
produce  on  them  its  characteristic  action.  Others  are  apparently  insus¬ 
ceptible  to  its  influence,  and  can  with  impunity  rub  the  juice  into  their 
skin,  or  even  chew  its  leaves. 

The  action  of  the  plant  when  locally  applied  is  that  of  a  cutaneous 
irritant,  causing  redness  and  swelling  of  the  affected  parts,  with  a  vesicu¬ 
lar  eruption  and  intolerable  itching,  which  may  spread  rapidly  over  the 
surface  of  the  body  and  extend  to  the  mucous  membranes,  producing 
conjunctivitis,  redness  and  tumefaction  of  the  mouth  and  throat,  thirst, 
cough,  nausea  and  vomiting,  vertigo,  stupefaction,  etc.  Colicky  pains 
are  experienced  in  the  abdomen,  are  worse  at  night  and  are  aggravated 
by  food  or  drink.  Diarrhoea  may  occur,  with  tenesmus  and  bloody 
stools,  also  diuresis,  bloody  urine,  or  even  complete  retention.  Fever 
with  delirium  is  frequently  present,  and  may  be  typhoid  in  character,  or 
intermittent  with  profuse  perspiration.  Pains  of  rheumatoid  type  are  ex¬ 
perienced  throughout  the  body,  but  particularly  in  the  joints  and  lumbar 
region,  apparently  intensified  by  rest  and  heat.  The  fibrous  structures 
are  evidently  the  seat  of  its  selective  action,  and  a  sensation  of  numb¬ 
ness  in  the  lower  extremities  is  frequently  experienced.  Similar  phe¬ 
nomena  attend  its  internal  administration,  but  fatal  results  have  not  fol¬ 
lowed  in  any  case  of  poisoning  recorded.  The  effects  of  the  poison 
usually  last  from  ten  to  fifteen  days,  and  are  then  followed  by  desquama¬ 
tion  of  the  epidermis. 

Antidotes. 

Grindelia  Robusta  is  the  best  local  application  in  cases  of  Rhus  poisoning,  but  a  solu¬ 
tion  of  Mercuric  Chloride  is  also  a  very  serviceable  lotion,  and  Lime-water  with  Linseed- 


340 


RICINI  OLEUM. 


oil,  solution  of  Plumbum  Acetate,  solution  of  Chlorinated  Soda,  and  Alum-curd  are  all 
very  useful.  Rest,  low  diet  and  laxatives  are  appropriate,  and  Opium  or  strong  black 
coffee  to  relieve  the  irritability  of  the  nervous  system. 

Therapeutics. 

Rhus  Toxicodendron  was  used  medicinally  by  Dufresnoy  in  France  and 
by  Alderson  in  England  about  the  close  of  the  eighteenth  century.  The 
attention  of  the  former  was  attracted  to  it  by  the  accidental  poisoning  of 
a  student  who  was  afflicted  with  chronic  eczema,  which  disappeared  on 
the  subsidence  of  the  Rhus  symptoms.  It  is  a  favorite  remedy  with  the 
so-called  homoeopathists,  who  ascribe  to  it  extraordinary  virtues  in  acute 
cutaneous  affections  of  vesicular  type,  subacute  and  chronic  rheumatism, 
vesicular  erysipelas  and  typhoid  fever.  Among  regular  authorities  it  meets 
with  very  little  favor  as  a  remedial  agent,  but  Dr.  Phillips  recommends  it 
strongly  in  rheumatic  affections  of  the  fibrous  tissues,  erythema  and  ery¬ 
sipelas,  eczema,  herpes  zoster  and  pemphigus.  Dr.  Piffard  corroborates 
these  opinions  of  its  therapeutical  value,  and  states  that  when  rheumatic 
pain  is  “  worse  at  night  ”  prompt  relief  may  be  expected  from  Rhus.  It 
was  used  by  Dufresnoy  in  paralyses  with  a  certain  degree  of  success,  and 
Eberle  reports  a  case  of  paralysis  in  which  it  proved  curative.  It  is  ad¬ 
mitted  by  many  observers  to  be  a  useful  remedy  in  paralytic  affections  of 
the  lower  extremities  depending  on  a  rheumatic  diathesis,  or  resulting 
from  exposure  to  cold  and  wet.  As  an  external  application  it  is  efficacious 
in  sprains  and  other  affections  of  ligaments  and  tendons,  also  to  extensive 
but  superficial  burns,  stings  of  insects  and  chilblains.  For  these  affections 
a  lotion  of  about  5ss  of  the  strong  tincture  to  a  pint  of  water  is  usually 
employed. 


RICINI  OLEUM,  Castor  Oil,  — is  a  fixed  oil  expressed  from  the 
seeds  of  Ricinus  communis ,  a  tree  of  the  nat.  ord.  Euphorbiacese,  indigen¬ 
ous  to  India,  but  extensively  cultivated  in  the  United  States,  where  it  is 
an  annual  plant  about  5  or  6  feet  high,  bearing  ovate  seeds,  smooth  and 
shiny,  of  gray  color  marbled  with  brownish  spots  and  stripes,  three  con¬ 
tained  in  a  pod.  The  oil  is  an  almost  colorless,  transparent,  viscid  liquid, 
of  faint  odor,  bland  or  slightly  acrid  taste,  neutral  reaction,  sp.  gr.  0.950 
to  0.970,  soluble  in  an  equal  weight  of  alcohol,  and  congealing  at  about 
0.40  F.  It  consists  mainly  of  Ricmoleic  Acid ,  C18H3403,  combined  with 
glycerin,  but  palmitin,  stearin,  cholesterin,  and  probably  a  resin  and  an 
alkaloid  also  occur  in  small  quantities.  Dose,  5j~5j-  It  is  contained  in 
Collodium  Flexile  (3  per  cent.)  and  in  Linimentum  Sinapis  Co.  (15  per 
cent.). 

Physiological  Action. 

Used  externally  pure  Castor  Oil  is  perfectly  bland.  Internally  admin¬ 
istered  it  is  non-irritant  until  it  reaches  the  duodenum,  where  it  is  decom- 


RICINI  OLEUM. 


341 


posed  by  the  pancreatic  juice,  setting  free  the  Ricinoleic  Acid,  which  pro¬ 
duces  purgation  by  a  mildly  irritant  action  on  the  bowel,  stimulating  the 
intestinal  glands  and  muscular  coat,  but  not  the  liver.  It  is  a  simple  pur¬ 
gative,  acting  in  four  to  six  hours,  producing  one  or  more  liquid  stools 
without  pain  or  tenesmus,  and  followed  by  a  sedative  effect  on  the  intes¬ 
tines.  The  leaves  are  believed  to  possess  galactagogue  properties  when 
locally  applied  as  a  poultice  to  the  breasts.  Ricinoleic  Acid  enters  the 
blood  and  the  tissues,  and  is  excreted  with  the  various  secretions  of  the 
body,  imparting  its  purgative  qualities  to  the  milk  of  the  nursing  mother. 

Therapeutics. 

Castor  Oil  is  the  best  of  simple  purgatives,  and  is  used  where  a  free 
evacuation  of  the  bowels  is  alone  indicated,  or  when  only  a  laxative  action 
is  desired,  as  in  the  constipation  of  typhoid  fever,  in  pregnancy  and  post¬ 
partum  conditions,  diarrhoea  from  the  presence  of  irritating  matter  in  the 
bowels,  and  after  operations  on  the  abdominal  or  pelvic  organs.  It  is 
often  used  as  a  purgative  for  children,  also  for  the  aged  and  infirm.  In¬ 
fants  bear  a  larger  relative  dose  than  adults,  probably  from  their  ability  to 
digest  a  larger  quantity  of  what  is  taken.  It  is  employed  with  great  benefit 
as  a  laxative  in  irritation  or  inflammation  of  the  bowels,  in  hemorrhoids, 
inflammatory  or  spasmodic  affections  of  the  genito-urinary  organs,  ne¬ 
phritis  or  cystitis,  gonorrhoea,  calculi,  and  stricture  of  the  urethra  and 
rectum.  In  cases  of  dysentery  10  to  20  drops  of  Laudanum  may  be  added 
to  each  dose  to  counteract  the  pain,  tenesmus  and  exhaustion  resulting 
from  the  frequency  of  the  passages.  If  much  depression  exists,  as  shown 
by  lowered  arterial  tension  and  a  dry,  glazed  tongue,  5  drops  of  Turpen¬ 
tine  should  also  be  added. 

Castor  Oil  is  much  used  in  the  puerperal  state  and  greatly  abused. 
There  is  considerable  evidence  in  support  of  the  charge  that  it  induces 
hemorrhoids  by  congesting  the  rectal  vessels.  Its  purgative  action  is 
milder  in  proportion  to  the  purity  of  the  sample  employed.  Externally, 
the  pure  oil  is  employed  as  a  local  sedative  and  protective,  as  in  neutraliz¬ 
ing  the  effects  of  lime  upon  the  conjunctiva. 

The  leaves  of  the  castor-oil  plant  are  used  to  promote  the  secretion  of 
milk.  They  may  be  applied  to  the  breast  in  poultice,  and  a  decoction  or 
fluid  extract  given  internally  at  the  same  time. 


A  d ministration . 

The  nauseous  smell  is  best  concealed  by  the  Essential  Oil  of  Bitter  Almonds.  Emul¬ 
sions  are  not  a  success.  Capsules  containing  the  requisite  dose  are  easily  obtained.  In 
the  absence  of  these  the  best  way  to  administer  a  dose  of  oil  is  to  smear  the  sides  of  a 
clean  wineglass  with  very  thick  cream,  then  to  pour  in  the  oil,  covering  it  with  a  little 
more  cream.  A  teaspoonful  of  cream  being  then  taken  into  the  patient’s  mouth,  he  is 
directed  to  bolt  the  dose  at  one  gulp.  Some  prefer  it  floated  on  orange-juice,  strong 
coffee,  gruel  or  wine.  One  of  the  best  vehicles  for  it  is  foaming  beer.  Glycerin  increases 
its  purgative  power,  when  given  conjointly. 


342  ROSA  CENTIFOLIA - ROSA  DAMASCENA - ROSA  GALLICA. 


ROSA  CENTIFOLIA,  Pale  Rose, — the  petals  of  Rosa  centifolia , 
the  Cabbage  Rose,  a  well-known  cultivated  shrub  of  the  nat.  ord.  Rosaceae. 
They  are  of  pink  color,  fragrant  odor,  sweetish  taste  changing  to  slightly 
bitter  and  fairly  astringent.  The  odor  is  due  to  a  minute  quantity  of  a 
Volatile  Oil  (Oil  of  Rose),  besides  which,  the  petals  contain  tannin,  fat, 
resin,  sugar,  etc.  If  it  is  desired  to  keep  Pale  Rose  fresh  for  any  length 
of  time,  it  should  be  mixed  with  half  its  weight  of  Sodium  Chloride, 
pressed  into  a  jar  and  kept,  well  closed,  in  a  cool  place. 

Preparations. 

Aqua  Rosce ,  Rose-water, — Pale  Rose  40,  Water  200  parts,  mixed  and  distilled  by  steam 
to  100  parts.  Dose,  indefinite. 

Unguentuvi  Aquce  Rosce,  Cold  Cream, — has  of  Expressed  Oil  of  Almond  50  parts, 
Spermaceti  10,  White  Wax  10,  Rose-water  30.  If  Glycerin  and  Benzoic  Acid  were 
added,  it  would  keep  better  and  be  much  more  efficient  as  an  emollient  and  protective. 

Pale  Rose  is  also  an  ingredient  of  the  Compound  Syrup  of  Sarsaparilla. 


Physiological  Action  and  Therapeutics. 

Pale  Rose  is  only  used  for  odoriferous  and  flavoring  purposes.  Rose¬ 
water  has  no  strictly  medicinal  properties,  but  is  an  agreeable  excipient 
for  lotions,  urethral  injections  and  collyria.  The  ointment,  commonly 
termed  “  cold  cream,”  is  an  agreeable  emollient  and  protective  in  chapped 
hands  and  other  superficial  skin  affections. 


ROSA  DAMASCENA,  — is  not  official,  but  is  the  source  of  the 
official  Oil  of  Rose.  It  is  largely  cultivated  in  Roumelia  on  the  southern 
slope  of  the  Balkan  Mountains,  from  whence  almost  all  of  the  product  is 
supplied  to  commerce. 

Oleum  Rosce,  Oil  of  Rosa,  Attar  of  Rose, — is  a  volatile  oil  distilled  from  the  fresh 
flowers  of  Rosa  damascena.  It  is  a  pale-yellowish,  transparent  liquid,  having  a  strong 
odor  of  rose,  a  sweetish  taste  and  a  slightly  acid  reaction,  but  slightly  soluble  in  alcohol, 
of  sp.  gr.  about  0.860.  Slowly  cooled  to  50°  F.,  it  congeals  to  a  transparent  solid,  inter¬ 
spersed  with  slender,  iridescent,  scale-like  crystals.  Rapidly  cooled  to  540  F.,  it  congeals 
to  a  solid  mass  of  feathery  scales  or  plates.  It  consists  of  an  aromatic  oxygenated  elaeop- 
ten  and  an  odorless  solid  stearopten  (rose-camphor).  Being  very  expensive  it  is  much 
adulterated  with  other  volatile  oils.  It  is  used  chiefly  for  perfuming  cosmetic  preparations, 
ointments  and  lotions. 


ROSA  GALLICA,  Red  Rose, — the  petals  of  Rosa  gallica  (nat. 
ord.  Rosaceae),  collected  before  expanding.  They  occur  in  small  cones 
of  roseate  odor,  and  a  bitter,  slightly  acid  and  distinctly  astringent  taste, 
and  contain  an  aromatic  oil,  tannic  and  gallic  acids,  quercitrin,  coloring 
matter,  salts,  etc. 

Preparations . 

Extraction  Rosce  Fluid  uni, — Dose,  TT^v-  3  ij. 

Confectio  Rosce, — has  of  Red  Rose  8  parts,  Sugar  64,  Honey  12,  Rose-water  16. 
A  basis  for  pills. 


ROSMARINUS - RUBUS. 


343 


Mel  Rosce,  Honey  of  Rose, — has  of  Red  Rose  8,  Honey  92,  Diluted  Alcohol  to  100 
parts.  For  local  use. 

Syrupus  Rosce, — has  of  the  Fluid  Extract  of  Rose  10  in  Syrup  90.  Dose,  ^j-ij,  for 
flavoring. 

Red  Rose  is  also  an  ingredient  of  Pilulae  Aloes  et  Mastiches. 


Physiological  Action  and  Therapeutics. 

Rosa  Gallica  is  classed  among  the  astringents  as  it  contains  an  appre¬ 
ciable  amount  of  Tannic  and  Gallic  Acids.  A  compound  infusion,  con¬ 
taining  sugar  and  dilute  Sulphuric  Acid,  was  formerly  official,  and  is  used 
as  an  agreeable  gargle  for  the  throat  and  mouth  in  inflamed  and  ulcerated 
conditions.  The  chief  uses  of  the  rose  preparations,  however,  are  as 
vehicles  for  other  agents,  or  to  impart  flavor  and  odor  to  extemporaneous 
prescriptions. 


ROSMARINUS,  Rosemary  , — the  leaves  of  Rosmarinus  officinalis , 
a  shrub  of  the  nat.  ord.  Labiatse,  cultivated  in  gardens  for  the  sake  of  its 
large  pale-blue  flowers.  The  leaves  are  pungently  aromatic  and  some¬ 
what  camphoraceous,  containing,  besides  the  official  volatile  oil,  a  little 
tannin,  resin  and  a  bitter  principle.  They  constitute  one  per  cent,  of 
the  ingredients  of  Vinum  Aromaticum  (see  ante ,  page  86). 

Oleum  Rosmarini , — is  the  volatile  oil  distilled  from  Rosemary,  a  colorless  or  yellowish 
liquid,  of  sp.  gr.  about  0.900,  having  the  characteristic  odor  of  the  plant,  a  camphoraceous 
taste,  and  is  readily  soluble  in  alcohol.  It  consists  of  a  terpene,  isomeric  with  Turpen¬ 
tine,  C10H1(J,  and  a  body  allied  to  Camphor.  It  is  an  ingredient  of  Linimentum  Sapo- 
nis,  Spiritus  Odoratus  and  Tinctura  Lavandulae  Composita.  Dose,  TT\j-v. 


Physiological  Action  and  Therapeutics. 

Rosemary  was  formerly  considered  emmenagogue,  galactagogue  and 
diuretic,  but  is  now  never  employed  in  substance.  Its  oil  is  somewhat 
stimulant  and  carminative,  and  in  excessive  quantity  has  caused  death. 
It  is  chiefly  employed  as  an  external  stimulant  in  liniments  and  lotions, 
especially  to  the  scalp  in  alopecia,  where  it  is  supposed  to  increase  the 
blood-supply  to  the  hair-bulbs,  and  is  usually  combined  with  cantharides. 
Inhaled  it  reduces  the  body  temperature  and  gives  the  urine  a  violaceous 
odor. 


RUBUS,  Blackberry-Bark  , — is  the  bark  of  the  root  of  Rulus  vil- 
losus ,  the  common  Blackberry,  Rubus  canadensis ,  the  Dewberry,  and 
Rubus  trivialis ,  the  Bush  Blackberry  of  the  Southern  States,  all  of  the 
nat.  ord.  Rosaceae.  It  occurs  in  thin,  tough,  flexible  bands,  blackish- 
gray  externally,  pale-brown  internally,  inodorous,  strongly  astringent  and 
of  somewhat  bitter  taste.  It  contains  over  10  per  cent,  of  Tannin. 
Dose,  gr.  xv-xxx. 


344 


RUBUS  IDyEUS - RUMEX. 


Preparations. 

Extractum  Rubi  Fluidum , — Dose,  npx- g  j. 

Syrupus  Rubi  has  of  the  Fluid  Extract  20  parts,  Syrup  80.  .Dose, 

Syrupus  Rubi  Aromaticus  (Unofficial), — contains  the  root  bark,  cinnamon,  cloves  and 
mace.  Each  has  gr.  xxx  of  the  drug. 


Physiological  Action  and  Therapeutics. 

Blackberry-bark  derives  its  virtues  from  its  tannin.  It  is  strongly 
astringent,  and  may  be  used  in  decoction,  wine  or  the  above-named 
official  preparations.  It  is  highly  esteemed  in  summer  and  infantile 
diarrhoeas. 


RUBUS  ID./EUS,  Raspberry, — is  the  fruit  of  Rubus  idceus,  the 
Raspberry  bush,  Rubus  occidentalism  the  Thimbleberry,  or  Rubus  strigosus, 
the  wild  Red  Raspberry,  all  of  the  nat.  ord.  Rosaceae.  It  contains  sugar, 
malic  and  citric  acids,  proteids,  pectin,  etc.,  also  a  Volatile  Oil  consist¬ 
ing  of  compound  ethers,  to  which  the  odor  is  due.  Its  sole  use  in  medi¬ 
cine  is  to  prepare  a  pleasantly  flavored  syrup. 


Preparation. 

Syrupus  Rubi  Idcei ,  Raspberry  Syrup, — has  of  Raspberries  and  Sugar  any  convenient 
quantity,  boiled  (but  not  in  tinned  vessels)  and  strained.  Dose,  ad  libitum.  It  has  a 
bright-red  color,  a  fruity,  agreeable  odor,  a  pleasant,  acidulous  taste  and  an  acid  reaction. 
It  has  no  special  medicinal  virtues,  but  forms  an  agreeable  flavoring  for  mixtures,  and 
mixed  with  water  a  pleasant  drink  in  febrile  conditions. 

The  leaves  of  the  wild  Red  Raspberry  [Ru^us  strigosus )  are  considerably  astringent, 
and  in  infusion,  3  j  to  the  pint,  are  a  popular  domestic  remedy  for  diarrhoeas. 


RUMEX,  Yellow  Dock,  — is  the  root  of  Rumex  crispus ,  and  of 
other  species  of  Rumex,  plants  of  the  nat.  ord.  Polygonacese,  growing 
as  common  weeds  along  roadsides.  Several  species  of  Rumex  have  sour 
leaves,  and  are  popularly  called  Sorrel  to  distinguish  them  from  the 
others  which  are  called  Dock.  The  official  root  is  8  to  12  inches  long, 
y2  inch  thick,  somewhat  fusiform  and  fleshy,  annulate  above,  deeply 
wrinkled  below,  externally  rusty-brown,  internally  whitish,  with  fine 
medullary  rays ;  fracture  short,  odor  slight,  taste  bitter  and  astringent. 
It  contains  tannin,  mucilage,  starch,  calcium  oxalate,  and  two  principles 
named  Rumicin  and  Lapathin ,  which  are  shown  to  be  identical  with 
Chrysophanic  Acid.  (See  ante,  page  336).  Its  constituents  are  nearly 
identical  with  those  of  Rhubarb.  Dose,  gr.  xv-5j. 

Preparations. 

Extractum  Rumicis  Fluidum , — Dose,  upxv-gj. 

Decoctimi  Rumicis  (Unofficial), —  5  ij  of  the  fresh  root,  or  5j  of  the  dry  root  to  Oj  of 
water.  Dose,  3  j— ij  - 


RUTA. 


345 


Physiological  Action  and  Therapeutics. 

Rumex  is  astringent,  tonic  and  laxative.  It  has  also  been  considered 
alterative  and  anti-scorbutic.  It  has  been  employed  chiefly  in  chronic 
cutaneous  disorders,  glandular  swellings,  and  other  symptoms  of  the  stru¬ 
mous  diathesis.  It  seems  to  possess  a  selective  action  on  the  mucous 
membrane  of  the  larynx,  and  in  many  cases  of  laryngeal  irritation  with 
catarrhal  symptoms,  dry,  violent  cough,  and  a  sense  of  soreness  behind 
the  sternum,  it  will  give  prompt  relief.  The  Rumex  Acetosa  has  a  popu¬ 
lar  reputation  as  a  local  application  for  cancer. 


RUTA,  Rue  , — is  the  source  of  the  official  Oil  of  Rue,  which  is  dis¬ 
tilled  from  the  leaves  of  Ruta  graveolens,  an  herbaceous  perennial  of  the 
nat.  ord.  Rutaceae,  growing  wild  throughout  Southern  Europe,  and  fre¬ 
quently  cultivated  in  gardens  for  its  yellowish  flowers.  The  fresh  leaves 
only  should  be  used,  and  as  drying  impairs  their  qualities  the  oil  is  gen¬ 
erally  employed. 

Oleum  Rut ce.  Oil  of  Rue, — the  volatile  oil  distilled  from  Ruta  graveolens  ;  a  colorless, 
or  greenish-yellow  liquid,  of  disagreeable  but  aromatic  odor,  pungent  acrid  taste  and  neu¬ 
tral  reaction,  sp.  gr.  about  0.880,  soluble  in  an  equal  weight  of  alcohol.  Dose,  rqj-v,  in 
mucilage. 

Physiological  Action  and  Therapeutics. 

Rue  is  an  active  irritant,  locally  a  rubefacient,  the  oil  producing  heat, 
inflammation  and  vesication.  In  the  ordinary  dose  it  causes  a  sensation 
of  heat  in  the  stomach  and  skin,  increases  the  action  of  the  heart,  and 
stimulates  the  bronchial,  cutaneous  and  renal  secretions,  the  odor  of  the 
oil  being  distinctly  perceptible  in  the  breath,  sweat  and  urine.  After 
toxic  doses  of  the  oil  violent  gastro-enteritis  results,  with  extreme  pros¬ 
tration,  convulsions,  strangury  and  suppression  of  the  urine.  Abortion 
maybe  produced  by  large  doses,  but  with  great  danger  to  life.  Rue  is  an 
efficient  emmenagogue,  and  in  men  aphrodisiac;  it  is  also  considered 
antispasmodic  and  carminative. 

The  Oil  of  Rue  is  employed  internally  in  amenorrhoea,  menorrhagia  and 
metrorrhagia,  hysteria,  convulsions  and  flatulence.  As  an  emmenagogue 
it  is  very  efficient  when  the  condition  is  one  of  functional  inactivity  of 
the  uterus  and  ovaries.  In  small  doses  it  has  been  well  used  in  metror¬ 
rhagia  from  debility  and  after  abortion.  A  decoction  of  the  fresh  leaves 
is  often  employed  by  injection  against  ascarides,  and  internally  to  remove 
lumbricoid  worms.  Externally  the  same  preparation  has  been  applied  to 
the  chest  in  chronic  bronchitis,  also  in  various  scaly  eruptions  and 
glandular  enlargements.  Used  as  an  abortifacient  it  has  frequently 
caused  death,  preceded  by  symptoms  of  narcotic  and  irritant  poisoning. 
Even  in  poisonous  doses  its  abortifacient  action  is  very  uncertain,  so  that 
only  the  most  ignorant  criminals  employ  it  with  such  purpose. 


346 


SABINA. 


SABINA,  Savine, — the  tops  of  Juniperus  Sabina ,  a  small  ever¬ 
green  shrub  of  the  nat.  ord.  Coniferae,  growing  in  Northern  Europe, 
Asia  and  America.  It  closely  resembles  Red  Cedar  (_ Juniperus  virginiana ), 
but  is  distinguished  from  the  latter  by  its  smaller  size  and  by  its  larger 
fruit.  It  occurs  in  short,  thin  branchlets,  having  oveo-lanceolate  leaves 
in  four  rows ;  of  peculiar,  terebinthinate  odor,  and  nauseous,  bitter, 
resinous  taste.  It  contains  a  Volatile  Oil  (which  is  official),  also  tannin, 
resin,  extractive  matters,  chlorophyll,  etc.  Dose,  gr.  v-x. 

Preparations. 

Extr actum  Sabina  Fluidum, — Dose,  ffyv-xv . 

Ceratum  Sabina , — has  of  the  Fluid  Extract  25,  Resin  Cerate  90  parts,  melted  and 
cooled. 

Oleum  Sabina , — a  volatile  oil  distilled  from  Savine  existing  in  the  fresh  tops  in  the 
proportion  of  2]/z  per  cent.,  and  in  the  berries  10  per  cent.  It  is  a  colorless, or  yellowish 
liquid,  isomeric  with  oil  of  turpentine,  C10H16,  having  a  peculiar,  terebinthinate  odor,  a 
pungent  camphoraceous  taste,  and  neutral  reaction,  of  sp.  gr.  about  0910  and  soluble  in 
an  equal  weight  of  alcohol.  Dose,  try -v. 

Physiological  Action. 

Externally  the  action  of  Savine  resembles  that  of  Turpentine,  except 
that  it  is  more  irritant,  the  oil  producing  vesication  if  applied  sufficiently 
long.  Internally  a  full  medicinal  dose  causes  heat  sensations,  nauseous 
eructations,  flatulence,  increased  cardiac  action,  stimulation  of  the  cuta¬ 
neous,  bronchial  and  renal  secretions,  irritation  of  the  kidneys,  hyperae- 
mia  of  the  ovaries  and  uterus  and  increased  menstrual  activity.  In  large 
doses  it  produces  hematuria,  dysuria,  and  intense  gastro-enteritis,  with 
violent  vomiting  and  purging.  It  may  originate  uterine  contractions  in 
the  pregnant  female,  but  its  abortifacient  effect  can  only  be  produced  by 
a  quantity  sufficient  to  endanger  life.  The  oil  diffuses  into  the  blood 
and  is  excreted  by  the  various  excretory  channels. 

Therapeutics. 

As  an  emmenagogue  Savine  is  highly  esteemed  by  many  authorities, 
Dr.  Phillips  considering  it  “  one  of  the  most  certain  and  powerful”  agents 
of  this  class,  “  with  the  additional  advantage  that  it  can  be  given  with 
perfect  freedom  from  risk  of  doing  harm.”  So  irritant  an  agent,  however, 
requires  the  exercise  of  great  caution  in  its  use.  It  has  been  found 
extremely  efficient  in  dysmenorrhoea  when  not  due  to  mechanical  causes; 
also,  in  menorrhagia  and  hemorrhage  after  abortion.  In  chronic  gout 
and  the  joint  affections  of  chronic  rheumatism,  it  was  formerly  much  em¬ 
ployed.  Externally  the  cerate  is  used  to  prolong  the  discharge  from 
blisters,  setons  or  issues,  and  to  stimulate  the  healing  of  indolent  ulcers. 
For  these  purposes  it  is  considered  safer  than  Cantharides,  as  its  prolonged 
employment  does  not  bring  on  strangury  or  vesical  irritation.  As  a 
caustic  it  is  efficient  for  the  destruction  of  warts  and  other  excrescences, 
and  the  moistened  powder  is  used  as  a  paste  on  venereal  condylomata,  in 


SACCHARINA — SACCHARUM.  347 

combination  with  burnt  alum  or  cupric  subacetate.  The  oil  is  the  most 
efficient  preparation  for  internal  administration. 

SACCHARINA,  Saccharine, — is  a  recently  discovered  derivative 
of  a  coal-tar  product,  Toluene ,  from  which  it  is  prepared  by  a  complicated 
process.  It  has  the  chemical  title  B enzoyl-sulphonic-imide ,  and  the  for¬ 
mula  C6H4(C0)(S0.2)NH.  It  occurs  as  a  white  amorphous  powder,  with 
a  very  sweet  taste,  and  a  faint  flavor  of  bitter  almonds,  soluble  in  alcohol 
and  in  ether  [Sugar  is  not  soluble  in  ether],  sparingly  in  cold  water,  more 
so  in  hot  water. 

Physiological  Action  and  Therapeutics. 

Saccharine  is  220  times  sweeter  than  sugar  to  the  taste,  and  is  also  an 
efficient  antiseptic.  It  is  not  a  food,  like  sugar ;  and  has  no  injurious 
action  on  man.  It  may  prove  of  use  as  a  substitute  for  sugar  in  cases  of 
diabetes,  but  it  has  no  curative  action  upon  that  disease. 

SACCHARUM,  Sugar,  Cane-Sugar,  C12H22Ou, — is  the  refined 
sugar  of  Saccharum  officinarum ,  or  Sugar-cane,  a  perennial  plant  of  the 
nat.  ord.  Graminacese,  indigenous  to  India  and  adjoining  countries,  but 
cultivated  in  tropical  regions  throughout  the  world.  This  sugar  is  also 
present  in  several  grasses  (as  Zea  Mays ,  maize,  Sorghum  saccharatum ,  etc.), 
in  the  juice  of  various  trees  (maple,  birch,  palm,  etc.),  and  in  many  roots, 
particularly  Beta  vulgaris ,  the  sugar-beet,  which  contains  12  per  cent. 

Cane-sugar  occurs  in  white,  dry,  hard,  crystalline  granules,  permanent  in  the  air,  odor¬ 
less,  of  purely  sweet  taste  and  neutral  reaction,  soluble  in  0.5  of  water  and  in  1 75  of 
alcohol  at  590  F.,  in  0.2  of  boiling  water  and  in  28  of  boiling  alcohol,  insoluble  in  ether. 
The  aqueous  solution,  saturated  at  590  F.,has  the  sp.  gr.  1.345,  and  is  miscible  with  alco¬ 
hol  in  all  proportions.  Its  freedom  from  Grape-sugar  (glucose)  and  from  more  than  a 
slight  quantity  of  Inverted  Sugar  (glucose  plus  levulose)  is  ascertained  by  dissolving  I 
gram  in  10  c.c.  of  boiling  water,  then  mixing  with  the  solution  4  or  5  drops  of  test- 
solution  of  Silver  Nitrate  and  about  2  c.c.  of  Aqua  Ammoniae,  and  quickly  heating  to 
boiling,  when  not  more  than  a  slight  coloration,  but  no  black  precipitate  should  appear 
after  standing  at  rest  for  5  minutes. 

Other  Sugars. 

Saccharum  Lactis,  Sugar  of  Milk,  Lactose,  C12H2  20n.H20, — described  on  next  page. 

Glucose ,  Dextrose,  Grape-sugar,  Starch-sugar,  C6II1206,  or  hydrated  C6H1206.H20 
(Unofficial),  also  known  as  liver-sugar,  diabetic  sugar, — forms  yellowish  nodules  or  crys¬ 
tals,  very  soluble  in  water  and  in  alcohol,  has  a  sweet  taste,  less  marked  than  that  of  cane- 
sugar,  may  be  obtained  artificially  from  cane-sugar  or  from  starch,  by  boiling  with  a  dilute 
mineral  acid,  or  by  the  action  of  Diastase,  a  vegetable  ferment  formed  during  the  germi¬ 
nation  of  grain.  Boiling  solutions  of  the  alkalies  convert  it  into  a  brown  substance 
(melassic  acid). 

Levulose,  Fruit-sugar,  CcH1206  (Unofficial), — frequently  found  with  grape-sugar  in 
fruits,  also  in  honey. 

Inosit,  Phaseo-mannit,  C6Hj  206.2ll20  (Unofficial), — exists  in  the  juice  of  some  meats, 
in  asparagus,  etc.  Is  very  sweet,  but  does  not  undergo  alcoholic  fermentation. 

Allied  Substances. 

Theriaca,  Treacle,  Sugar-house  Molasses  (Unofficial), — is  the  uncrystallizable  residue 
of  the  process  for  refining  sugar, — a  thick,  brown,  fermentable  syrup,  very  sweet,  and  of 
sp.  gr.  about  1.40.  It  is  official  in  the  B.  P.,  and  is  used  in  making  up  some  of  the  official 
pills  of  that  pharmacopoeia. 


34§ 


SACCHARUM  LACTIS. 


Amylurn,  Starch,  C6H10O5, — when  boiled  with  dilute  mineral  acids  or  when  subjected 
to  the  action  of  diastase,  ptyalin  or  pancreatin,  starch  is  converted  into  glucose.  (See  ante , 
article  Amylum.  page  ioo.) 

Cellulose ,  C6H10O5,  (Unofficial), — forms  the  basis  of  all  vegetable  fibre,  and  is  isomeric 
with  starch.  It  exists  almost  pure  in  cotton  and  in  Swedish  filter  paper.  Pyroxylin  (see 
ante ,  page  229),  or  gun-cotton,  is  dinitro-cellulose. 

Glycogen  (Unofficial), — closely  resembles  starch  in  its  properties,  being  converted  into 
glucose  by  the  same  agents  which  so  act  on  starch.  It  exists  in  the  liver  of  all  animals. 

Dextrin  (Unofficial), — is  produced  by  the  action  of  dilute  acids  on  starch,  and  is  an 
intermediate  product  in  the  conversion  of  starch  into  glucose.  It  is  a  transparent,  brittle 
solid,  looking  like  gum,  soluble  in  water  and  dilute  alcohol,  is  not  fermentable,  nor  is  it 
colored  by  Iodine. 

Preparations. 

Sugar  is  an  ingredient  of  Pil.  Ferri  Carbonatis,  Pil.  Ferri  Iodidi,  Ferri  Carbonas  Saccha- 
ratus,  Mistura  Ferri  Composita,  Pulvis  Cretae  Compositus,  Pulvis  Glycyrrhizae  Compositus, 
and  the  Troches,  Syrups,  Compound  Syrups,  etc. 

Physiological  Action  and  Therapeutics. 

Sugar  is  employed  in  pharmacy  and  therapeutics  chiefly  as  a  vehicle,  a 
corrigent,  a  preservative  and  an  antiseptic.  Syrups  protect  the  active 
ingredients  against  putrefaction,  but  not  always  against  fermentation. 
They  also  protect  certain  ferruginous  preparations  against  oxidation.  As 
an  ingredient  in  troches,  powders  and  extemporaneous  mixtures  sugar  is 
used  to  cover  the  taste  or  to  make  insoluble  substances  more  easily  mis¬ 
cible  with  water.  It  increases  the  solubility  of  Lime  in  water.  As  a  food 
it  possesses  well-known  properties,  being  a  nutrient  to  adipose  tissue  and 
a  respiratory  fuel,  and  is  decidedly  diuretic  in  its  action  upon  healthy 
kidneys. 


SACCHARUM  LACTIS,  Sugar  of  Milk,  Lactose, — 

C12H220n.H20, — is  one  of  the  constituents  of  the  milk  of  mammals,  and 
is  officially  described  as  a  peculiar,  crystalline  sugar  obtained  from  the 
whey  of  cow’s  milk  by  evaporation  and  purified  by  re-crystallization. 
Occurs  in  white,  hard,  crystalline  masses,  yielding  a  gritty,  white  powder, 
odorless,  permanent  in  the  air,  of  faintly  sweet  taste  and  neutral  reaction, 
soluble  in  7  of  water  at  590  F.  and  in  1  of  boiling  water,  insoluble  in  alco¬ 
hol,  ether  or  chloroform.  On  adding  to  a  solution  of  sugar  of  milk  in  an 
equal  weight  of  boiling  water  some  solution  of  soda,  the  liquid  turns  brown¬ 
ish,  and  on  further  addition  of  test-solution  of  Cupric  Sulphate  a  brick- 
red  precipitate  separates. 


Sugar  of  Milk  is  the  least  soluble  of  all  sugars  in  water  and  is  insoluble  in  alcohol.  It 
enters  into  alcoholic  fermentation  with  difficulty.  In  the  presence  of  decomposing  albu¬ 
minous  matter  and  under  certain  other  influences,  it  undergoes  the  lactic  fermentation , 
which  results  in  the  formation  of  Lactic  Acid,  Carbon  Dioxide  and  Alcohol.  It  readily 
reacts  with  the  reduction  tests. 

Lactose  has  been  shown  to  act  as  a  powerful  diuretic,  especially  in  cardiac  dropsy,  in 
which  Dr.  See  considers  it  “  the  best  and  most  certain  diuretic  we  possess,  the  excretion 
of  urine  caused  by  it  being  greater  than  that  due  to  any  other  drug.”  He  found  that  it 
acts  similarly  to,  though  more  powerfully  than,  Caffeine,  while  possessing  none  of  the 


salix.  349 

disadvantages  of  the  latter.  Its  diuretic  action  is  but  very  little  in  cases  where  extensive 
renal  disease  exists,  and  it  has  no  power  over  dyspnoea. 

Sugar  of  Milk  is  used  in  the  Triturations,  also  in  the  Abstracts,  Dover’s 
Powder,  Denarcotized  Opium,  etc.,  as  a  diluent.  Being  much  harder 
than  cane-sugar  it  is  considered  a  valuable  excipient  for  powders  requiring 
fine  trituration  and  the  minute  subdivision  of  their  medicinal  constituent. 
It  is  less  sweet  than  cane-sugar,  and  being  less  apt  to  ferment  in  the  stom¬ 
ach  and  bowels  is  better  than  the  latter  for  use  with  infants’  food. 


SALIX,  Willow  , — is  the  bark  of  Salix  alba ,  the  common  White 
Willow,  and  of  other  species  of  Salix,  trees  of  the  nat.  ord.  Salicaceae. 
It  occurs  in  fragments  or  quills,  inodorous,  bitter  or  astringent,  and  con¬ 
tains  a  large  proportion  of  tannin,  besides  resin,  gum,  wax,  lignin,  etc., 
and  the  characteristic  constituent  Salicin ,  which  is  official.  Dose  of  the 
bark,  gr.  x-3j,  or  more,  in  infusion. 

Salix  Nigra,  the  Pussy  Willow ,  grows  along  streams  in  the  Southern 
States.  A  fluid  extract  is  on  the  market,  and  may  be  used  in  doses  of  5ss 
thrice  daily,  as  a  sexual  sedative. 

Salicin,  C13H1807,  is  a  crystalline  glucoside,  consisting  of  Saligenin  and 
glucose  ;  found  in  Gaultheria  procumbens  (Wintergreen),  and  in  the  bark 
of  several  species  of  Salix  (willow).  Salicylic  Acid,  HC7H503,  is  a  deriva¬ 
tive  of  Salicin,  probably  by  double  oxidation;  but  may  also  be  considered 
as  a  substitution-derivative  of  Benzene,  formed  by  replacing  2  atoms  of  its 
hydrogen,  the  one  by  hydroxyl,  and  the  other  by  carboxyl.  (See  page 
179,  a?itel)  It  is  obtained,  therefore,  either  synthetically  by  combining 
the  elements  of  Carbolic  Acid  with  those  of  Carbonic  Acid,  and  subse¬ 
quent  purification, — or  from  natural  salicylates  as  the  oils  of  wintergreen 
and  sweet-birch, — or  from  salicin,  by  heating  with  caustic  potash  and 
treating  the  mass  with  hydrochloric  acid.  The  acid  prepared  from  natu¬ 
ral  sources  is  purer  and  more  efficient  than  that  prepared  artificially,  and 
will  often  be  tolerated  by  a  patient  who  cannot  bear  the  latter. 

Preparations. 

Salicinutn,  Salicin,  C13H1807, — a  neutral  principle  prepared  from  the  bark  of  Salix 
Helix  and  of  other  species  of  Salix.  White,  shiny,  silky  crystals,  odorless,  of  very  bitter 
taste  and  neutral  reaction ; — soluble  in  28  of  water  and  in  30  of  alcohol  at  50°  F.,  in  0.7 
of  boiling  water  and  in  2  of  boiling  alcohol;  insoluble  in  ether  or  chloroform.  Dose, 
gr.  x-^ij. 

Acidum  Salicylicu?n ,  Salicylic  Acid,  IIC7H503, — occurs  in  fine,  white,  needle-shaped 
crystals,  of  sweetish-acrid  taste  and  acid  reaction,  soluble  in  450  of  water  and  in  of 
alcohol  at  590  F. ;  loo  parts  may  be  dissolved  in  100  of  water  by  the  aid  of  8  parts  of 
Borax.  Dose,  gr.  v-g  j. 

Sodii  Salicylas ,  Salicylate  of  Sodium,  2NaC7H503.H20, — is  soluble  in  1  yz  parts  of 
water.  Dose,  gr.  v-^j. 

Lithii  Salicylas ,  Salicylate  of  Lithium,  2LiC7H503.II20, — is  very  soluble  in  water  or 
alcohol.  Dose,  gr.  v-f3j. 

Physostigmince  Salicylas , — is  described  under  Physostigma,  ante ,  page  308.  Dose, 

Sr>  T$TF“sV  .  r.  -r^ 

Oleum  Gaultheria ?,  Oil  of  Wintergreen.  Doss,  ttyv-xv.  (See  ante,  page  223.) 


350 


SALIX. 


Unofficial  Preparations. 

Salol,  Salicylate  of  Phenol, — consists  of  60  parts  by  weight  of  Salicylic  Acid  and  40  of 
Carbolic  Acid.  Is  insoluble  in  water,  almost  tasteless  and  odorless.  Dose,  gr.  v-^j,  in 
compressed  tablet. 

Salipyrin,  C]8H18N204, — is  a  combination  of  Salicylic  Acid  57.7  parts,  and  Antipyrine 
42.3  parts;  a  white,  odorless  powder,  very  soluble  in  alcohol,  insoluble  in  water.  Thera¬ 
peutically,  it  is  an  antipyretic  and  antirheumatic  of  considerable  value,  according  to  Dr. 
Guttmann.  Dose,  gr.  x-xx,  every  two  hours. 

Physiological  Actions. 

Willow-bark  is  highly  astringent  and  antiperiodic  and  feebly  tonic, 
but  is  never  employed  medicinally,  owing  to  its  bulk.  Salicin  is  a  bitter 
tonic,  an  antiferment,  antiseptic,  and  is  highly  destructive  to  low  organ¬ 
isms.  It  has  slight  antiperiodic  power  and  is  feebly  antipyretic.  It  pre¬ 
vents  the  reaction  between  Amygdalin  and  Emulsin  (see  page  67),  and 
also  that  of  Ptyalin,  etc.,  on  Starch  (see  page  100).  It  seems  to  be  devoid 
of  toxic  power  on  man,  and  is  mainly  excreted  as  Salicylic,  Salicyluric 
and  Salicylous  acids,  being  first  changed  in  the  bowel  into  Saligenin  and 
Glucose.  Salicin  is  well  borne  by  the  stomach. 

Salicylic  Acid  has  properties  similar  to  the  above,  but  is  much  more 
energetic  in  its  action,  being  a  powerful  antipyretic  and  antiseptic.  It  is 
also  anhydrotic,  checking  local  perspiration  when  locally  applied.  Inhaled 
it  causes  irritation  of  the  respiratory  passages,  producing  sneezing  and 
cough.  In  small  doses  it  stimulates  the  stomach,  heart  and  respiration, 
but  moderate  quantities  derange  the  stomach,  causing  nausea  and  vomit¬ 
ing,  while  large  doses  depress  the  heart’s  action  and  the  respiration  after 
a  primary  excitation  of  both,  lower  the  arterial  tension,  relax  the  vessels, 
produce  free  perspiration,  and  reduce  the  temperature  in  fever.  It  causes 
vertigo,  dilated  pupils,  tinnitus  aurium,  a  sensation  of  tension  in  the 
frontal  cerebrum,  delirium,  and  may  produce  bed-sores  from  depression 
of  the  circulation,  but  does  not  affect  the  peripheral  nerves  as  to  either 
motion  or  sensation.  In  the  blood  it  is  first  changed  to  Salicylate  of 
Sodium,  but  a  portion  is  again  set  free  and  uniting  with  glycocoll  forms 
Salicyluric  Acid  (HC9H8N04),  coloring  the  urine  green.  It  is  slowly 
excreted  through  the  secretions  generally,  especially  in  the  urine,  sweat, 
saliva  and  bile.  It  stimulates  the  kidneys,  at  the  same  time  disinfecting 
them  and  increasing  the  acidity  of  the  urine,  but  may  so  irritate  the  kid¬ 
neys  as  to  produce  albuminuria  and  hematuria. 

Salicylic  Acid  is  destructive  to  the  torula,  prevents  alcoholic  fermenta¬ 
tion,  also  that  caused  by  the  organic  ferments,  (pepsin,  ptyalin,  etc.).  In 
solutions  containing  bacteria,  it  will  prevent  their  development,  if  in  the 
proportion  of  1  per  cent.  ;  and  in  that  of  1  in  60  it  will  destroy  them 
when  in  full  activity. 

Salicylate  of  Sodium  is  remarkably  antipyretic  in  doses  of  gr.  xv, 
given  4  or  5  times  in  24  hours.  It  is  a  powerful  diaphoretic,  and  an  effi¬ 
cient  cholagogue,  and  it  is  supposed  to  possess  the  curious  property  of 


SALIX. 


351 


increasing  the  fluidity  of  the  bile,  at  the  same  that  it  promotes  its 
secretion, — other  cholagogues  increasing  the  proportion  of  solids  therein. 
(Brunton.)  It  has  no  antiseptic  power  unless  in  association  with  a  strong 
mineral  acid,  which  will  liberate  the  salicylic  acid. 

Salol  is  antiseptic,  antipyretic,  and  germicide,  in  a  higher  degree  than 
either  of  its  constituents.  As  an  antipyretic  in  fever  it  stands  next  after 
Antipyrine,  and  it  acts  with  such  force  as  to  frequently  depress  the  tem¬ 
perature  a  degree  or  two  below  normal.  It  is  sedative  to  the  cerebro¬ 
spinal  system,  and  somewhat  analgesic.  It  causes  profuse  sweating,  and 
in  a  few  cases  considerable  depression  has  accompanied  its  antipyretic 
employment;  but  it  is  not  toxic,  and  may  be  used  freely  in  its  proper 
dosage,  which  ranges  from  5  to  60  grains,  up  to  2  or  3  drachms  in  the  24 
hours. 

Therapeutics. 

Salicin  and  its  derivatives  are  chiefly  used  in  acute  rheumatism,  to 
lower  temperature,  relieve  pain,  and  reduce  articular  swelling.  They 
are  most  suitable  to  strong,  vigorous  patients,  and  if  not  promptly  efficient 
they  should  be  abandoned.  The  acid  is  much  used  as  an  antipyretic  in 
fevers,  especially  those  of  septicsemic  character.  It  is  a  useful  local  appli¬ 
cation  in  gangrenous  wounds,  eczema  of  the  hands  or  feet,  cancer,  burns, 
and  in  fetid  perspirations,  in  the  last  affection  being  used  in  solution 
with  borax. 

Salicylate  of  Sodium  is  more  soluble  than  the  acid  and  less  irritant 
to  the  stomach,  while  in  doses  about  50  per  cent,  larger  it  is  equally  effi¬ 
cient.  It  is  employed  in  3-  to  5-grain  doses  internally  after  meals,  to 
arrest  gastric  fermentation,  and  to  prevent  acidity  and  flatulence.  It  is 
used  instead  of  the  acid  in  acute  and  chronic  rheumatism,  to  relieve  head¬ 
aches,  and  for  phlegmasia  alba,  it  which  it  is  considered  very  efficient, — 
also  in  cases  where  there  is  a  tendency  to  the  formation  of  gall-stones. 
It  is  considered  a  very  efficient  remedy  to  cut  short  an  attack  of  ton¬ 
sillitis,  a  “bad  cold,”  and  also  other  acute  affections  of  the  respira¬ 
tory  mucous  membrane. 

Salicylate  of  Lithium  is  also  non-irritant  and  is  supposed  to  act 
towards  uric  acid  in  the  same  manner  as  the  other  salts  of  this  metal.  It  is 
expected  to  be  of  especial  value  in  acute  rheumatism  and  rheumatic  gout. 

Salol  is  a  most  efficient  remedy  for  duodenal  catarrh,  catarrh  of  the 
bile-ducts  and  catarrhal  jaundice ;  also  in  the  bilious  form  of  sick-head  - 
ache,  and  in  some  forms  of  neuralgia.  Its  greatest  power  is  manifested 
over  acute  rheumatism,  in  which  disease  many  clinicians  maintain  that  it 
has  no  superior,  if  given  in  15-  to  30-grain  doses,  up  to  2  drachms,  in  the 
24  hours,  and  continued  for  some  time  after  the  acute  symptoms  have 
subsided.  It  should  prove  an  efficient  disinfectant  in  catarrh  of  the  blad¬ 
der,  as  its  constituents  are  excreted  with  the  urine,  and  come  in  contact 
with  the  vesical  mucous  membrane  for  a  considerable  period  of  time. 


352 


SALVIA - SAMBUCUS - SANGUINARIA. 


SALVIA,  Sage,  — the  leaves  of  Salvia  officinalis ,  the  common  gar¬ 
den  sage,  a  perennial  plant  of  the  nat.  ord.  Labiatae,  native  in  Southern 
Europe,  but  cultivated  in  our  gardens  for  its  strong,  fragrant  odor.  The 
leaves  are  about  2  inches  long,  finely  crenulate,  grayish-green,  thick  and 
wrinkled  ;  soft,  hairy  and  glandular  beneath,  of  aromatic  odor  and  bitter¬ 
ish,  astringent  taste.  They  contain  tannin,  resin,  etc.,  and  a  volatile  oil 
which  consists  of  Salviol  (C10Hi6O),  camphor  and  terpenes.  Sage  is  a 
constituent  of  Vinum  Aromaticum.  There  are  no  official  preparations. 
Dose  of  the  powdered  leaves,  g.  xx-xxx,  in  infusion. 

Sage  is  aromatic,  stimulant,  tonic,  astringent,  and  a  vulnerary.  It  was 
highly  esteemed  in  ancient  times,  and  even  yet  is  popular  as  a  domestic 
cure-all  with  many  people.  In  an  infusion  it  may  be  used  as  a  beverage 
in  febrile  conditions  and  to  check  sweating,  also  for  the  night-sweats  of 
phthisis.  Like  other  members  of  the  same  class  it  has  a  slight  influence 
over  enteralgia  and  flatulence.  It  makes  a  good  astringent  and  stimulat¬ 
ing  gargle. 


SAMBUCUS,  Elder, — the  flowers  of  Sambucus  canadensis ,  the 
common  elder,  a  shrub  of  the  nat.  ord.  Caprifoliaceae,  from  6  to  10  feet 
high,  having  small  white  flowers  disposed  in  loose  cymes  of  five  divisions, 
the  cream-colored  corolla  being  whorl-shaped  with  five  stamens  on  the 
tube.  The  berries  are  small,  globular,  and  when  ripe  of  a  deep  purple 
color.  The  plant  contains  a  small  quantity  of  a  volatile  oil,  also  a  resin 
and  valerianic  acid.  The  common  elder  of  Europe  (S.  nigra)  is  more  of 
a  tree,  and  is  official  in  the  B.  P.  There  are  no  official  preparations. 
Dose,  gr.  xxx-5j,  in  hot  infusion. 

Elder-flowers  are  stimulant  and  diaphoretic,  also  perhaps  diuretic  in 
some  degree.  The  berries  are  diaphoretic  and  laxative,  while  the  inner 
bark  is  a  hydragogue  cathartic  and  in  large  doses  emetic.  Formerly  the 
inspissated  juice  of  the  berries  was  employed  as  an  alterative  in  rheuma¬ 
tism  and  syphilis,  but  at  present  the  flowers  are  used  only  for  flavoring 
purposes.  Elder-flower  Water  (Aqua  Sambuci,  B.  P.)  is  a  nice  vehicle 
for  collyria  and  lotions. 


SANGUINARIA,  Blood-root,  — is  the  rhizome,  collected  in 
autumn,  of  Sanguinaria  canadensis ,  a  perennial  plant  of  the  nat.  ord 
Papaveraceae,  which  grows  abundantly  throughout  the  U.  S.,  being  one  of 
the  earliest  and  most  beautiful  of  the  spring  flowers.  It  has  a  single  white 
flower  on  an  erect  stalk,  the  petals  often  tinged  with  rose  or  purple.  Leaf 
reniform,  smooth,  deeply  lobed,  yellow-greenish  above,  paler  beneath, 
and  strongly  marked  with  orange-colored  veins.  The  rhizome  is  about  2 
inches  long  and  -|ths  inch  thick,  cylindrical,  horizontal,  wrinkled,  red- 


SANGUINARIA. 


353 


dish-brown,  fracture  short,  waxy,  with  numerous  small  red  resin-cells, 
bark  thin,  odor  slight,  taste  very  bitter  and  acrid.  It  contains  3  alkaloids, 
— Sanguinarine ,  C17H15N04,  which  is  probably  identical  with  Chelery- 
thrine  (see  Chelidonium),  Porphyroxine ,  and  Puccine ,  combined  with 
Chelidonic  and  Sanguinarinic  Acids, — also  resin,  gum,  albumen,  sugar, 
etc.  The  salts  of  its  alkaloids  are  of  brilliant  red  and  orange  colors  and 
are  all  soluble  in  water.  Dose  of  the  powdered  root  as  expectorant, 
gr.  j-v  ;  as  emetic,  gr.  x-xx,  best  given  in  pill. 

Preparations. 

Extractum  Sangninarice  Fluidum , — Dose,  npj-v  as  expectorant  and  stimulant;  npx-lx 
as  emetic,  cautiously. 

Tindura  Sangninarice , — strength  15  per  cent.  Dose,  as  expectorant,  rrpv-^j,  as 
emetic  ^j-iij. 

Acetum  Sangninarice , — has  of  Sanguinaria  10,  in  Diluted  Acetic  Acid  90.  Dose, 
n\x  -xxx  ;  as  an  emetic,  sjij-^ss. 

Sanguinarina,  Sanguinarine,  C17H15N04,  (Unofficial), — is  the  chief  alkaloid  and 
probably  the  active  principle  of  the  plant.  Dose,  as  an  expectorant,  gr.  yL-i  ;  as  an 
emetic,  gr.  x/z  repeated  in  10  minutes  will  produce  vomiting  after  the  second  or  third  dose. 

Physiological  Action. 

Sanguinaria  is  sternutatory,  sialagogue,  expectorant  and  emmenagogue, 
a  systemic  emetic,  a  cardiac  paralyzer,  a  violent  irritant,  an  acro-narcotic 
and  an  alterative.  Its  taste  is  bitter  and  acrid.  It  causes  violent  sneez¬ 
ing  when  inhaled,  increases  secretion  by  irritating  the  secretory  organs 
as  it  is  eliminated,  and  in  full  doses  produces  salivation,  catharsis  and 
vomiting  with  great  depression.  Overdoses  are  violently  irritant,  the 
heart’s  action  being  at  first  increased,  together  with  the  arterial  tension, 
then  markedly  depressed,  and  finally  paralyzed  by  stimulation  of  its  in¬ 
hibition.  The  reflexes  are  lowered  by  paralysis  of  the  spinal  centres, 
muscular  contractility  impaired,  the  pupils  dilated,  temperature  lowered, 
cold  sweats,  great  thirst  and  collapse  supervene,  and  death  occurs  by 
paralysis  of  the  cardiac  and  respiratory  centres,  often  preceded  by  con¬ 
vulsions.  Locally  used,  Sanguinaria  is  a  feeble  escharotic. 

Antagonists  and  Incompatibles. 

Opium,  Amyl  Nitrite,  Atropine,  etc.,  to  antagonize  the  depression  of  the  circulation  and 
the  local  irritant  action.  Incompatibles  are  alkalies,  tannin,  and  most  of  the  metallic 
salts. 

Therapeutics. 

As  a  tonic  to  the  stomach  and  a  stimulant  to  the  liver  Sanguinaria  or 
its  active  principle  is  well  employed  in  small  doses  (gtt.  iij  of  the  tinc¬ 
ture  or  gr.  -Aj  of  the  alkaloid)  for  atonic  dyspepsia,  duodenal  catarrh  and 
catarrh  of  the  biliary  ducts  with  jaundice.  Respiratory  affections  are 
often  remarkably  amenable  to  its  influence,  particularly  chronic  nasal 
catarrh,  asthma  and  acute  bronchitis.  In  these  affections  expectorant 
doses  are  the  best,  namely,  gtt.  x  of  the  tincture,  and  in  the  former  the 
23 


354 


SANTALUM  ALBUM — SANTALUM  RUBRUM. 


powder  locally  as  a  sternutatory.  A  decoction  is  a  very  efficient  gargle 
in  the  sore-throat  of  scarlet  fever.  Sanguinaria  is  a  very  serviceable 
remedy  in  chronic  bronchitis  and  in  amenorrhoea  of  functional  charac¬ 
ter,  also  in  functional  impotence  from  irritability  of  the  organs,  with 
daily  losses  and  relaxation  of  the  genitalia.  By  many  practitioners  it  is 
considered  a  specific  emetic  in  croup,  but  others  look  upon  it  with  dis¬ 
favor  as  too  uncertain  and  harsh  in  its  action.  It  has  been  thought  to 
have  alterative  properties,  and  hence  is  frequently  used  with  Stillingia  and 
other  plants  in  the  treatment  of  strumous  and  syphilitic  affections.  In 
pneumonia  of  typhoid  type  and  in  pleuro-pneumonia  it  has  undoubtedly 
been  of  great  service  in  many  cases. 

Locally,  the  powdered  root  is  well  employed  as  an  application  to  foul 
ulcers  and  fungous  granulations,  and  by  insufflation  to  nasal  polypi,  and 
for  chronic  hypertrophy  of  the  nasal  mucous  membrane. 

Sanguinarine  has  been  used  with  good  results  in  pneumonia,  bronchitis 
and  atonic  dyspepsia.  Doses  of  gr.  ~  to  are  expectorant  without  irri¬ 
tating  the  stomach ;  and  still  smaller  doses  (gr.  to  are  stimulating 
to  the  gastric  and  intestinal  secretions. 

SANTALUM  ALBUM,  White  Sandalwood, — is  the  source 
of  the  official  Oil  of  Santal  (see  below),  but  is  not  itself  official.  It  is  a 
tree  of  the  nat.  ord.  Santalaceae,  having  its  habitat  in  India  but  now  nearly 
exterminated  there  ; — Santalum  citrinum ,  the  yellow  sandalwood,  from 
the  Sandwich  and  Feejee  Islands,  is  more  commonly  met  with  in  commerce. 

Preparations . 

Oleu7n  Santali,  Oil  of  Santal,  Oil  of  Sandalwood, — a  volatile  oil  distilled  from  the 
wTood  of  Santalum  album  ;  a  pale-yellow  liquid,  of  sp.  gr.  about  0.945,  soluble  in  alcohol, 
.  of  peculiar  and  aromatic  odor,  pungent  taste  and  acid  reaction.  Dose,  npx-xxx,  in 
emulsion  or  capsule. 

Extractum  Santali  Fluidum  (Unofficial), — made  with  alcohol  as  a  menstruum.  Dose, 

3  J-iij  ■ 

Physiological  Action  and  Therapeutics. 

Sandalwood  is  a  very  agreeable  perfume.  The  Oil  is  astringent  to 
mucous  membranes,  producing  dryness  of  the  fauces,  thirst,  colic,  and  a 
sense  of  fulness  in  the  renal  regions.  In  concentrated  form  it  is  a  local 
irritant,  but  the  effects  of  large  doses  have  not  been  studied.  It  is  exten¬ 
sively  used  in  chronic  bronchitis  and  in  gonorrhoea,  forming  the  contents 
of  proprietary  capsules  which  are  sold  for  the  cure  of  the  latter  disease  in 
all  drug  stores.  As  found  in  the  shops  it  is  extensively  adulterated  with 
Oil  of  Cedar,  and  hence  is  a  very  unreliable  remedy. 

SANTALUM  RUBRUM,  Red  Saunders, — is  the  wood  of 
Pterocarpus  santa/inus,  a  tree  of  the  nat.  ord.  Leguminosae,  native  in 
India.  It  comes  as  a  dark  reddish-brown,  heavy,  coarse  wood,  in  chips 


SANTONICA. 


355 


or  as  a  coarse  powder,  nearly  inodorous  and  tasteless,  not  imparting  any 
red  color  to  water  when  macerated  in  it,  but  coloring  alcohol,  ether  and 
alkaline  solutions  a  bright  red.  The  wood  has  no  medicinal  properties 
and  is  employed  solely  for  the  purpose  of  coloring  alcoholic  preparations. 
It  is  a  constituent  of  Tinctura  Lavandulae  Compositus. 


SANTONICA,  Levant  Wormseed, — the  unexpanded  flower- 
heads  of  Artemisia  maritima ,  var.  Stechmanniana ,  a  small,  perennial  plant 
of  the  nat.  ord.  Compositae,  which  grows  in  Asia  Minor,  Turkestan,  etc., 
and  contains  a  volatile  oil  and  the  peculiar,  crystalline  principle  Santonin 
(see  below). 

Flowerheads  about  inch  long,  pale  greenish-brown,  smooth,  resem¬ 
bling  seeds  in  appearance,  but  consisting  of  imbricated  involucral  scales 
with  a  green  midrib,  enclosing  4  or  5  tubular  florets ;  odor  strong  and 
peculiar,  somewhat  camphoraceous,  taste  aromatic  and  bitter.  Dose,  gr. 
x-lx. 

Preparations . 

Santoninum,  Santonin,  C15H1803, — the  neutral  principle  prepared  from  Santonica. 
Occurs  in  colorless,  prismatic  crystals,  turning  yellow  on  exposure  to  light,  odorless,  of 
bitter  after-taste,  and  neutral  reaction,  nearly  insoluble  in  cold  water,  but  soluble  in  250 
of  boiling  water,  in  40  of  alcohol,  3  of  boiling  alcohol,  160  of  ether,  4  of  chloroform,  also 
in  solutions  of  the  alkalies.  Dose,  gr.  j  for  a  child,  gr.  j-v  for  an  adult,  not  repeated 
too  soon,  as  the  action  of  the  drug  is  slow. 

Sodii  Santoninas ,  Santoninate  of  Sodium,  2NaC15H1904.7H20, — colorless,  rhombic 
crystals,  turning  yellow  on  exposure  to  light,  slightly  efflorescent,  of  saline  taste  and 
slightly  alkaline  reaction,  soluble  in  3  of  water  and  in  12  of  alcohol  at  590  F.,  in  0.5  of 
boiling  water  and  in  3.4  of  boiling  alcohol.  Dose,  gr.  ij-x,  as  per  age. 

Trochisci  Sodii  Santoninatis , — each  troche  contains  of  the  preceding  gr.  j,  with  sugar, 
tragacanth  and  orange-flower  water.  Dose,  ij-x,  as  per  age. 

Trochisci  Santonini  (Unofficial), — each  troche  contains  gr.  ss  of  Santonin.  Dose,  j-v, 
as  per  age. 

Santonin  and  its  preparations  are  sensitive  to  light  and  should  be  kept  in  amber-colored 
bottles  tightly  corked. 

Physiological  Action. 

Santonin  is  anthelmintic  to  the  round  worm  (Ascaris  lumbricoides), 
also  but  in  less  degree  to  the  thread-worm  (Oxyuris  vermicularis).  It  is 
taken  into  the  blood  as  Santoninate  of  Sodium,  and  affects  the  cerebral 
faculties  and  the  vision,  objects  appearing  at  first  blue,  green  or  red,  then 
yellow  (chromatopsia),  often  succeeded  by  blindness  for  a  week  or  more. 
Large  doses  disturb  the  consciousness  of  the  patient,  produce  a  sort  of 
intoxication,  tremors,  weakness,  with  enfeebled  respiration  and  slowing 
of  the  pulse,  coldness  of  the  surface,  vomiting,  sweating,  mydriasis,  con¬ 
vulsions  and  death  from  failure  of  respiration.  A  dose  of  2  grains  is  said 
to  have  proved  fatal  to  a  feeble  child  of  five  years  old.  It  is  excreted  by 
the  kidneys,  coloring  the  urine  if  acid  a  greenish-yellow,  if  alkaline  a  red¬ 
dish-purple,  and  produces  considerable  enuresis. 

Santoninate  of  Sodium  acts  similarly,'  but  being  more  soluble  it  is 


356 


SAPO. 


more  rapidly  absorbed  and  eliminated,  and  does  not  produce  the  consti¬ 
tutional  symptoms  of  the  drug  in  so  marked  a  degree. 

Therapeutics. 

As  an  anthelmintic  Santonin  is  the  most  certain  agent  against  the  round- 
worm,  and  is  best  administered  in  powder  with  Calomel  at  bedtime  after 
a  day  of  fasting,  a  Senna-draught  or  a  dose  of  Castor  Oil  being  used  the 
following  morning.  It  also  acts  fairly  well  in  suppository  against  the 
thread-worm,  but  is  inoperative  against  tape-worm.  Some  observers  con¬ 
sider  that  it  is  more  promptly  efficient  when  given  in  Castor  Oil,  and  that 
the  oil  lessens  the  risk  of  evil  after-effects.  It  has  also  been  prescribed 
with  great  benefit  for  nocturnal  incontinence  of  urine,  and  for  certain  eye 
affections,  particularly  amaurosis  from  atrophic  or  inflammatory  changes 
in  the  retina  and  optic  nerve.  It  should  never  be  given  to  children  during 
a  fever,  nor  when  the  bowels  are  constipated,  for  fear  of  toxic  results. 


SAPO,  Soap, — is  soap  prepared  from  Soda  and  Olive  Oil ;  a  white 
solid,  hard  yet  easily  cut  when  fresh,  of  slight,  peculiar  odor  free  from  ran¬ 
cidity,  a  disagreeable,  alkaline  taste,  and  an  alkaline  reaction,  readily  solu¬ 
ble  in  water  and  in  alcohol.  It  is  well  represented  by  the  best  “white 
Castile  soap.” 

• 

Sapo  Viridis,  Green  Soap, — is  soap  prepared  from  Potassa  and  fixed 
oils;  a  soft,  greenish-yellow  unctuous  jelly,  having  a  peculiar  odor  and 
an  alkaline  reaction,  soluble  in  water  and  in  alcohol,  does  not  impart  an 
oily  stain  to  paper.  Incinerated  it  yields  an  ash  which  is  very  deliques¬ 
cent.  Green  Soap  is  a  bad  name  for  it,  as  its  color  is  usually  brown. 

Saponification  is  a  process  of  double  decomposition  between  a  fat  (stearate,  palmi- 
tate  or  oleate  of  glyceryl)  and  an  alkali,  in  which  glycerin  and  the  metallic  salt  of  the 
fatty  acid  are  formed.  The  glycerin,  not  being  saponifiable,  is  set  free,  but  the  fatty  acid 
(stearic,  palmitic  or  oleic)  unites  with  the  salifiable  base  to  form  soaps,  which  are  there¬ 
fore  mixed  stearates,  oleates  and  palmitatesof  various  bases.  Nearly  all  soaps  are  oleates 
or  palmitates  (or  both)  of  sodium  or  potassium  (or  both).  Hard  soaps  are  soda  soaps, 
soft  soaps  are  potassium  soaps.  [Compare  the  articles  Oleum  Olivte,  Adeps,  Acidum 
Oleicum,  Glycerinum,  etc.] 

Insoluble  Soaps  are  combinations  of  the  oily  acids  with  earths  and 
metallic  oxides.  Two  of  them  are  official,  viz., — the  Soap  of  the  Mon¬ 
oxide  of  Lead  (Emplastrum  Plumbi)  and  the  Soap  of  Lime  (Linimentum 
Calcis). 

Unojficial  Soaps. 

Sapo  Mollis,  Soft  Soap, — official  in  the  Br.  Phar.,  is  made  with  Olive  Oil  and  Potash, 
the  solution  of  the  alkali  being  present  in  excess.  It  is  often  adulterated  with  starch. 

Sapo  Animalis ,  Curd  Soap, — official  in  the  Br.  Phar., — is  made  with  Soda  and  a  puri¬ 
fied  animal  fat,  consisting  chiefly  of  Stearin.  Used  in  pills  and  suppositories. 

Sapo  Medicatus , — official  in  the  Fr.  Codex, — is  a  Soda  soap  prepared  from  expressed 
Almond  Oil. 


SARSAPARILLA. 


357 


Preparations. 

Emplastrum  Saponis,  Soap  Plaster, — has  of  Soap  io  parts,  Lead  Plaster  90,  Water  q.  s. 
Linimentum  Saponis,  Soap  Liniment, — has  of  Soap  10  parts,  Camphor  5,  Oil  of  Rose¬ 
mary  I,  Alcohol  70,  Water  q.  s.  ad  100  parts.  Opodeldoc  is  a  similar  preparation. 

Tinctura  Saponis  Viridis , — has  of  Green  Soap  65  parts,  Oil  of  Lavender  2,  Alcohol 
q.  s.  ad  100  parts.  For  external  use. 

Soap  is  also  an  ingredient  of  Chloroform  Liniment  and  several  of  the  official  pills. 


Physiological  Action  and  Therapeutics. 

Soap  is  a  laxative,  antacid  and  antilithic ;  externally  it  is  a  stimulating 
discutient,  and  is  used  for  cleansing  the  skin,  removing  fatty  substances 
and  softening  the  epidermis,  but  if  too  long  applied  it  may  prove  de¬ 
cidedly  irritant.  It  is  a  good  antidote  in  poisoning  by  acids,  and  should 
be  administered  freely  in  such  cases  until  more  energetic  alkalies  can  be 
obtained.  In  aqueous  solution  it  makes  a  useful  enema  for  constipation, 
or  a  plug  of  soap  may  be  inserted  into  the  rectum. 

Green  Soap  is  a  powerful  detergent  stimulant  and  is  much  employed 
in  skin  diseases,  especially  eczema  rubrum,  in  which  the  tincture  is  well 
rubbed  on,  the  diseased  skin  well  washed  and  then  covered  with  a  bland 
ointment.  The  tincture  is  the  most  elegant  form  for  use,  and  may  be 
diluted  with  three  parts  of  alcohol  for  shampooing  the  scalp. 

The  Liniment  is  used  with  friction  in  sprains,  bruises  and  stiff  joints, 
being  a  little  more  stimulating  than  Camphor-liniment.  It  makes  a  good 
basis  for  extemporaneous  liniment  prescriptions. 


SARSAPARILLA  , — is  the  root  of  Smilax  officinalis,  Smilax  medica, 
and  of  other  undetermined  species  of  Smilax ,  plants  of  the  nat.  ord. 
Smilacese,  growing  in  Mexico,  Central  America,  Brazil,  etc.  There  are 
six  commercial  varieties  on  the  market,  which  are  generally  put  up  in 
differently  formed  bundles.  The  roots  are  about  as  thick  as  a  goose-quill, 
reddish-brown,  several  feet  in  length,  covered  with  rootlets  and  folded  in 
bundles  about  18  inches  long,  taste  mucilaginous,  bitter  and  acrid.  It 
contains  starch,  resin,  oxalate  of  calcium,  an  essential  oil,  and  an  acrid 
neutral  principle  named  Parilliti  or  Smilacin ,  which  when  acted  on  by 
dilute  sulphuric  acid  affords  another  principle,  Parigenin. 


Preparations. 

Extractum  Sarsaparilla  Eluidum. — Dose,  'Z  ss-  g  j . 

Ext.  Sarsaparilla  Composition  Eluidum, — contains  Sarsaparilla  75,  Glycyrrhiza  12, 
Sassafras  bark  10,  Mezereum  3,  Glycerin  10,  Water  and  Alcohol  up  to  100.  Dose, 
3SS-3J. 

Syrupus  Sarsaparilla  Compositus , — Sarsaparilla  150,  Guaiacum  Wood  20,  Pale  Rose 
12,  Glycyrrhiza  12,  Senna  12,  Sassafras  6,  Anise  6,  Gaultheria  6,  Sugar  600,  Alcohol  and 
Water  up  to  1000  parts.  Dose,  ^j-  ^ss.  A  good  vehicle  for  Potassium  Iodide. 

Decoctum  Sarsaparilla  Compositum , — Sarsaparilla  10,  Sassafras  2,  Guaiacum  Wood  2, 
Glycyrrhiza  2,  Mezereum  1,  Water  q.  s.  ad  100  parts.  Dose,  gj-iv. 

Syrup  of  Sarsaparilla  (Unofficial), — so  much  used  in  flavoring  soda-water,  is  a  mixture 
of  the  oils  of  sassafras  and  gaultheria. 


358 


SASSAFRAS. 


Physiological  Action  and  Therapeutics. 

Those  who  believe  that  Sarsaparilla  has  any  action  ascribe  to  it  prop¬ 
erties  as  a  diuretic,  diaphoretic,  tonic  and  alterative.  So  far  careful 
physiological  experiments  with  the  drug  and  its  principle  have  given  nega¬ 
tive  results.  It  has  been  used  as  a  so-called  “blood-purifier  ”  in  scrofula, 
chronic  abscesses,  necrosis,  old  ulcers,  many  cutaneous  diseases,  etc., 
but  is  generally  combined  with  other  agents  of  undoubted  activity.  The 
compound  decoction  is  considered  a  good  agent  in  tertiary  syphilis,  espe¬ 
cially  in  debilitated  subjects ;  while  the  other  preparations  are  commonly 
employed  as  vehicles  for  Iodide  of  Potassium  and  Bichloride  of  Mercury  in 
syphilis  of  any  form.  Whenever  used,  the  compound  decoction  will  give 
the  best  results,  the  hot  water  and  its  other  constituents  being  each  of 
medicinal  value. 


SASSAFRAS  , — is  the  root-bark  of  Sassafras  officmalis ,  a  tree  of  the 
nat.  ord.  Lauraceae,  growing  throughout  the  U.  S.,  and  occurs  in  irregular 
fragments  of  a  bright,  rust-brown  color,  strongly  fragrant,  taste  sweetish, 
aromatic  and  somewhat  astringent.  The  volatile  oil  is  official. 

Sassafras  Medulla,  Sassafras  Pith, — is  the  pith  of  the  tree  described 
above.  Occurs  in  slender  cylindrical  pieces,  often  curved  or  coiled, 
light,  spongy,  white,  inodorous,  insipid.  Macerated  in  water  it  forms  a 
mucilaginous  liquid  which  is  not  precipitated  on  the  addition  of  alcohol. 


Preparations. 

Mucilago  Sassafras  Medulla , — has  of  the  pith  2  parts  in  too  of  water.  Dose,  indefinite. 

Oleum  Sassafras , — is  a  volatile  oil  distilled  from  Sassafras, — a  colorless  or  yellowish 
liquid,  having  the  odor  of  Sassafras,  a  warm,  aromatic  taste  and  a  neutral  reaction,  readily 
soluble  in  alcohol.  Sp.  gr.  about  1. 090.  Treated  with  cold  nitric  acid  it  becomes  of  a 
dark-red  color,  and  is  finally  converted  into  a  red  resin.  Dose,  rt\j-iv. 

Infusum  Sassafras  (Unofficial), —  a  popular  “  tea”  which  may  be  drank  ad  libitum. 

Sassafras  is  a  constituent  of  the  three  compound  Sarsaparilla  preparations. 


Physiological  Action  and  Therapeutics. 

Sassafras  is  a  stimulant  diaphoretic  when  used  in  quantity  of  the  hot 
infusion.  It  enjoys  a  popular  reputation  as  a  “blood-purifier,”  and  has 
a  destructive  influence  on  infusoria.  It  is  employed  chiefly  in  combina¬ 
tion  with  Sarsaparilla  and  Guaiacum  in  cutaneous  disorders  and  rheumatic 
and  syphilitic  affections.  The  mucilage  of  the  pith  is  an  excellent  demul¬ 
cent  drink  in  acute  gastritis  or  enteritis,  or  in  poisoning  by  irritant  or 
corrosive  agents.  It  may  also  be  used  in  extemporaneous  prescriptions  to 
hold  insoluble  substances  in  suspension  and  for  flavoring  purposes.  The 
oil  is  chiefly  used  for  flavoring  in  mixtures  and  confectionery.  The  syrup 
popularly  known  as  “Sarsaparilla”  is  composed  of  Oil  of  Sassafras  and 
Oil  of  Gaultheria. 


SCAMMONIUM — SCILLA. 


359 


SCAMMONIUM,  Scammony, — is  a  resinous  exudation  from  the 
root  of  Convolvulus  Scammonia ,  a  plant  of  the  nat.  ord.  Convolvulaceae, 
growing  chiefly  in  Syria  and  Asia  Minor.  It  occurs  in  irregular,  angular 
pieces  or  circular  cakes,  of  a  greenish-gray  or  blackish  color,  a  peculiar, 
cheese-like  odor,  and  a  slightly  acrid  taste  ;  easily  triturated  into  a  dirty- 
gray  powder,  and  with  water  yields  a  smooth,  greenish  emulsion.  It  con¬ 
tains  about  80  per  cent,  of  Resin ,  with  gum,  sugar,  starch,  etc.  The 
active  principle,  Jalapin ,  is  probably  identical  with  the  Convolvulin  of 
Jalap,  and  is  contained  in  the  root,  the  resin,  etc.  Dose,  gr.  v-x. 

Preparations. 

Resina  Scammonii ,  Resin  of  Scammony, — is  wholly  soluble  in  ether.  Dose,  gr.  iij-viij. 

Extraction  Colocynthidis  Composition, — (see  ante,  page  185)  contains  14  per  cent,  of 
Resin  of  Scammony,  and  is  an  ingredient  of  the  Compound  Cathartic  Pill. 

Physiological  Action  and  Therapeutics. 

Scammony  is  an  active  cathartic,  stimulating  the  liver  and  the  intestinal 
glands,  and  causing  free  purgation  in  a  few  hours,  with  considerable 
griping.  Its  solution  in  the  bile  is  necessary  to  its  action,  and  it  combines 
with  the  soda  in  that  secretion.  Though  quite  drastic  in  action  it  is 
somewhat  uncertain  as  a  purgative  and  is  generally  employed  in  combina¬ 
tion  with  similarly  acting  agents.  It  is  anthelmintic  against  the  tapeworm, 
and  in  overdoses  produces  a  high  degree  of  irritation. 

It  is  used  as  a  drastic  purgative  for  children  with  Calomel  or  Potassium 
Sulphate,  when  an  active  cathartic  is  indicated.  In  the  same  way  it  is 
the  appropriate  agent  on  the  principle  of  derivation  in  dropsies  and 
cerebral  affections,  also  in  torpid  states  of  the  intestines  with  much  slimy 
intestinal  mucus ;  but  it  is  contraindicated  in  cases  attended  by  irritability 
of  the  stomach  and  bowels. 


SCILLA,  Squill  , — is  the  sliced  bulb  of  Urginea  Scilla,  or  Scilla 
maritima ,  a  perennial  plant  of  the  nat.  ord.  Liliaceae,  growing  on  the 
shores  of  the  Mediterranean.  It  comes  in  narrow  segments  about  two 
inches  long,  of  yellowish-white  or  reddish  color,  slightly  translucent, 
inodorous,  mucilaginous,  bitter  and  acrid  to  the  taste.  Its  active  prin¬ 
ciple  has  not  yet  been  definitely  isolated,  but  it  is  probably  the  acrid, 
bitter  glucoside  Scillitoxin.  Other  principles  have  been  obtained  and 
named  Scillipicrin ,  Scillitin  and  Scillin,  also  Sinistrin,  a  peculiar  carbo¬ 
hydrate  or  mucilage,  and  the  usual  constituents  of  plants.  Dose,  in 
powder,  gr.  j-iij. 

Preparations. 

Extraction  Scillce  Fluid um , — Dose,  rry-v. 

Tinctura  Scillce, — 15  per  cent.  Dose,  rr^v-xxx. 

Acetum  Scilla , — 10  percent.  Dose,  TTLx-^j. 

Syrupus  Scillce , — has  of  the  Acetum  40  parts  with  Sugar  60  and  Water.  Dose, 

3  ss_ ij  • 


360 


SCOPARIUS. 


Syrupus  Scillce  Compositus , — has  of  Squill  120,  Senega  120,  Tartar  Emetic  3,  Sugar 
1200,  Calcium  Phosphate  9,  Diluted  Alcohol  and  Water  up  to  2000  parts.  Is  known  as 
Coxe's  Hive  Mixture,  and  each  fluid  ounce  contains  about  gr.  ^  of  Tartar  Emetic. 
Dose,  rr\,v-gj,  for  children,  the  latter  being  an  emetic  dose;  as  an  expectorant  for  adults 
TTLxx-xxx. 

Physiological  Action. 

In  small  doses  Squill  is  expectorant,  in  larger  doses  emetic  and  diuretic, 
and  in  overdoses  it  is  a  violent  irritant  poison,  producing  nausea,  vomit¬ 
ing,  purging,  gastro-enteritis,  strangury,  bloody  urine,  perhaps  suppression 
of  urine,  paralysis  and  convulsions,  with  death  by  paralysis  of  the  heart  in 
systole.  Medicinal  doses  slow  the  heart,  making  the  pulse  stronger  and 
slower,  raising  the  arterial  tension,  and  increasing  the  flow  of  urine  (like 
Digitalis).  Its  active  constituents  diffuse  into  the  blood,  and  its  systemic 
effects  follow  on  its  application  to  the  skin  and  seem  to  be  exerted  upon 
the  mucous  membrane  of  the  secretory  organs,  especially  affecting  the 
bronchial,  gastro-intestinal  and  genito-urinary. 

Therapeutics. 

Squill  is  employed  in  medicine  for  its  expectorant  and  diuretic  effects. 
It  is  especially  applicable  in  cardiac  dropsy,  combined  with  Digitalis  or 
the  saline  diuretics,  and  in  chronic  bronchitis  associated  with  Ipecac  or 
Ammonia,  Asafoetida,  Benzoin,  etc.  It  is  also  used  in  croup,  but  is 
usually  combined  in  this  affection  with  some  other  emetic,  as  Tartar 
Emetic  in  the  Compound  Syrup,  a  mixture  which  may  produce  very 
depressing  effects  and  should  be  used  with  caution.  In  whooping-cough 
and  other  irritant  coughs  with  tickling  sensations  in  the  throat  the  Syrup 
or  Vinegar  of  Squill  is  often  of  great  service. 

The  actions  and  uses  of  Squill  should  be  studied  in  connection  with 
those  of  Digitalis  and  Ipecacuanha. 

SCOPARIUS,  Broom, — the  tops  of  Saroihamnus  Scoparius ,  or 
Broom-plant,  a  common  garden  shrub  of  the  nat.  ord.  Leguminosae, 
having  small,  downy  leaves  and  numerous  large  golden-yellow  flowers. 
It  occurs  in  thin,  flexible  twigs,  usually  free  from  leaves,  nearly  smooth, 
tough,  of  a  peculiar  odor  when  bruised  and  a  disagreeably  bitter  taste. 
It  contains  Scoparin,  C21H22O10,  a  neutral,  crystallizable  principle ;  and 
Sparteine ,  C15H26N2,  a  volatile,  liquid  alkaloid,  having  no  oxygen,  but 
possessing  very  decided  basic  qualities  and  being  highly  poisonous. 
There  are  no  official  preparations,  but  a  decoction  may  be  prepared  in 
the  proportion  of  5j  to  the  pint,  and  administered  in  doses  of  5j  every 
three  hours  until  its  diuretic  effect  is  produced. 

Sparteine  Sulphas,  Sulphate  of  Sparteine,  Dose,  gr.  ^-3,  hypo¬ 
dermically; — gr.  ^-ij  per  orem.  Small  doses,  gr.  Ty— every  5  hours, 
for  cardiac  action ; — larger,  gr.  j-ij,  for  diuresis.  (Clarke.)  Larger 
doses  are  necessary,  say  gr.  iss-iij,  ter  die.  (Prior.) 


SCOPARIUS. 


361 

Physiological  Action. 

Broom-tops  are  diuretic  and  laxative,  also  emetic  and  cathartic  in  large 
doses.  In  the  form  of  decoction  they  have  long  been  a  favorite  diuretic 
and  vehicle  for  other  diuretics,  in  the  treatment  of  dropsies  both  cardiac 
and  renal,  but  are  considered  most  reliable  in  the  dropsy  of  renal  origin. 

Sparteine  has  been  thought  to  resemble  Coniine  in  its  action,  paraly¬ 
zing  the  end-organs  of  the  motor  nerves  and  vagi,  lowering  the  reflex  ex¬ 
citability  of  the  cord,  and  causing  death  by  paralyzing  the  respiratory 
centre  in  the  medulla.  Recent  observations,  however,  place  it  in  the 
Digitalis  group,  and  in  the  front  rank  among  the  members  thereof. 

In  small  doses  Sparteine  slows  and  strengthens  the  heart-beats,  and 
raises  arterial  tension,  at  the  same  time  increasing  the  cutaneous  and  renal 
circulation,  so  that  the  surface  becomes  flushed  and  moist,  and  in  some 
cases  marked  diuresis  and  diaphoresis  occur.  The  respiration,  at  first 
quickened,  is  soon  slowed  and  deepened, — the  patient  having  a  sense  of 
increased  warmth  and  well-being,  and  if  suffering  from  irregular  cardiac 
action,  praecordial  distress  and  dyspnoea,  these  symptoms  are  promptly 
relieved.  If  the  pulse  has  been  abnormally  slow  Sparteine  will  quicken 
it,  though  its  general  action  is  to  slow  the  cardiac  rate.  An  overdose 
brings  on  marked  palpitation,  a  small  and  rapid  pulse  of  very  high  ten¬ 
sion,  praecordial  pain  and  a  sense  of  “  tightness  ”  about  the  chest,  with 
anxiety,  and  a  feeling  of  intense  debility,  perhaps  even  muscular  tremor. 
Death  occurs  by  asphyxia  from  depression  of  both  the  centre  and  the 
muscles  of  respiration. 

The  action  of  Sparteine  upon  the  circulation  is  manifested  quickly  as 
compared  with  that  of  other  similarly-acting  drugs.  In  hour  after  its 
ingestion  the  pulse  is  markedly  slower, — in  another  ^  hour  the  arterial 
tension  rises,  and  both  effects  last  from  5  to  6  hours.  When  taken  regu¬ 
larly  for  several  days  or  weeks  its  influence  remains  for  nearly  a  week  after 
its  discontinuance.  There  is,  however,  no  danger  of  cumulative  action, 
and  though  the  dosage  employed  has  varied  from  gr.  —  every  4  hours,  to 
gr.  xij  in  24  hours,  no  toxic  action  was  observed,  nor  was  there  any  evi¬ 
dence  of  accumulation,  even  when  given  continuously  for  3  to  4  months. 
(Clarke.)  Only  from  a  dose  of  gr.  xxxj  were  evil  effects  observed.  (Prior.) 

Its  diuretic  power  on  healthy  persons  is  denied  by  some  observers  and 
affirmed  by  others,  though  all  acknowledge  it  in  disease.  It  is  accompa¬ 
nied  by  increased  excretion  of  urea, — is  due  to  the  increase  of  blood- 
pressure  both  behind  and  in  front  of  the  renal  circulation, — and  is 
produced  only  by  large  doses,  gr.  yi~gr.  ij. 

Sparteine  acts  directly  on  the  cardiac  muscle,  as  well  as  upon  the  inhib¬ 
itory  apparatus,  thus  giving  greater  force  to  the  cardiac  contractions,  and 
regulating  (generally  slowing)  the  pulse-rate.  It  also  stimulates  the  vaso¬ 
motor  centre  to  contract  the  vessels  throughout  the  splanchnic  area,  thus 


362 


SCUTELLARIA. 


increasing  the  circulation  in  the  skin  and  kidneys,  and  raising  arterial 
tension  generally. 

Therapeutics. 

Broom-tops  are  a  favorite  remedy  for  dropsies  of  cardiac  origin,  and 
for  the  general  anasarca  of  chronic  kidney  disease,  but  are  inadmissible 
in  acute  renal  affections  or  where  there  is  pulmonary  congestion  or  in¬ 
flammation. 

Sparteine  has  been  employed  with  very  great  benefit  in  cardiac  affec¬ 
tions  requiring  stimulation  of  the  heart’s  action  with  the  smallest  possible 
increase  of  arterial  tension,  relief  of  dyspnoea,  praecordial  pain,  palpita¬ 
tion  and  oedema.  In  such  cases  small  doses,  gr.  are  best,  and  as 

the  influence  of  the  drug  is  remarkably  sustained,  they  need  not  be 
repeated  oftener  than  once  in  5  or  6  hours.  It  has  given  the  most  marked 
satisfaction  in  mitral  regurgitation,  in  which  it  relieves  all  the  symptoms ; 
also  in  mitral  stenosis,  when  the  pulse  is  small,  weak  and  irregular.  In 
aortic  regurgitation,  it  quiets  excited  action  of  the  heart,  without  unduly 
prolonging  the  systole,  and  is  of  great  value.  Used  in  chronic  Bright’s 
disease,  with  hypertrophy  and  high  arterial  tension,  it  stimulates  the 
heart  without  increasing  the  tension.  In  exophthalmos,  it  gives  remark¬ 
able  relief  to  all  the  symptoms.  For  cardiac  palpitation  and  arhythmia, 
small  doses  are  of  great  service.  In  asthma  it  is  of  signal  benefit,  cutting 
short  the  paroxysms,  and  rendering  their  recurrence  much  less  frequent. 
In  the  opium-habit  it  is  used  at  periods  of  depression  during  the  treatment, 
to  overcome  the  “  plateau  ”  shown  in  the  sphygmograph  trace,  by  stimu¬ 
lating  the  cardiac  action.  (Jennings.)  For  this  purpose,  doses  of  gr. 
iss-iij  three  or  four  times  daily  are  necessary.  (Prior.) 


SCUTELLARIA,  Skull-cap,  — is  the  plant  Scutellaria  lateriflora , 
an  indigenous,  perennial  herb  of  the  nat.  ord.  Labiatae,  growing  in  moist 
places  and  along  ditches  ;  having  small,  pale-blue  flowers  disposed  in  long, 
leafy  racemes,  of  slight  odor  and  bitterish  taste.  It  contains  a  little  vola¬ 
tile  oil,  traces  of  a  bitter  principle,  besides  fat,  tannin,  sugar,  etc. 

Preparation. 

Extractum  Scutellarice  Ftuidum, — Dose,  g  ss-ij. 

Physiological  Action  and  Therapeutics. 

Scutellaria  produces  no  very  obvious  effects  when  taken  internally.  By 
some  practitioners  it  is  said  to  have  tonic,  nervine  and  antispasmodic 
powers,  and  it  has  been  used  in  domestic  practice  to  calm  the  nervous 
system  in  diseases  characterized  by  restlessness,  tremors,  spasms,  twitch¬ 
ing  of  the  muscles,  hyperresthesia,  etc.,  as  chorea,  delirium  tremens,  nerv¬ 
ous  exhaustion  from  fatigue  or  over-excitement,  hydrophobia,  hysteria  and 


SENEGA. 


363 


epilepsy.  The  Scutellarin  of  the  Eclectics  is  not  a  proximate  principle, 
but  an  extract  precipitated  by  alum  from  a  concentrated  aqueous  tincture. 
It  is  given  in  dose  of  from  one  to  four  grains. 

SENEGA  , — is  the  root  of  Polygala  Senega ,  an  indigenous,  perennial 
plant  of  the  nat.  ord.  Polygalaceae,  having  small,  white  flowers  in  a  close 
spike  at  the  summit  of  the  stem.  The  root  is  about  4  inches  long,  with  a 
knotty  crown  and  tortuous,  spreading  branches,  thick  bark  inclosing  a 
porous,  yellowish  wood  ;  odor  slight  but  unpleasant,  taste  at  first  sweetish, 
afterwards  acrid.  Its  principal  constituent  is  the  glucoside  Senegin, 
C32H54018,  which  is  identical  with  Saponin,  and  closely  allied  to  Digitonin. 
It  is  a  white,  amorphous  powder,  readily  soluble  in  alcohol  and  hot  water, 
forming  a  soapy  emulsion  when  mixed  with  boiling  water,  and  decom¬ 
posed  by  HC1  into  sugar  and  Sapogenin ,  C14H2202. 

Preparations. 

Abstractum  Senega, — Dose,  gr.  v-x. 

Extradum  Senega  Fluidum , — Dose,  npx-xx. 

Syrupus  Senega , — has  of  the  fluid  extract  160,  Aqua  Ammonite  4,  Sugar  600,  Water 
to  1000  parts.  Dose,  ^j-ij. 

Syrupus  Scilla  Compositus , — contains  6  per  cent,  of  Senega.  (See  page  360.)  Dose  for 
children,  f°r  adults  as  an  expectorant,  rr^xx-^ss. 

Physiological  Action. 

Senega  is  a  stimulating  expectorant,  a  diuretic  and  a  diaphoretic.  It 
causes  irritation  of  the  throat,  with  some  salivation  and  gastro-intestinal 
irritation,  an  inclination  to  cough,  increased  bronchial  secretion,  and 
perhaps  some  diuresis  and  diaphoresis.  Inhaled  as  a  snuff  it  is  very  irri¬ 
tant  to  the  mucous  membrane  of  the  nose,  causing  cough,  sneezing  and 
nasal  catarrh.  Senegin  is  violently  irritant  and  a  powerful  depressant  to 
the  heart,  vessels,  nervous  and  muscular  systems.  It  is  excreted  by  the 
bronchial  mucous  membrane,  the  kidneys  and  the  skin,  all  of  which  it 
stimulates  and  in  large  quantity  irritates. 

Therapeutics. 

The  use  of  Senega  is  chiefly  that  of  a  stimulating  expectorant  in  chronic 
bronchitis,  the  second  stage  of  acute  bronchitis,  typhoid  pneumonia, 
asthma,  croup,  and  as  a  diuretic  in  dropsy  due  to  renal  disease.  It  re¬ 
moves  the  tightness  and  oppression  experienced  in  subacute  chest  affec¬ 
tions,  relieves  the  cough  and  rapidly  promotes  expectoration.  When  the 
mucus  is  tough  and  scanty  this  remedy  is  of  no  value.  It  has  been  used 
with  great  benefit  in  amenorrhoea,  given  in  saturated  decoction  for  two 
weeks  before  the  expected  period.  In  chronic  rheumatism  and  in  rheu¬ 
matic  paralysis  its  stimulating  and  diaphoretic  powers  have  been  of  great 
value.  Senegin  has  been  successfully  used  in  2-grain  doses  as  a  remedy 
for  uterine  hemorrhage. 


364 


SENNA. 


SENNA, — the  leaflets  of  Cassia  acutifolia  (Alexandria  Senna),  and  of 
Cassia  e/ongata  (Indian  Senna),  shrubs  of  the  nat.  ord.  Leguminosae, 
growing  in  Egypt  and  India.  The  leaflets  are  from  i  to  2  inches  long, 
lanceolate,  brittle,  dull  green,  of  peculiar  odor,  and  nauseous,  bitter  taste. 
They  contain  an  amorphous  glucoside,  Cathartic  Acid ,  C180H192N2SO82, 
which  forms  salts  with  bases  and  may  be  decomposed  into  glucose  and 
Cathartogenic  Acid.  Other  constituents  are  Sennapicrm  and  Sennacrol, 
both  glucosides; — Catharto-mannite ,  a  peculiar  unfermentable  sugar  ;  also 
a  coloring  matter  allied  to  Chrysarobin  (see  page  174),  and  various  vege¬ 
table  salts. 

Preparations. 

Extraction  Sennce  Fluidum. — Dose,  gj.  An  excellent  preparation. 

Syrupus  Sennce., — has  of  Senna  33  parts,  Sugar  60,  Alcohol  4,  Oil  of  Coriander  and 
Water  to  100  parts.  Dose,  gss-ij. 

Confectio  Sennce , — has  of  Senna  10,  Coriander  6,  Cassia  Fistula  16,  Tamarind  10, 
Prune  7,  Fig  12,  Sugar  50,  Water  60  parts.  Is  sold  under  the  titles  “  Tamar-Indien,” 
“  Tropical  Fruit  Laxative,”  etc.  Dose, 

Infusum  Sennce  Composition ,  Black  Draught, — has  of  Senna  6,  Manna  12,  Magnesium 
Sulphate  12,  Fennel  2,  Water  100  parts.  Dose,  3  j— iij . 

Pulvis  Glycyrrhizce  Compositus,  (see  ante ,  page  228), — contains  18  per  cent,  of  Senna. 
Dose,  gr.  xx-  ^j. 

Syrupus  Sarsaparillce  Compositus  (see  ante ,  page  3 57), — contains  12  per  1000  of  Senna. 
Dose,  3  j— i v. 

Physiological  Action. 

Senna  is  a  very  efficient  and  safe  cathartic,  producing,  when  taken  in¬ 
ternally,  copious  yellow  stools  in  about  4  hours,  with  considerable  griping 
and  flatulence,  which  may,  however,  be  lessened  by  combining  it  with 
carminatives.  Its  action  is  chiefly  expended  on  the  small  intestine,  and 
it  increases  both  peristalsis  and  secretion.  It  has  no  irritant  qualities  in 
ordinary  medicinal  doses,  and  does  not  produce  hypercatharsis,  nor  leave 
constipation  as  an  after  result.  Its  infusion  injected  into  the  veins  causes 
both  vomiting  and  purging ;  and  in  large  doses  per  orem  it  produces  nau¬ 
sea,  vomiting,  flatulence,  excited  pulse,  drastic  purgation  with  severe  tenes¬ 
mus,  but  its  effects  are  never  poisonous.  It  may  produce  hemorrhoids 
and  increase  the  menstrual  flow  in  women.  Given  to  a  nursing  mother 
her  milk  will  acquire  purgative  powers.  In  some  very  susceptible  per¬ 
sons  the  odor  of  the  leaves  or  of  the  infusion  will  cause  an  evacuation  of 
the  bowels.  Its  odor  and  taste  are  particularly  disagreeable,  especially 
when  administered  in  infusion. 

Therapeutics. 

Senna  would  probably  take  rank  as  our  best  and  safest  cathartic  but  for 
the  nauseousness  of  its  smell  and  taste.  It  is  a  favorite  laxative  in  Eng¬ 
land  for  children,  and  is  used  with  great  benefit  in  habitual  constipation 
or  where  prompt  evacuation  of  the  bowels  is  required.  In  hemorrhoids 
and  anal  fissures  it  is  employed  to  produce  soft  and  easy  motions ;  but  if 
a  tendency  to  hemorrhoids  exists,  the  use  of  this  drug  in  cathartic  doses 


SERPENTARIA. 


365 


will  cause  irritation  of  the  part  and  induce  an  acute  attack.  For  the 
same  reason  it  is  contraindicated  in  any  such  conditions  as  hemorrhage 
or  inflammation  of  the  intestinal  mucous  membrane,  hemorrhoids,  menor¬ 
rhagia,  abortion,  etc.  The  least  disagreeable  of  its  preparations  are  the 
Confection  of  Senna  and  the  Compound  Liquorice  Powder. 


SERPENTARIA,  Virginia  Snake-root  , — is  the  rhizome  and 
rootlets  of  Aristolochia  Serpentaria  and  of  Aristolochia  reticulata ,  indi¬ 
genous  herbaceous  plants  of  the  nat.  ord.  Aristolochiaceae,  growing  in 
rich,  shady  woods,  with  purple  flowers  arising  from  joints  near  the  root. 
The  rhizome  is  about  an  inch  long,  thin  and  bent,  having  on  the  upper 
side  short  stem-remnants,  on  the  lower  side  numerous  thin,  branching 
rootlets  ;  odor  and  taste  are  aromatic  and  camphoraceous.  It  contains  a 
volatile  oil,  a  camphor-resin  and  a  bitter  principle  named  Aristolochine , 
which  is  soluble  in  both  alcohol  and  water.  All  its  preparations  should 
be  made  from  the  fresh  root,  as  it  deteriorates  by  keeping. 

Preparations. 

Extractum  Serpentarice  Fluidum, — Dose,  rtyx-xxx. 

Tinctura  Serpentarice, — 10  per  cent.  Dose,  gss-ij. 

Tinctura  Cinchonce  Composita, — has  2  parts  of  Serpentaria  in  100.  (See  ante,  page 
177).  Dose,  3j-ij. 

Physiological  Action. 

Serpentaria  is  a  stimulant  expectorant  and  tonic,  also  a  cardiac  stimu¬ 
lant,  a  diaphoretic,  diuretic,  emmenagogue,  aphrodisiac,  and  somewhat 
of  an  antiperiodic.  Its  taste  is  warm  and  pungent,  its  odor  characteris¬ 
tic.  Small  doses  promote  appetite  and  digestion,  increase  the  bronchial 
and  intestinal  secretions,  the  action  of  the  heart,  the  cutaneous  circula¬ 
tion  and  the  surface  temperature,  and  produce  considerable  mental  exhila¬ 
ration.  Large  doses  are  irritant,  causing  nausea  and  vomiting,  vertigo 
and  headache,  colic,  borborygmi,  rectal  tenesmus,  flatulent  distention  and 
frequent  but  not  watery  stools.  The  irritant  action  seems  to  produce  gas 
rather  than  fluid.  Pruritus  ani  and  hemorrhoids  are  occasionally  caused 
by  its  use. 

Therapeutics. 

Serpentaria  is  chiefly  employed  as  a  vehicle  for  other  stimulant  drugs, 
but  has  many  uses  of  its  own.  In  bronchial  affections  it  is  extremely 
valuable  as  a  stimulating  expectorant.  In  typhoid  pneumonia  it  is  a  good 
vehicle  for  carbonate  of  ammonium,  and  in  the  exanthemata  is  extremely 
useful  when  much  depression  exists.  It  is  indicated  in  typhoid  condi¬ 
tions  generally,  and  in  the  amenorrhoea  of  anaemia  and  chlorosis  it  is  an 
efficient  emmenagogue  in  many  cases.  It  will  often  restore  the  waning 
sexual  power  in  functional  impotence,  while  in  bilious  vomiting  it  fre¬ 
quently  checks  the  nausea  and  settles  the  stomach.  It  is  used  as  a 


366 


SESAMI  OLEUM - SEVUM - SILICATES. 


vehicle  for  Cinchona  in  remittent  fever.  In  diphtheria,  scarlatina,  etc., 
the  infusion  forms  an  excellent  gargle.  Its  diaphoretic  and  diuretic  prop¬ 
erties,  though  slight,  are  sometimes  of  avail  in  chronic  rheumatism. 


SESAMI  OLEUM,  Oil  of  Sesamum,  Benne  Oil, — is  a  fixed 
oil  expressed  from  the  seeds  of  Sesamum  indicum ,  or  Benne  plant  (nat. 
ord.  Pedaliaceae),  which  is  a  native  of  India,  but  is  cultivated  in  the 
southern  portion  of  the  U.  S.  It  is  a  yellowish  or  yellow,  oily  liquid, 
inodorous  or  nearly  so,  having  a  bland,  nut-like  taste  and  a  neutral  reac¬ 
tion.  It  is  a  bland  fixed  oil,  very  similar  in  its  properties  to  olive  oil, 
and  may  be  used  for  the  same  purposes.  It  is  rich  in  Olein  (76  percent.) 
and  keeps  better  than  olive  oil.  It  is  chiefly  employed  as  a  hair-oil. 


SEVUM,  Suet  , — is  the  internal  fat  of  the  abdomen  of  Ovis  Aries 
(the  Sheep),  purified  by  melting  and  straining.  It  should  be  kept  in 
well-closed  vessels  and  not  used  after  it  has  become  rancid,  as  it  will  on 
exposure  to  air.  It  is  a  white,  smooth,  solid  fat,  of  bland  taste  and  neu¬ 
tral  reaction,  soluble  in  24  of  boiling  alcohol,  60  of  ether,  and  slowly  in 
2  of  benzin.  It  consists  chiefly  of  Stearin,  but  also  has  Palmitin  and 
Olein,  and  is  a  constituent  of  Unguentum  Hydrargyri  and  Unguentum 
Picis  Liquidae.  It  is  a  harder  fat  than  lard  and  more  liable  to  turn  rancid. 
It  is  used  in  ointments  and  liniments  to  give  them  greater  consistency, 
but  may  be  applied  alone  as  a  dressing  to  ulcers.  In  physiological 
action  and  therapeutics  it  follows  the  other  oils  and  fats  (see  ante ,  pages 
282,  290). 


SILICATES  of  Sodium  (Na2Si03)  of  Potassium  (K2Si03),  and  of 
Magnesium  (2Mg03Si02)  are  used  in  medicine  and  surgery,  a  solution  of 
the  Silicate  of  Sodium  being  official. 

Liquor  Sodii  Silicatis,  Soluble  Glass  Solution — is  a  semi-trans¬ 
parent,  colorless  or  yellowish,  viscid  liquid,  odorless,  of  sharp  saline  and 
alkaline  taste  and  alkaline  reaction,  of  sp.  gr.  1.300  to  1.400.  A  small 
quantity  should  not  produce  any  caustic  effect  when  applied  to  the  skin. 
It  usually  contains  about  20  per  cent,  of  Silica  and  10  per  cent,  of  Soda, 
and  is  used  on  bandages  to  make  immovable  dressings,  being  lighter  than 
plaster-of-Paris  and  stronger  than  starch. 


Liquor  Potassii  Silicatis  (Unofficial), — also  known  as  Soluble  Glass  Solution, — is  used 
for  immovable  dressings  in  the  same  manner  as  the  preceding.  A  mixture  of  2  parts  of 
this  solution  with  one  of  the  soda  salt  solution  is  said  to  set  more  quickly  and  firmly  than 
either  solution  separately.  Diluted  (1  to  4)  the  solution  of  the  Potassium  Silicate  has 
been  applied  locally  in  erysipelas,  gonorrhoea,  cystitis,  vaginitis,  etc.,  as  an  antiseptic,  and 
with  good  results. 


SINAPIS. 


367 


Magnesii  Silicas  Hydratus,  Hydrated  Silicate  of  Magnesium,  Meerschaum,  2MgO, 
3Si02  +  2H20  (Unofficial), — a  mineral  used  for  the  manufacture  of  smoking-pipes,  and 
employed  in  France  as  a  substitute  for  Bismuth  Subnitrate  in  obstinate  choleraic  diarrhoea, 
to  protect  the  intestinal  mucous  membrane  or  as  an  absorbent.  It  is  given  in  fine  powder 
and  in  doses  of  sjj-iv  per  diem. 


SINAPIS,  Mustard  , — is  official  under  the  two  following  titles, 
but  all  the  pharmacopoeial  preparations  are  made  from  Black  Mustard 
only. 

Sinapis  Alba,  White  Mustard, — the  seed  of  Sinapis  Alba ,  an  annual 
plant  of  the  nat.  ord.  Cruciferae,  cultivated  in  our  gardens.  It  has  yellow 
flowers  in  racemes,  and  ribbed  pods  with  a  long,  ensiform  beak.  The 
seeds  are  about  y1^  inch  in  diameter,  yellowish,  hard,  almost  globular  with 
a  circular  hilum ;  embryo  oily,  with  a  curved  radicle  and  two  cotyledons, 
one  folded  over  the  other;  inodorous,  taste  pungent  and  acrid. 


White  Mustard  contains  Myrosin ,  a  ferment,  and  Sinalbin,  a  crystalline  substance, 
which  reacting  on  each  other  in  the  presence  of  water  produce  Sulpho-cyanate  of  Acrinyl, 
a  rubefacient  principle  allied  to  the  volatile  oil  of  black  mustard.  It  also  contains  Sin- 
apine ,  an  alkaloid,  Erucic  or  Brassic  Acid ,  and  a  bland,  fixed  oil,  all  three  contained 
also  in  Black  Mustard. 

1 

Sinapis  Nigra,  Black  Mustard, — is  the  seed  of  Sinapis  nigra ,  an 
annual  plant  of  the  nat.  ord.  Cruciferae,  native  of  Europe  but  naturalized 
in  the  U.  S.  It  has  small,  yellow  flowers  standing  closely  together  on 
peduncles  at  the  end  of  the  branches,  also  smooth,  erect  pods  with  a 
short  beak.  The  seeds  are  about  one-half  the  size  of  those  from  white 
mustard,  black  and  hard,  almost  globular  with  a  circular  hilum ;  embryo 
as  in  Sinapis  Alba;  inodorous  when  dry,  but  when  moist  of  a  pungent, 
irritating  odor  ;  taste  pungent  and  acrid. 

Black  Mustard  contains  Myrosin ,  a  ferment,  and  Sinigrin  (Potassium  Myronate), 
which  reacting  on  each  other  in  the  presence  of  water  produce  the  Snlpho-cyanide  of 
Ally l,  or  Volatile  Oil  of  Mustard.  It  also  contains  Sinapine,  an  alkaloid,  Erucic  or 
Brassic  Acid,  and  a  bland,  fixed  oil;  all  three  of  which  are  contained  also  in  White 
Mustard. 

Commercial  Flour  of  Mustard  (Unofficial), — is  a  mixture  of  white 
and  black  mustard  seeds  ground  to  a  fine  powder.  It  may  be  employed 
in  lieu  of  either  variety.  Dose,  as  emetic,  3 ij— iv. 

Preparations. 

Oleum  Sinapis  Volatile ,  Sulpho-cyanide  of  Allyl,  C4H5NS, — a  colorless  or  pale  yellow 
liquid,  of  very  pungent  and  acrid  odor  and  taste  and  neutral  reaction,  sp.  gr.  i.oiyto 
1. 021,  almost  insoluble  in  water  but  freely  soluble  in  alcohol  and  ether.  Dose, 

Charta  Sinapis ,  Mustard  Paper, — consists  of  Black  Mustard,  the  fixed  oil  removed  by 
percolation  with  Benzin,  mixed  with  Solution  of  Gutta-Percha  and  spread  on  paper. 
Each  square  inch  should  contain  about  gr.  vj  of  Mustard.  For  local  use. 

Linimentum  Sinapis  Composition, — has  of  the  Volatile  Oil  3,  Extract  of  Mezereum  2, 
Camphor  6,  Castor  Oil  15,  Alcohol  to  100  parts.  For  local  use. 


368 


SODIUM. 


Physiological  Action. 

Locally  used,  Mustard  is  rubefacient,  counter-irritant,  and  a  nervous 
stimulant,  causing  heat,  redness  and  severe  burning  pain.  Its  prolonged 
application  produces  vesication  by  inducing  local  inflammation.  Inter¬ 
nally  it  is  a  local  emetic  in  full  doses,  in  smaller  a  condiment  and  carmi¬ 
native.  Its  irritant  effect  on  the  gastric  mucous  membrane  is  much  less 
powerful  than  on  the  skin. 

Therapeutics. 

Mustard  is  commonly  used  as  a  local  application  to  relieve  local  pain, 
to  stimulate  the  viscera,  and  to  produce  counter-irritation.  These  objects 
find  their  application  in  muscular  rheumatism,  neuralgia,  colic,  gastralgia, 
inflammation  of  the  throat,  larynx,  bronchi,  lungs,  pleurae  and  peri¬ 
cardium,  also  as  a  derivative  in  headache,  cerebral  congestion,  and  sup¬ 
pressed  menstruation.  It  may  also  be  used  as  a  stimulant  to  the  heart, 
vascular  system  and  respiratory  apparatus.  When  action  of  a  mild  cha¬ 
racter  is  desired  it  may  be  diluted  with  flaxseed  or  flour. 

Internally  it  may  be  employed  as  an  emetic  in  indigestion  or  narcotic 
poisoning.  Its  use  as  a  condiment  is  familiar,  acting  by  stimulation  of 
the  gastric  mucous  membrane.  In  overdoses  it  may  excite  severe  gastritis. 
White  mustard  seed,  unground,  has  been  used  as  a  laxative,  as  it  pro¬ 
duces  no  irritation. 

The  Oil  is  one  of  the  most  irritant  of  the  volatile  oils,  producing  severe 
gastro-enteritis.  It  is  used  chiefly  as  an  ingredient  of  stimulating  lini¬ 
ments,  but  may  be  employed  internally  in  small  doses. 


SODIUM,  Natrium,  Na. — This  metal  is  not  official,  but  is  repre¬ 
sented  by  a  number  of  official  salts,  which  are  generally  colorless  or  white, 
and  with  very  few  exceptions  are  readily  soluble  in  water.  Some  of  them 
are  found  native,  as  the  Chloride  (in  sea-water,  salt  lakes,  salt  mines), — 
the  Nitrate  (in  Peruvian  deserts,  etc.)  and  the  Borate  (in  lakes  of  Persia, 
California,  etc.).  The  Carbonate  is  found  in  the  ashes  of  marine  plants. 
From  the  Chloride  is  prepared  the  Sulphate,  from  this  the  Carbonate,  and 
from  the  latter  most  of  the  other  salts  are  prepared.  All  sodium  salts 
impart  a  yellow  color  to  flame,  which  should  not  appear  more  than  tran¬ 
siently  red  when  observed  through  a  blue  glass,  which  cuts  off  the  yellow 
rays  but  allows  the  violet  ones  of  Potassium  to  be  seen. 

Sodium  Compounds  and  their  Preparations. 

Soda,  Sodium  Hydrate,  Caustic  Soda,  NaHO, — a  white,  hard,  opaque  solid,  deliques¬ 
cent  in  moist  air,  efflorescent  in  dry  air,  odorless,  of  intensely  acrid  and  caustic  taste  and 
strongly  alkaline  reaction,  soluble  in  1.7  of  water  at  590  F.,and  in  0.8  of  boiling  water, 
very  soluble  in  alcohol.  Is  a  powerful  caustic  but  milder  than  Potassa,  and  should  be 
kept  in  well-stoppered  bottles  made  of  hard  glass. 

Liquor  Sodce,  Solution  of  Soda, — contains  about  5  per  cent,  of  the  hydrate,  and  is  pre 
pared  by  dissolving  180  parts  of  Sodium  Carbonate  in  400  of  boiling  Distilled  Water, 


SODIUM. 


369 


also  60  of  Lime  in  the  same  quantity  of  Distilled  Water,  boiling,  mixing  the  solutions 
gradually,  again  boiling  and  when  cold  adding  water  up  to  1000  parts,  straining,  settling, 
and  then  removing  the  clear  solution.  Or,  by  dissolving  56  of  Soda  in  944  of  Distilled 
Water.  It  is  a  clear,  colorless  liquid,  odorless,  of  acrid  and  caustic  taste  and  strongly 
alkaline.  Dose,  rqv-^ss,  well  diluted  with  water. 

Sodii  Acetas,  Acetate  of  Sodium,  NaC2H302.3H20, — large,  transparent  prisms,  efflo¬ 
rescent  in  dry  air,  odorless,  of  saline,  bitter  taste,  and  a  neutral  or  faintly  alkaline  reaction, 
soluble  in  3  of  water  and  in  30  of  alcohol  at  590  F.,  in  1  of  boiling  water  and  in  2  of 
boiling  alcohol.  Dose,  gr.  xx-^j. 

Sodii  Carbonas,  Carbonate  of  Sodium,  Na2C03.ioH20, — large,  colorless  crystals, 
rapidly  efflorescent,  with  a  harsh  alkaline  taste  and  strongly  alkaline  reaction  ;  very  solu¬ 
ble  in  water,  insoluble  in  alcohol.  By  heat  it  undergoes  aqueous  fusion  and  then  dries 
up,  losing  63  per  cent,  of  its  weight.  Of  it  20  grains  will  neutralize  9.7  grains  of  Citric 
Acid,  or  io*4  grains  of  Tartaric  Acid.  Dose,  gr.  v-xxx. 

Sodii  Carbonas  Exsiccatus ,  Dried  Carbonate  of  Sodium, — is  the  Carbonate  200  parts 
dried  at  a  heat  of  1130  F.,  until  it  is  converted  into  a  white  powder  weighing  100  parts. 
Is  chiefly  used  for  pharmaceutical  purposes. 

Sodii  Bicarbonas,  Bicarbonate  of  Sodium,  NaHC03, — an  opaque,  white  powder, perma¬ 
nent  in  the  air,  odorless,  of  cooling,  saline  taste,  and  a  slightly  alkaline  reaction  ;  soluble  in 
12  of  water  at  590  F.,  insoluble  in  alcohol,  decomposed  by  hot  water.  It  is  distinguished 
from  the  Carbonate  by  its  solution  in  cold  water  giving  a  white  and  not  a  colored  precip¬ 
itate  with  solution  of  perchloride  of  mercury.  Of  it  20  grains  neutralize  16.7  grains  of 
Citric  Acid,  or  17.8  grains  of  Tartaric  Acid.  It  is  a  constituent  of  Mistura  Rhei  et  Sodae 
(see  page  336)  and  of  Pulvis  Effervescens  Compositus  (see  page  323).  Dose,  gr.  x-^j. 

Sodii  Bicarbonas  Venalis ,  Commercial  Bicarbonate  of  Sodium, — should  contain  95 
per  cent,  of  pure  bicarbonate,  which  it  resembles  in  appearance  and  properties.  It  is 
employed  solely  for  external  applications. 

Trochisci  Sodii  Bicarbonatis, — each  troche  contains  of  the  Bicarbonate  3  grains,  with 
Sugar,  Nutmeg  and  Mucilage  of  Tragacanth.  Dose,  as  of  the  bicarbonate. 

Sodii  Chloras ,  Chlorate  of  Sodium,  NaC103, — colorless,  transparent  tetrahedrons  of 
the  regular  system,  permanent  in  dry  air,  odorless;  of  cooling,  saline  taste  and  neutral 
reaction,  soluble  in  I.i  of  water  and  in  40  of  alcohol  at  590  F.,  also  in  0.5  of  boiling 
water  and  in  43  of  boiling  alcohol.  When  heated  it  melts  and  then  gives  off  a  portion 
of  its  oxygen,  leaving  a  residue  of  sodium  chloride.  Should  be  kept  in  well-stoppered 
bottles,  and  should  not  be  triturated  with  readily  oxidizable  or  combustible  substances. 
Dose,  gr.  v-xx. 

Sodii  Chloridum ,  Chloride  of  Sodium,  Common  Salt,  NaCl, — white,  hard,  cubical  crys¬ 
tals  or  a  crystalline  powder,  permanent  in  the  air,  odorless,  of  a  purely  saline  taste  and 
neutral  reaction;  soluble  in  2.8  of  water  at  590  F.,  and  in  2.5  of  boiling  water.  Almost 
insoluble  in  alcohol.  Dose,  gr.  x-^j. 

Sodii  Niiras,  Nitrate  of  Sodium,  Cubic  Nitre,  Chili  Nitre,  Chili  Saltpetre,  NaN03, — 
colorless,  transparent  crystals,  slightly  deliquescent,  odorless,  of  cooling,  saline  and  bitter 
taste,  and  neutral  reaction  ;  soluble  in  1.3  of  water  at  590  F.,  and  in  0.6  of  boiling  water, 
scarcely  soluble  in  cold  alcohol.  Dose,  ^j-ij. 

Sodii  Sulphas ,  Sulphate  of  Sodium,  Glauber’s  Salt,  Na2S04.ioH20, — large,  colorless, 
transparent,  monoclinic  prisms,  rapidly  efflorescent  in  air;  of  cooling,  saline  taste  and 
neutral  reaction;  soluble  in  2.8  of  water  at  590  F.,  in  0.25  of  water  at  91. 40  F.,  and  in 
0.4  of  boiling  water,  insoluble  in  alcohol.  Dose,  gr.  v-xx;  as  purgative  ^ ss— j  or  a 
third  of  a  teaspoonful  in  a  large  glass  of  water. 

Sodii  Ethylas ,  Ethylate  of  Sodium,  Caustic  Alcohol,  C2H5NaO  (Unofficial), — is  a 
white  powder,  often  having  a  brownish  tinge,  dissolving  in  water  with  a  hissing  sound. 
Upon  contact  with  the  smallest  quantity  of  water  or  moist  living  tissue  it  splits  into  alco¬ 
hol  and  caustic  soda.  An  alcoholic  solution  is  made  by  dissolving  sodium  in  absolute 
alcohol,  and  is  used  as  a  caustic.  Chloroform  decomposes  it  at  once  into  ether  and  chlo¬ 
ride  of  sodium.  It  should  be  kept  in  a  cool  place  as  it  is  liable  to  explode. 

The  Arseniate  of  Sodmm  is  described  under  Arsenic,  page  1 16  ; — the  Benzoate  under 
Benzoin,  page  129; — the  Borate  under  Ac.  Boricum,  page  59; — the  Bromide  under 
Bromum,  page  133; — the  Solution  of  Chlorinated  Soda  under  Chlorum,  page  172; — 
the  Iodide  under  Iodum,  page  252; — the  Hypophosphite ,  Phosphate  and  Pyrophosphate 
under  Phosphorus,  page  305  ; — the  Salicylate  under  Salicin,  page  349; — the  Santoni- 
nate  and  its  Troches  under  SANTONICA,  page  355  ; — the  Sulphite ,  Bisulphite  and  Hyposul¬ 
phite  under  Acidum  Sulphurosum,  page  73  ;  and  the  Sulpho-carbolate  under  Carholic 
Acid,  page  61. 

24 


370 


SODIUM. 


Physiological  Action. 

The  action  of  the  Sodium  salts  is  similar  to  that  of  the  Potassium  salts, 
except  that  the  former  are  feebler  as  alkalies,  are  not  so  depressant,  and 
are  not  so  poisonous  to  the  cardiac  muscle  or  the  nerves.  They  are  dif¬ 
fused  more  slowly,  are  neither  absorbed  nor  excreted  so  readily,  and  have 
not  so  marked  a  diuretic  action.  Locally  applied  in  large  doses  to  mus¬ 
cular  and  nervous  tissue  they  are  paralyzant,  but  not  so  powerfully  as 
potassium  salts.  Urate  of  Sodium  is  not  soluble  like  the  urates  of  lithium 
or  potassium,  being  therefore  much  less  readily  excreted,  and  forming 
the  masses  called  “  chalk-stones  ”  in  gouty  subjects.  Soda  is  a  less 
active  escharotic  than  potash,  having  less  affinity  for  water.  Liquor 
Sod^e  renders  the  blood  and  secretions  more  alkaline,  but  does  not  alter 
nutrition  to  the  extent  that  liquor  potassse  does.  The  Acetate  is  con¬ 
verted  into  the  Carbonate  in  the  blood,  and  is  a  less  active  diuretic  than 
the  corresponding  potassium  salt.  The  Carbonate  is  chiefly  used  in 
the  preparation  of  the  other  salts.  The  Bicarbonate  is  slightly  irritant, 
stimulates  the  secretion  of  gastric  juice,  acts  as  an  antacid  and  will 
increase  the  alkalinity  of  the  blood.  The  Chloride  is  a  most  important 
food.  It  exists  normally  in  the  blood,  where  it  keeps  the  fibrin  and 
albumen  in  solution,  and  plays  an  important  part  in  tissue  change.  In 
inflammation,  being  thus  needed,  it  accumulates  at  the  seat  of  the  morbid 
action,  disappearing  from  the  urine ;  its  reappearance  therein  being  a 
sign  of  improvement.  A  solution  of  0.65  part  to  100  of  water  does  not 
destroy  animal  tissues  like  water  alone,  and  may  be  mixed  with  blood 
without  destroying  the  corpuscles,  though  strong  solutions  are  intensely 
irritating.  Internally  used  in  quantity  it  is  emetic  and  hemostatic.  As 
an  enema  it  is  destructive  to  ascarides. 

Nitrate  of  Sodium  is  a  mild  cathartic,  and  in  solution  is  a  solvent  of 
false  membranes.  The  Sulphate  is  generally  cathartic  in  action,  though 
in  small  doses  and  with  little  water  it  may  be  passed  off  by  the  kidneys. 
It  is  mixed  with  the  Bicarbonate  to  imitate  the  salts  obtained  by  evapora¬ 
tion  of  Carlsbad  water.  The  Ethylate  is  antiseptic,  and  a  powerful 
but  almost  painless  caustic. 

[The  actions  of  the  other  Sodium  salts  are  respectively  described  under  the 
titles  of  their  other  constituents,  to  which  their  effects  are  mainly  referable.] 

Antagonists  and  Incompatibles. 

Poisoning  by  caustic  alkalies  is  treated  by  the  dilute  Vegetable  acids,  as  vinegar,  cider, 
lemon-juice ;  then  demulcent  drinks  and  oils  to  protect  the  mucous  membrane,  and  the 
usual  vital  supporters.  The  alkalies  and  their  carbonates  are  incompatible  with  the  acids 
and  also  with  metallic  salts,  and  the  caustic  alkalies  decompose  most  alkaloids. 

Therapeutics. 

The  Sodium  salts  treated  of  in  this  article  are  not  much  used  internally, 
the  corresponding  Potassium  salts  being  preferred,  especially  when  it  is 
desired  to  alkalinize  the  urine  or  to  promote  oxidation.  In  the  alkaline 


SOMNAL. 


371 


treatment  of  stomach  affections  the  Sodium  salts  are  the  most  efficient, 
especially  the  Bicarbonate  before  meals  or  on  an  empty  stomach  to 
increase  the  secretion  of  the  gastric  juice.  This  same  salt  is  used  in 
diabetes  to  lessen  the  amount  of  sugar,  in  frontal  headache  with  constipa¬ 
tion,  the  pain  being  seated  at  the  junction  of  the  forehead  with  the  hairy 
scalp, — also  as  a  wash  (gr.  ij  ad  3j)  in  itching  skin-affections  and  as  a 
lotion  in  burns  and  eczema.  The  Chloride  is  used  internally  as  an 
antidote  in  poisoning  by  Nitrate  of  Silver  and  as  an  emetic,  and  will 
often  relieve  hemoptysis  and  migraine.  In  bilious  diarrhoea  it  is  employed 
in  doses  of  gr.  x-5j,  thrice  daily.  Locally  in  baths  it  is  a  good  stimu¬ 
lant  to  the  skin,  and  in  solution  to  1  per  cent.)  to  wash  wounds  in 
place  of  water,  to  cleanse  the  nasal  cavities,  or  to  destroy  ascarides,  in 
which  case  it  is  given  by  enema  of  the  strength  of  two  tablespoon fuls  to 
the  pint.  The  Carbonate  may  be  used  in  dilute  solution  locally  to  pre¬ 
vent  itching,  but  is  chiefly  employed  in  the  preparation  of  the  other 
salts.  The  Sulphate  is  a  good  purgative,  either  alone  or  with  the  Bicar¬ 
bonate  in  imitation  of  Carlsbad  Salts,  for  bilious  disorders,  gouty  affec¬ 
tions,  chronic  constipation,  obesity  and  diabetes  mellitus.  The  Chlo¬ 
rate  has  similar  uses  to  those  of  the  Potassium  Chlorate,  but  being  more 
soluble  can  be  used  in  stronger  solutions,  but  this  is  of  doubtful  benefit 
for  internal  use  as  it  has  all  of  the  irritating  power  on  the  kidneys  and 
destructive  action  on  the  blood  possessed  by  the  other  salt.  (See  a?ite , 
page  324.)  The  Nitrate  is  employed  as  a  mild  cathartic,  and  in  solu¬ 
tion  by  atomization  to  destroy  the  false  membrane  in  croup.  .  The 
Ethylate  has  been  of  service  as  a  caustic  in  cancer,  lupus  and  naevi,  for 
the  latter  affection  being  painted  over  the  growth  with  a  glass  rod. 
Caustic  Soda  is  a  better  caustic  than  Potassa  as  it  has  less  affinity  for 
water  and  hence  does  not  destroy  the  tissues  so  deeply,  nor  has  it  the 
same  tendency  to  run  over  adjacent  parts. 

[The  therapeutics  of  the  other  Sodium  Compounds  are  described  as 
noted  on  page  370.] 

SOMNAL,  QH12CI3O3N,  isa  new  hypnotic,  introduced  by  a  German 
manufacturer,  and  formed  by  the  union  of  Chloral,  Alcohol  and  Urethan, 
the  result  being  a  complex  body,  and  not  a  simple  mixture.  It  is  a  color¬ 
less  liquid,  resembling  chloroform  in  its  behavior  with  cold  water,  with 
which  it  forms  globules  and  refuses  to  mix  or  dissolve.  It  is  soluble  in 
hot  water  in  alcoholic  solutions  and  in  alcohol,  3  parts  in  1.  The  ad¬ 
vantage  claimed  for  Somnal  is  that  when  administered  in  20-grain  doses 
it  induces  within  half  an  hour  a  quiet  sleep  lasting  from  six  to  eight 
hours  without  any  inconvenient  after-  or  by-effects. 

Doses  of  45  and  even  60  minims  produced  no  depression  of  the  circulation  or  respira¬ 
tion.  In  doses  of  3  ss  its  action  is  usually  very  prompt,  the  dose  is  well  borne  always, 
easily  taken  (in  a  little  syrup  of  tolu  or  whiskey),  and  entirely  without  deleterious  effect. 


372 


SPIGELIA - STAPHISAGRIA. 


The  effects  are  much  more  striking  and  certain  than  those  of  urethane,  and  far  less  de¬ 
pressing  than  those  of  chloral ;  and  there  is  no  vertigo  or  depression,  as  may  follow  the 
use  of  Sulphonal.  In  drachm-doses,  this  drug  is  not  powerful  enough  to  decidedly  con¬ 
trol  delirium  tremens,  maniacal  delirium  or  severe  pain.  (Dr.  Gilman  Thompson.) 

SPIGELIA,  Pink-root  , — is  the  rhizome  and  rootlets  of  Spigelia 
marilandica ,  the  Carolina  Pink,  an  herbaceous  perennial  of  the  nat.  ord. 
Loganiaceae,  native  of  the  southern  states  ;  having  large,  showy  flowers, 
scarlet  or  crimson  externally,  yellow  within.  The  rhizome  is  2  inches 
long,  inch  thick,  horizontal,  bent  and  branched;  having  cup-shaped 
scars  above  and  numerous  thin  rootlets  below.  It  contains  a  bitter  prin¬ 
ciple  and  a  volatile  oil,  also  tannin,  wax,  resin,  lignin  and  salts.  Dose, 
5j-ij  for  an  adult,  gr.  x-xx  for  a  child  of  3  years. 

Preparations. 

Extraction  Spigelice  Fluidum , — Dose  for  an  adult,  z  j-ij ;  for  a  child  of  3  years,  ttyx-xx. 

Infusum  Spigelice  Composition,  Worm  Tea  (Unofficial), — has  of  Spigelia  15,  Senna 
10,  Fennel  10,  Manna  30,  Water  500.  Dose,  3  iss-v. 

Spigelia  is  anthelmintic  against  the  round  worm  (Ascaris  lumbricoides), 
and  is  in  popular  use  as  a  vermifuge,  administered  usually  with  Senna.  In 
large  doses  it  is  an  uncertain  cathartic,  and  may  produce  quite  serious 
symptoms,  as  vertigo,  dimness  of  vision,  dilated  pupils,  spasms  and  even 
convulsions.  These  effects  are  most  apt  to  occur  when  the  drug  fails  to 
produce  purgation,  hence  it  is  usually  administered  with  an  active 
cathartic. 

Spigelia  Anthelmia,  the  Demarara  Pink-root,  or  Worm-grass,  pro¬ 
duces  vomiting,  dilated  pupils,  dyspnoea,  convulsions,  and  death.  If 
eaten  by  cattle  they  perish  in  great  agony.  It  has  been  used  with  real 
benefit  in  cardiac  affections  of  rheumatic  origin,  also  in  rheumatic  fever, 
and  in  cardiac  palpitation  with  dyspnoea,  due  to  mitral  and  aortic  disease. 
A  tincture  (1  to  8)  may  be  used  in  doses  of  upv-xx. 

STAPHISAGRIA,  Stavesacre, — is  the  seed  of  Delphinium  Sla- 
phisagria ,  an  annual  or  biennial  plant  of  the  nat.  ord.  Ranunculaceae,  a 
native  of  Europe,  having  bluish  or  purple  flowers,  in  terminal  racemes ; 
and  seeds  in  straight,  oblong  capsules.  The  seeds  contain  an  alkaloid 
Delphinine,  probably  3  other  alkaloids,  a  bitter  principle,  a  volatile  oil  and 
a  fixed  oil,  etc.  There  are  no  official  preparations. 

Preparations. 

Unguentum  Staphisagrice  (Unofficial), — contains  of  the  powdered  seeds  1  part  with  2 
each  of  olive  oil  and  lard. 

Delphinina,  Delphinine,  C22H35N06  (Unofficial), — is  the  active  alkaloid,  and  exists  in 
the  fatty  oil  which  is  extracted  by  ether.  Dose,  gr.  A-j. 

Stavesacre  is  a  violent  emetic  and  cathartic,  also  parasiticide.  The 
alkaloid  is  irritant  to  the  skin  if  locally  used,  producing  tingling,  burn¬ 
ing,  and  inflammation.  Internally,  it  lowers  the  activity  of  the  heart 


STILLINGIA. 


373 


and  respiration  and  produces  a  most  profound  adynamia,  and  may  prove 
fatal  from  paralysis  of  the  spinal  cord  and  asphyxia.  In  many  respects 
its  alkaloid  resembles  Aconitine  and  Veratrine. 

The  ointment  is  often  employed  as  a  parasiticide  against  pediculi  and 
the  acarus  scabies.  The  fixed  oil  is  probably  equally  effective.  Delphi- 
nine  has  been  used  internally  in  asthma,  rheumatism  and  neuralgia,  and 
in  the  latter  affection  is  well  employed  as  an  ointment  (gr.  xx  to  5j)> 
applied  over  the  course  of  painful  superficial  nerves.  It  has  been  sug¬ 
gested  as  an  antipyretic  and  for  dropsy.  A  tincture  or  fluid  extract  is  a 
very  efficient  application  against  pediculi. 

STILLINGIA,  Queen’s  Root, — is  the  root  of  Stillingia  sylvatica, 
or  Queen’s  Delight,  an  indigenous,  perennial  plant  of  the  nat.  ord. 
Euphorbiacese,  with  yellow  flowers  on  a  spike,  and  a  large,  thick  and 
woody  root,  of  peculiar  and  unpleasant  odor,  and  an  acrid,  pungent, 
bitter  taste.  It  contains  a  resin  and  a  volatile  oil,  but  its  active  principle 
has  not  yet  been  isolated.  The  fresh  root  should  be  used  in  making  the 
preparations,  as  those  from  the  dried  root  are  almost  inactive.  Dose  of 
the  powdered  root,  gr.  x-5j. 

Preparations. 

Extractum  Stillingice  Fluidum , — Dose,  rrpx-^j. 

Tindura  Stillingice  (Unofficial), — Dose,  3 ss— ij. 

Decodum  Stillingice  (Unofficial), —  ad  Oj.  Dose,  5 j-ij . 

Syrupus  Stillingice  Compositus  (Unofficial), — is  composed  of  Stillingia,  Corydalis,  Iris, 
Chimaphila,  Coriander,  Xanthoxylum,  Sambucus,  Sugar,  Water  and  Alcohol.  For  the 
formula,  see  U.  S.  Disp.,  page  1363. 

Physiological  Action. 

Stillingia  in  large  doses  is  emetic  and  cathartic,  in  smaller  doses  it  is 
expectorant,  diaphoretic,  diuretic,  sialagogue  and  cholagogue,  possessing 
the  various  properties  which  are  considered  “alterative.”  Its  taste  is 
acrid  and  pungent,  and  it  increases  the  action  of  the  heart,  skin,  kidneys, 
and  bronchial  mucous  membrane;  and  the  gastric,  hepatic,  intestinal  and 
salivary  excretions.  Full  doses  often  excite  epigastric  pain,  nausea  and 
vomiting. 

Therapeutics. 

Stillingia  is  much  employed  with  Sarsaparilla  and  similar  acting  drugs 
as  an  alterative  in  syphilitic  affections,  particularly  in  chronic  cases  of 
the  tertiary  form,  in  which  the  system  is  greatly  reduced  by  the  abuse  of 
mercurials  and  iodides.  In  these  cases  it  possesses  considerable  power 
and  frequently  cures.  It  is  also  valuable  in  strumous  affections,  in  ascites 
due  to  hepatic  changes,  portal  congestions  with  jaundice  following  mala¬ 
ria,  habitual  constipation,  hemorrhoids  from  hepatic  obstruction,  and 
intermittents.  In  the  latter  affection  the  fluid  extract  with  Quinine  or 
Arsenic  is  a  very  useful  combination.  A  strong  decoction  is  used  toward 
off  an  impending  paroxysm  of  ague. 


374 


STRAMONIUM. 


STRAMONIUM,  Thornapple.  — The  plant  Datura  Stramonium , 
Jamestown  Weed  or  Thornapple  (nat.  ord.  Solanaceae),  is  official  in  two 
forms,  the  leaves  and  the  seed.  It  is  an  annual,  of  rank  and  vigorous 
growth,  having  a  green  stem  with  large  white  flowers,  and  numerous  seeds 
in  a  large,  fleshy,  four-celled  capsule,  open  at  the  summit.  It  grows  wild 
in  Southern  Russia  and  the  middle  United  States,  and  contains  an  alka¬ 
loid,  Daturine ,  which  is  generally  considered  identical  with  Atropine 
both  physiologically  and  chemically, — also  malic  acid,  albumen,  gum, 
resin,  etc. 

Stramonii  Folia, — the  leaves  of  Datura  Stramoniutn,  are  about  6 
inches  long,  smooth,  petiolate,  ovate,  pointed,  unequal  at  the  base,  coarsely 
toothed,  of  bitter  and  nauseous  taste.  Dose,  gr.  ij-xx. 

Stramonii  Semen, — the  seed  of  Datura  Stramonium,  is  about 
inch  long,  reniform,  flattened,  pitted  and  wrinkled,  the  testa  blackish 
and  hard,  enclosing  a  curved  embryo  embedded  in  whitish,  oily  albu¬ 
men  ;  of  unpleasant  odor  when  bruised  and  an  oily,  bitter  taste.  Dose, 
gr.  j.  The  official  preparations  are  all  made  from  the  seed. 

Preparations. 

Extra ctum  Stratnonii, — Dose,  gr 

Extraction  Stramonii  Fluidum , — Dose,  TT\j-v. 

Tinctura  Stramonii , — io  per  cent.  Dose,  ftp  v-xxx. 

Unguentum  Stramonii , — has  of  the  Extract  io,  Water  5,  Benzoinated  Lard  85  parts. 

Daturina,  Daturine,  C17H23N03  (Unofficial), — is  the  alkaloid  found  in  all  parts  of 
the  plant,  also  in  Datura  Tatula.  It  is  a  Tropate  of  Tropin,  isomeric  and  identical  with 
Atropine.  Dose,  gr. 

Physiological  Action. 

The  action  of  Stramonium  is  similar  to  that  of  Belladonna  in  almost 
every  particular,  except  that  Stramonium  is  more  powerful  and  chiefly 
influences  the  sympathetic  nervous  system,  not  affecting  the  motor  or  sen¬ 
sory  nerves.  It  excites  a  greater  degree  of  cardiac  irregularity  and  a 
more  furious  delirium,  and  seems  to  have  a  special  affinity  for  the  gen¬ 
erative  apparatus,  being  decidedly  aphrodisiac  in  full  doses.  [Compare 
Belladonna,  ante,  page  126.] 

As  previously  stated  the  alkaloids,  Atropine,  Daturine,  Hyoscyamine, 
and  Duboisine  are  chemically  alike  and  almost  identical  physiologically. 
They  all  produce  dilatation  of  the  pupil,  increase  the  cardiac  action,  the 
pulse  and  respiration  rate,  and  cause  delirium.  Poisoning  by  one  of  them 
is  indistinguishable  from  that  by  another. 

Antagonists  and  Incompatibles. 

These  are  the  same  as  for  Belladonna.  Poisoning  by  Stramonium  is  not  uncommon,  as 
children  may  eat  the  seeds,  which  should  be  evacuated  by  an  emetic.  If  physiological 
symptoms  follow  Opium  must  be  exhibited  as  the  antagonist,  but  cautiously,  lest  opium- 
narcosis  be  substituted. 

Therapeutics. 

Stramonium  is  chiefly  used  as  an  antispasmodic  and  to  relieve  pain.  In 
asthma  the  leaves  are  smoked  with  advantage  at  the  commencement  of  a 


STROPHANTHUS. 


375 


paroxysm,  the  smoke  being  drawn  into  the  lungs.  In  other  spasmodic 
affections,  as  hepatic  colic,  laryngeal  cough,  chorea  and  stammering,  it  is 
very  beneficial.  In  dysmenorrhcea  and  neuralgia  it  is  used  in  combina¬ 
tion  with  Opium  and  Hyoscyamus,  and  in  tic  douloureux  and  sciatica  it 
is  often  very  efficient.  In  nymphomania  with  great  mental  depression  it 
is  often  very  effective,  and  in  mania  of  furious  character,  particularly  the 
puerperal  form  with  suicidal  tendency,  it  is  highly  serviceable  in  10-20 
minim  doses  of  the  tincture  every  3  or  4  hours.  The  ointment  is  much 
used  in  irritable  ulcers,  and  as  an  anodyne  application  in  painful  hemor¬ 
rhoids  and  certain  cutaneous  diseases. 


STROPHANTHUS, — is  the  seed  of  Strophanthus  hispidus ,  an  Af¬ 
rican  climbing  plant  (nat.  ord.  Apocynacese),  from  which  the  natives 
extract  a  toxic  preparation  known  as  the  Kombd  arrow-poison.  It  con¬ 
tains  a  crystalline  glucoside,  named  Strophanthin ,  the  active  principle, 
which  is  bitter,  slightly  acid,  soluble  in  water  and  in  alcohol,  but  almost 
insoluble  in  ether,  chloroform,  benzin,  etc.  It  is  very  plentiful  in  the 
seeds  (8  to  10  per  cent.),  and  is  an  agent  of  great  energy,  the  frog  being 
killed  by  a  solution  of  1  in  10,000,000.  (Denian.) 

Preparations. 

Professor  Frazer  recommends  the  tincture. 

Tinclura  Strophanthi  (1  in  20), — Dose,  rr^v-x,  or  rrp^-ij  frequently  repeated.  A 
stronger  tincture  (i  in  8)  is  on  the  market. 

Strophanthinum,  Strophanthin, — Dose,  gr.  hypodermically,  gr.  has  been 

used,  the  influence  of  the  one  injection  upon  the  circulation  lasting  at  least  8  days. 

Physiological  Action. 

Strophanthus  acts  primarily  upon  muscular  tissue,  by  direct  contact 
through  the  blood,  and  with  great  energy.  It  increases  the  contractile 
power  of  all  striped  muscle,  and  in  poisonous  quantity  it  fixes  the  muscu¬ 
lar  contraction  into  a  condition  of  tetanic  permanence,  the  muscle  being 
unable  to  resume  its  normal  condition  of  partial  flexibility.  As  the  heart 
receives  much  more  blood  in  a  given  time  than  any  other  muscle  in  the 
body,  it  is  quickly  and  markedly  affected  by  the  strophanthus-charged 
fluid,  and  by  regulating  the  dosage,  the  cardiac  muscle  may  alone  be 
affected,  by  a  quantity  which  would  not  influence  the  other  muscles. 

Small  doses  stimulate  the  cardiac  contractions,  increasing  the  force  of 
the  ventricular  systole,  and  lowering  the  rate  of  the  heart-beats.  At  the 
same  time  the  general  blood-pressure  is  raised,  and  diuresis  produced, 
both  being  due  to  the  vis  a  tergo , — the  direct  stimulation  of  the  circulation 
from  behind.  Large  doses  paralyze  the  heart  in  systole,  and  leave  the 
cardiac  muscle  in  a  state  of  contraction  resembling  cadaveric  rigidity.  It 
does  not  act  through  the  nervous  system,  but  paralyzes  muscular  tissue, 
striated  and  non-striated,  by  direct  contact ; — and  when  contractility  has 


376 


STYRAX. 


been  once  destroyed  thereby,  no  stimulus  will  re-excite  it.  It  does  not 
affect  the  vascular  system  directly. 

Compared  with  Digitalis,  then,  we  have  in  Strophanthus  a  much  more 
powerful  cardiac  stimulant,  differing  from  Digitalis  in  not  producing  any 
vaso-motor  constriction  of  the  arterioles.  It  reduces  the  pulse,  lowers 
body-temperature  somewhat,  is  not  cumulative  in  action,  and  does  not 
cause  any  gastro-intestinal  disturbance.  It  is  diuretic,  by  direct  stimula¬ 
tion  of  the  renal  circulation  ;  and  has  power  over  rigors,  by  its  rapid 
cardiac  action,  stopping  them,  and  preventing  their  recurrence. 

Therapeutics. 

Strophanthus  is  the  most  valuable  of  the  cardiac  stimulants,  from  the 
rapidity  and  permanence  of  its  action,  as  well  as  its  non-interference  with 
the  calibre  of  the  peripheral  vessels.  It  relieves  cardiac  dyspnoea  in  a  few 
minutes,  in  less  than  an  hour  it  modifies  the  pulse-rate,  and  the  influence 
of  a  single  dose  upon  the  circulation  persists  for  a  very  long  time.  It  is 
certain  to  replace  Digitalis  in  the  treatment  of  chronic  Bright’s  disease 
and  valvular  lesions  of  the  heart,  where  it  is  important  that  the  work  of 
the  heart  should  not  be  increased  by  any  additional  resistance  in  the 
arterial  system. 

Strophanthus  has  been  exceedingly  useful  in  the  treatment  of  Bright’s 
disease,  for  the  dyspnoea,  orthopnoea,  dropsy  and  uraemia  ;  also  in  mitral 
insufficiency,  with  great  anasarca  and  dyspnoea ;  in  palpitation,  exagge¬ 
rated  cardiac  action,  and  in  weak  heart,  and  for  exophthalmos,  with 
tumultuous  action  of  the  heart ;  also  pulmonary  oedema,  due  to  valvular 
lesions,  or  to  pneumonia.  It  is  useful  in  endocarditis,  also  in  atheroma 
of  the  arteries ;  in  reflex  palpitation  of  neurasthenia,  hysteria  and  chlo¬ 
rosis,  and  for  rigors  due  to  catheterization,  or  operations  on  the  urethra. 


STYRAX,  Storax  , — is  a  balsam  prepared  from  the  inner  bark  of 
Liquidambar  orientalis ,  the  Oriental  Sweet-gum,  a  tree  of  the  nat.  ord. 
Hamamelaceae,  growing  in  Asia  Minor.  It  is  semi-liquid,  sticky,  opaque 
and  gray-colored,  of  agreeable  odor  and  balsamic  taste,  completely 
soluble  (except  accidental  impurities)  in  an  equal  weight  of  warm  alcohol. 
It  consists  of  a  volatile  oil  named  Styrol ,  C8H8, — a  crystalline  solid 
Styracin ,  which  is  a  cinnamate  of  cinnamic  ether, — two  peculiar  resins, 
one  hard,  the  other  soft, — and  Cinnatnic  Acid ,  C9H902,  a  colorless,  odor¬ 
less,  crystalline  body,  closely  allied  to  Benzoic  Acid,  excreted  in  the 
urine  partly  as  Hippuric  Acid,  and  occurs  also  in  the  Balsams  of  Peru  and 
Tolu.  Dose  of  Storax,  gr.  v-xx. 

Preparation. 

Tinctura  Benzoini  Composita ,  Friar’s  Balsam, — contains  8  per  cent,  of  Storax.  (See 
ante,  page  129.)  Dose,  gss-ij. 


SUCCINUM - SULPHUR  AND  SULPHIDES. 


377 


Storax  is  a  stimulant  expectorant,  an  antiseptic  and  a  disinfectant, 
acting  both  locally  and  remotely,  like  Benzoin  and  the  Balsams  of  Tolu 
and  Peru.  It  is  used  with  benefit  in  chronic  bronchitis  and  other  affec¬ 
tions  of  the  respiratory  organs,  also  in  chronic  catarrhs  of  the  genito¬ 
urinary  passages,  in  gonorrhoea  and  in  amenorrhcea.  Externally  it  is 
employed  in  ointment  as  a  detergent  for  foul  ulcers,  and  as  a  parasiticide 
for  scabies  and  phthiriasis. 


SUCCINUM,  Amber,— the  source  of  the  official  Oil  of  Amber,  is 
a  fossil  resin,  occurring  in  alluvial  deposits,  chiefly  in  Prussia,  Bohemia, 
and  Courland.  It  is  usually  associated  with  lignite,  sometimes  encloses 
insects  and  parts  of  vegetables,  and  consists  of  a  volatile  oil,  a  yellow 
resin,  another  resin,  succinic  acid  and  a  bituminous  principle.  Its 
source  is  thought  to  be  an  extinct  coniferous  tree,  the  Pinites  succinifer , 
of  which  amber  represents  the  exudation. 

Preparation. 

Oleum  Succini ,  Oil  of  Amber, — is  a  volatile  oil  obtained  by  the  destructive  distillation 
of  Amber,  and  purified  by  subsequent  rectification ; — a  colorless  or  pale  yellow,  thin 
liquid,  of  sp.  gr.  about  0.920,  of  empyreumatic  and  balsamic  odor,  a  warm,  acrid  taste, 
and  a  neutral  or  faintly  acid  reaction,  and  readily  soluble  in  alcohol.  Dose,  gtt.  v-x. 

Oil  of  Amber  is  stimulant,  antispasmodic  and  diuretic,  when  used 
internally.  Externally  it  is  irritant  and  rubefacient.  It  has  been  em¬ 
ployed  with  benefit  in  epilepsy,  hysteria,  convulsions,  amenorrhcea, 
whooping-cough,  etc.  As  a  liniment  it  is  often  used  in  chronic  rheuma¬ 
tism,  and  has  been  applied  along  the  spine  in  infantile  convulsions,  mixed 
with  an  equal  part  of  laudanum  and  diluted  with  olive  oil  or  brandy. 


SULPHUR,  and  SULPHIDES. — The  non-metallic  element  Sul¬ 
phur,  S,  is  a  brittle  solid  of  a  pale  yellow  color,  permanent  in  the  air,  of 
crystalline  texture  and  susceptible  of  several  allotropic  states,  which  are 
for  the  most  part  induced  by  heat.  It  is  obtained  native  in  several  vol¬ 
canic  districts,  or  from  the  native  Sulphides  of  Iron  and  Copper  (iron 
and  copper  pyrites)  by  roasting,  as  it  sublimes  at  about  238°  F.  It  is 
official  in  three  forms,  viz.: 

Sulphur  Sublimatum,  Sublimed  Sulphur,  S, — is  prepared  from 
crude  Sulphur  by  sublimation  and  condensation.  It  is  a  fine  citron-yel¬ 
low  powder,  of  faintly  acid  taste  and  acid  reaction,  insoluble  in  water  or 
alcohol.  Ignited  it  burns  with  a  blue  flame,  forming  sulphurous  acid  gas, 
and  leaving  no  residue  or  only  a  trace.  Dose,  gr.  x-xx-lx. 

Sulphur  Lotum,  Washed  Sulphur,  S, — prepared  by  digesting  sub¬ 
limed  Sulphur  with  dilute  Water  of  Ammonia,  thoroughly  washing  with 
water  and  passing  through  a  No.  30  sieve.  In  this  process  the  Ammonia 


37§ 


SULPHUR  AND  SULPHIDES. 


dissolves  out  any  Sulphide  of  Arsenic  which  may  be  present  and  neutral¬ 
izes  any  Sulphurous  or  Sulphuric  Acid.  [For  solubility  and  dose  see  S. 
Pr^cipitatum,  below.] 

Sulphur  Praecipitatum,  Precipitated  Sulphur,  Lac  Sulphuris,  Milk 
of  Sulphur,  S, — prepared  by  boiling  sublimed  Sulphur  with  slaked  lime 
and  water,  thus  forming  the  Sulphide  and  Hyposulphite  of  Calcium. 
These  are  then  decomposed  by  HC1,  and  Sulphur  is  precipitated  as  a  very 
fine  powder  which  is  next  washed  until  the  washings  are  tasteless,  and  it 
is  dried  with  a  gentle  heat.  The  result  is  a  very  fine,  yellowish-white, 
amorphous  powder,  odorless  and  almost  tasteless,  insoluble  in  water  or 
alcohol,  but  completely  soluble  in  disulphide  of  carbon  or  a  boiling  solu¬ 
tion  of  soda.  By  heat  it  is  completely  volatilized.  Dose,  gr.  x-3j. 

Preparations  of  Sulphur. 

Unguentum  Sulphuris, — has  of  Sublimed  Sulphur  30,  Benzoinated  Lard  70  parts, 
rubbed  together. 

Unguentum  Sulphuris  Alkalinum , — has  of  Washed  Sulphur  20,  Potassium  Carbonate 
10,  Water  5,  Benzoinated  Lard  65  parts,  thoroughly  rubbed  together. 

Pulvis  Glycyrrhizce  Compositus  (see  ante ,  page  228)  contains  8  per  cent,  of  Sulphur 
Lotum ;  and  Emplastrum  Ammoniaci  cum  Hydrargyro  (see  ante,  page  93)  contains  I 
per  1000  of  Sulphur  Sublimatum. 

Sulphuric  Acid  is  described  under  Acidum  Sulphuricum,  ante,  page  72;  Sulphurous 
Acid  and  the  Sulphites  under  Acidum  Sulphurosum ,  ante,  page  73.  The  Sulphates  are 
noted  under  the  titles  of  their  respective  bases. 

Ichthyol , — is  a  preparation  obtained  from  a  bitumen  found  in  the  Tyrol,  and  regarded  as 
the  residue  of  extinct  fishes.  It  contains  Sulphur  in  the  proportion  of  about  10  per  cent., 
is  soluble  in  a  mixture  of  Ether  and  Alcohol  mixes  with  vaseline,  oils  and  lard,  and  is 
non-irritant  to  the  skin.  For  local  use,  in  a  10  to  20  per  cent,  ointment. 

Sulphides  and  their  Preparations. 

Calcii  Sulphidum,  Sulphide  of  Calcium,  CaS  (Unofficial), — is  the  preparation  named 
“  Hepar  Sulphuris,  Liver  of  Sulphur,”  by  the  homceopathists,  who  prepare  it  by  mixing 
equal  parts  of  powdered  oyster-shell  and  sublimed  sulphur,  and  heating  at  a  white  heat 
in  a  crucible  hermetically  sealed.  It  is  a  constituent  of  the  following  official  compound, 
viz.: 

Calx  Sulphurata ,  Sulphurated  Lime, — is  commonly  misnamed  Sulphide  of  Calcium. 
It  is  a  mixture  of  Calcium  Sulphide  and  Calcium  Sulphate,  CaS  -f-  CaS04,  in  varying  pro¬ 
portions,  but  containing  not  less  than  36  per  cent,  of  the  former,  and  is  prepared  by  heat- 
ing  together  in  a  closed  crucible  Powdered  Lime  100  parts  and  Precipitated  Sulphur  90 
parts,  at  a  low  red  heat  for  one  hour.  The  result,  rubbed  to  powder,  is  grayish-white,  of 
offensive  taste  and  alkaline  reaction,  very  slightly  soluble  in  water,  insoluble  in  alcohol. 
Dose,  gr.  ^4. 

Potassa  Sulphurata,  Sulphurated  Potassa, — formerly  called  Hepar  Sulphuris, — is  a 
mixture  of  Potassium  Trisulphide  with  small  quantities  of  Potassium  Hyposulphite  and 
Sulphate,  formed  by  heating  together  1  part  of  Sublimed  Sulphur  with  2  of  Potassium 
Carbonate,  until  melted.  Of  a  liver-brown  color  gradually  changing  with  age  to  a  greenish- 
or  brownish-yellow,  of  disagreeable  odor,  alkaline  and  repulsive  taste  and  alkaline  reaction. 
Soluble  in  2  of  water,  excepting  a  small  residue,  partly  soluble  in  alcohol.  Dose,  gr. 
ij-x,  in  pill  or  solution. 

Sulphuris  Iodidum,  Iodide  of  Sulphur,  Iodine  Disulphide,  I.2S2, — is  prepared  by  fusing 
together  Washed  Sulphur  1  part,  and  Iodine  4.  It  is  a  grayi>h-black  crystalline  solid,  having 
the  odor  of  iodine,  an  acrid  taste  and  a  faintly  acid  reaction,  insoluble  in  water,  but  very 
soluble  in  disulphide  of  carbon  and  in  about  60  of  glycerin.  Alcohol  and  ether  dissolve 
out  the  iodine,  leaving  the  sulphur.  Only  used  as  ointment,  gr.  xxx  to  the  5 . 

Hydrogen  Sulphide,  Sulphuretted  Hydrogen,  Id2S  (Unofficial), — is  used  only  as  a 
test.  It  is  a  colorless  gas  having  the  smell  of  rotten  eggs,  prepared  by  the  action  of  dilute 
Sulphuric  Acid  on  Sulphide  of  Iron  ;  the  gas  being  passed  into  water  a  solution  is  obtained. 


SULPHUR  AND  SULPHIDES. 


379 


It  precipitates  most  of  the  metals  from  acid  solutions  as  sulphides,  that  with  Arsenic 
being  yellow;  with  Antimony,  orange ;  with  Cadmium,  yellow ;  with  Copper,  Lead, 
Mercury  and  Silver,  black ;  with  Bismuth,  brown  ;  with  Gold  and  Platinum,  brownish- 
black. 

Bisulphide  of  Carbon  is  described  under  Carbo,  ante,  page  1 54  ;  Sulphide  of  Antimony 
and  Sulphurated  Antimony  under  Antimonium,  ante ,  page  102. 


Physiological  Action. 

Sulphur  is  a  mild  laxative  and  a  diaphoretic.  In  contact  with  living 
protoplasm  it  enters  into  combination  and  produces  either  sulphuretted 
hydrogen  or  sulphurous  acid ;  taken  into  the  intestinal  canal  a  large  por¬ 
tion  passes  out  unchanged,  some  of  it  being  converted  by  the  alkaline  bile 
into  sulphuretted  hydrogen  and  sulphides.  The  former  is  excreted  by 
the  lungs,  giving  to  the  breath  the  smell  of  rotten  eggs,  and  by  the  skin, 
discoloring  silver  articles  carried  about  the  person  by  forming  a  sulphide 
of  silver.  The  Sulphides  are  partly  absorbed  into  the  blood,  and  are 
excreted  in  the  urine,  chiefly  as  sulphates,  and  in  the  faeces,  which  they 
blacken  and  render  soft.  Given  in  full  doses  they  are  irritant  to  the 
stomach  and  intestines,  extremely  nauseous  to  the  taste  and  smell,  increase 
the  secretions  of  the  intestinal  glands,  and  peristaltic  action,  and  if  used 
for  any  length  of  time  they  impair  the  blood,  causing  anaemia,  emacia¬ 
tion,  tremor  and  great  debility. 

Sulphuretted  Hydrogen  is  very  destructive  to  plant  life,  and  in  ani¬ 
mals  it  destroys  the  tissue  functions,  decomposing  the  blood  and  para¬ 
lyzing  the  nervous  and  the  muscular  systems.  The  symptoms  of  poisoning 
are  those  of  asphyxia;  muscular  tremors  occur  and  are  followed  by  con¬ 
vulsions  and  death.  This  gas  is  often  found  in  cesspools  in  large  quantities, 
but  in  one  case  poisoning  occurred  from  its  excessive  formation  in  the 
intestines  and  subsequent  absorption  into  the  blood. 

Calx  Sulphurata  and  Potassa  Sulphurata  act  like  the  sulphides  as 
local  irritants  and  in  large  doses  as  irritant  poisons,  producing  narcotic 
symptoms  and  convulsions.  In  small  doses  they  act  like  sulphur  and  are 
supposed  by  many  observers  to  have  a  peculiar  influence  on  suppuration 
to  limit  or  prevent  it  if  given  in  small  doses  frequently  repeated. 

The  Iodide  is  believed  to  possess  some  of  the  properties  of  both  its 
elements.  It  is  doubtful  whether  it  is  a  distinct  chemical  compound  or 
merely  a  physical  mixture.  As  a  parasiticide  it  is  very  efficient,  and  has 
been  found  remarkably  alterative  in  many  local  affections  of  chronic  char¬ 
acter,  but  may  prove  very  irritant  to  the  skin  if  improperly  prepared. 

[The  actions  of  Sulphuric  Acid,  Sulphurous  Acid  and  the  Sulphites 
are  respectively  described  on  pages  72  and  73,  ante.~\ 

Antagonists  and  Incompatibles. 

Solutions  of  the  Sulphides  are  decomposed  by  the  mineral  acids  and  by  solutions  of 
metallic  salts.  Antidotes  are  Chlorine-water,  Chlorides  of  Sodium  and  Potassium,  Sul¬ 
phate  of  Iron,  etc.  Poisoning  by  Sulphuretted  Hydrogen  is  best  treated  by  artificial 
respiration. 


SUMBUL. 


38O 

Therapeutics. 

Sulphur  is  chiefly  used  as  a  laxative  when  pultaceous  rather  than  liquid 
stools  are  required,  as  in  hemorrhoids,  anal  fissure,  or  constipation. 
Scabies  has  long  been  treated  by  its  local  and  internal  use,  but  sulphur 
alone  does  not  kill  the  itch  insect.  The  older  sulphur  ointments  were 
made  with  sublimed  sulphur,  and  probably  contained  a  considerable 
amount  of  sulphurous  acid  on  which  their  parasiticide  property  depended. 
The  recent  ointments,  made  with  purified  sulphur,  all  contain  an  alkaline 
ingredient  and  develop  sulphides  which  are  powerful  insect  poisons. 
Sulphur  fumigations  are  practically  applications  of  volatile  sulphurous 
acid,  while  most  of  the  sulphur  baths  and  mineral  waters  are  solutions  of 
sulphuretted  hydrogen  or  of  the  alkaline  sulphides.  They  are  of  value  in 
lead  poisoning  to  favor  the  elimination  of  that  metal,  in  chronic  consti¬ 
pation,  chronic  rheumatism  and  sciatica,  and  many  skin  diseases,  especially 
chronic  psoriasis,  eczema,  pityriasis  and  prurigo.  The  Ointment  and  the 
Alkaline  Ointment  are  both  used  in  scabies. 

The  Iodide  has  been  used  internally  in  scrofula,  glanders  and  cutaneous 
disorders,  but  it  is  chiefly  employed  as  an  ointment  in  lupus  and  parasitic 
skin  diseases,  especially  herpes  circinatus. 

Calx  Sulphurata  is  extremely  efficient  as  an  internal  remedy  in  crops 
of  boils,  scrofulous  sores,  glandular  enlargements,  acne,  etc.,  and  will 
prevent  or  limit  suppuration.  For  these  purposes  it  must  be  used  in  small 
doses  (gr.  d_)  frequently  repeated. 

Potassa  Sulphurata  is  only  used  externally  as  baths  or  ointment  in 
skin  diseases  and  mucous  discharges,  also  in  chronic  rheumatism. 

Ichthyol  has  been  introduced  by  Dr.  Unna,  of  Hamburg,  the  cele¬ 
brated  dermatologist,  as  a  promptly  efficient  remedy  in  certain  chronic 
skin  diseases,  particularly  eczema  and  psoriasis.  It  mixes  with  vaseline, 
lard  and  oils,  is  soluble  in  a  mixture  of  ether  and  alcohol,  and  is  not  irri¬ 
tant  locally,  even  if  covered  with  oiled  silk. 

In  one  case  of  eczema  infantile,  an  ointment  was  applied  containing  1 
part  of  Ichthyol  to  5  of  Vaseline,  resulting  in  the  child’s  sinking  into  a 
stupor  which  lasted  for  12  hours.  Though  recovery  was  complete,  the 
result  of  the  application  shows  that  care  must  be  used  in  the  employment 
of  the  remedy,  as  it  is  not  devoid  of  danger  (Sinclair). 

SUMBUL  , — is  the  root  of  Ferula  Sumbul,  a  very  large  plant  of  the  nat. 
ord.  Umbelliferse,  which  grows  to  the  height  of  8  feet  in  the  mountains  of 
Northern  Asia.  The  root  occurs  in  transverse  segments  of  a  strong  and 
musk-like  odor  and  a  bitter,  balsamic  taste,  and  contains  Angelic  Acid, 
C5H80..j,  Valerianic  Acid,  C5H10O2,  also  a  volatile  oil,  two  balsamic  resins,  a 
bitter  substance,  etc.  Dose,  gr.  xxx-5j  or  more  in  infusion,  decoction,  etc. 

Preparation. 

Tinctura  Sumbul ,  10  per  cent.  Dose,  gj-iv. 


TABACUM. 


3Sl 

Sumbul  is  an  efficient  nerve  tonic,  having  qualities  closely  resembling 
musk  and  valerian.  It  is  used  by  the  Russian  physicians  in  very  many 
morbid  conditions,  and  seems  to  be  a  favorite  remedy  in  that  country  for 
almost  any  disease.  It  is  probably  of  some  value  in  hysteria  and  other 
nervous  derangements  of  delicate  females,  and  may  be  used  as  a  substitute 
for  musk  in  typhoid  conditions  and  fevers,  asthma,  delirium  tremens  and 
perhaps  in  epilepsy. 


TABACUM,  Tobacco, — the  commercial,  dried  leaves  of  Nicotiana 
Tabacum ,  an  annual  plant  of  the  nat.  ord.  Solanaceae,  native  of  tropical 
America,  but  cultivated  in  several  parts  of  the  world,  especially  in  Cuba 
and  Virginia.  The  leaves  are  large,  as  long  as  20  inches,  mottled-brown, 
ovate  or  lanceolate,  glandular-hairy ;  having  a  heavy,  peculiar  odor,  and 
a  nauseous,  bitter  and  acrid  taste.  It  contains  a  very  powerful  and  poi¬ 
sonous  fluid  alkaloid  named  Nicotine ,  C10HUN2,  also  a  concrete,  campho- 
raceous,  volatile  oil,  Nicotianin ,  besides  alkaline  salts  (nitrates,  phos¬ 
phates),  and  other  less  important  substances.  Its  combustion  gives  rise 
to  several  empyreumatic  products,  of  which  Pyridine ,  C5H5N,  and  its  com¬ 
pounds  are  the  chief,  having  somewhat  the  same  action  as  Nicotine,  but  of 
less  severity.  Besides  these  products,  tobacco-smoke  contains  Creasote, 
Hydrocyanic  and  Hydrosulphurous  acids,  etc.,  but  little  or  no  Nicotine. 


Unofficial  Preparations. 

Enema  Tabaci , — gr.  xx  infused  in  ^  viij  Boiling  Water,  and  administered  as  one 
enema. 

Vinum  Tabaci , —  3 j  to  the  pint.  Dose,  npv-^j. 

Oleum  Tabaci , — is  an  empyreumatic  product,  obtained  by  distillation  at  a  temperature 
above  that  of  boiling  water,  and  a  most  virulent  poison. 

Nicotina,  Nicotine,  Cj qHj 4N2, — the  alkaloid  and  active  principle;  a  colorless,  oily- 
looking  fluid,  having  the  odor  of  tobacco  and  an  acrid  taste  ;  readily  soluble  in  water,  and 
forming  soluble  salts  with  acids.  Dose,  TT^^j—rV  m  strychnine-poisoning,  up  to  ttpij  in  2 
hours. 

[Other  Liquid  Alkaloids  besides  Nicotine  are — Coniine,  Muscarine,  Sparteine,  Lobe¬ 
line,  Lupuline,  and  Pyridine.] 

Physiological  Action. 

Tobacco  is  a  very  depressant  nauseant,  an  emetic  by  irritant  as  well  as 
systemic  action,  and  an  antispasmodic  ;  also  sternutatory,  diuretic,  dia¬ 
phoretic,  cathartic,  sedative  and  narcotic.  It  paralyzes  the  motor  nerv¬ 
ous  system,  its  action  commencing  at  the  periphery  and  extending  to  the 
spinal  cord.  It  increases  the  salivary  and  intestinal  secretions,  and  pro¬ 
duces  diuresis,  tremor,  clonic  spasms  and  a  tetanic  stage  followed  by  pa¬ 
resis.  It  contracts  the  pupils,  depresses  the  heart,  lowers  arterial  tension, 
reduces  body-temperature,  and  causes  profuse  sweating,  cold  and  clammy 
skin,  collapse  and  death  usually  by  paralysis  of  respiration,  sometimes  by 


382 


TAMARINDUS. 


paralysis  of  the  heart.  It  does  not  impair  the  muscular  irritability,  nor 
does  it  act  upon  the  cerebrum  directly.  Its  empyreumatic  products  act 
similarly  but  less  powerfully.  Fatal  results  have  followed  on  the  inhalation 
of  its  vapor  into  the  lungs. 

Nicotine  is  almost  as  rapidly  fatal  as  Prussic  Acid,  death  having  oc¬ 
curred  from  a  toxic  dose  in  three  minutes,  with  no  symptoms  except  a 
wild  stare  and  a  deep  sigh. 

The  continued  use  of  Tobacco  in  excess  by  smoking  or  chewing  pro¬ 
duces  granular  inflammation  of  the  fauces  and  pharynx,  atrophy  of  the 
retina,  dyspepsia,  lowered  sexual  power,  nervous  depression,  and  occa¬ 
sionally  angina  pectoris.  Used  by  the  young  it  hinders  the  development 
of  the  higher  nerve  centres,  and  impairs  the  body  nutrition  by  interfering 
with  the  processes  of  digestion  and  assimilation. 

Strychnine  is  the  true  physiological  antagonist  to  Nicotine  (or  Tobacco)  and  vice  versa. 
Alcohol,  Ammonia,  Ergot,  Digitalis,  Belladonna,  etc.,  antagonize  its  action  on  the  circu¬ 
lation.  In  poisoning  by  Tobacco  the  means  resorted  to  are  evacuation  of  the  stomach, 
Tannin,  Iodides,  and  artificial  respiration.  A  curious  synergism  has  been  observed  by  the 
author  between  Opium  and  Tobacco.  If  a  person,  habituated  to  the  use  of  the  latter, 
either  by  smoking  or  chewing,  begins  to  use  Morphine,  the  smallest  quantity  of  Tobacco 
will  make  him  sick,  the  symptoms  being  those  experienced  by  a  novice  in  its  use. 

Therapeutics. 

Tobacco  is  now  but  little  used  in  medicine ;  the  dangers  attending  its 
employment  either  internally  or  externally  have  caused  it  to  be  super¬ 
seded  by  less  violently  acting  agents.  The  chief  indications  for  its  use 
are  to  relax  spasm  and  to  relieve  local  pain.  It  may  be  employed  with 
advantage  in  habitual  constipation,  for  the  dyspnoea  of  spasmodic  asthma 
and  emphysema,  and  in  nymphomania  and  chordee.  Intestinal  affections 
like  impaction  of  the  caecum,  intussusception  and  strangulated  hernia  may 
be  overcome  by  a  tobacco-enema  to  relax  spasm,  but  it  is  a  dangerous  ex¬ 
pedient.  In  dropsy,  especially  the  renal  form,  it  makes  a  very  efficient 
diuretic.  In  tetanus  there  is  no  more  effective  remedy  than  minim  doses 
of  the  alkaloid  every  two  hours  by  the  stomach,  or  npij  by  the  rectum, 
or  better  still  the  wine  in  io-minim  doses  repeated  for  effect.  Strych¬ 
nine-poisoning  is  best  met  by  minute  doses  of  Nicotine  (gr.  hypoder¬ 
mically,  as  a  physiological  antagonist. 

The  use  of  Tobacco  in  moderation,  when  under  excessive  exertion,  aids 
in  supporting  the  system  and  lessening  the  sense  of  fatigue.  Smokers 
rarely  suffer  from  constipation,  but  generally  experience  an  immediate 
laxative  result  from  their  morning  cigar. 

TAMARINDUS,  Tamarind,  — is  the  preserved  pulp  of  the  fruit  of 
Tamarindus  indica,  a  large  tree  of  the  nat.  ord.  Leguminosae,  native  in 
the  East  and  West  Indies.  It  occurs  as  a  reddish-brown,  sweet-acid  and 


TANACETUM - TARAXACUM. 


383 


pulpy  mass,  containing  strong,  branching  fibres  and  brown,  quadrangular 
seeds,  each  enclosed  in  a  tough  membrane.  It  contains  citric,  tartaric 
and  malic  acids,  sugar,  gum,  potassium  bitartrate,  etc. 

Preparation. 

Confectio  Senna  (see  ante ,  page  364), — contains  Tamarind  to  the  amount  of  10  per 
cent.  Dose,  gj-ij. 

Tamarind  is  a  laxative  and  refrigerant  fruit.  In  infusion  it  may  be 
used  by  convalescents  as  a  pleasant  acidulous  drink,  or  the  pulp  may  be 
boiled  with  milk  as  a  whey  for  the  same  purpose.  As  a  laxative  it  is 
usually  prescribed  in  connection  with  other  agents  having  the  same 
action. 


TANACETUM,  Tansy  , — the  leaves  and  tops  of  Tanacetum  vul- 
gare,  a  perennial,  herbaceous  plant  of  the  nat.  ord.  Compositae,  having 
yellow  flowers  in  dense  terminal  corymbs,  indigenous  in  Europe,  but 
cultivated  in  our  gardens,  and  growing  wild  in  roads  and  old  fields.  It 
contains  a  volatile  oil,  a  bitter  principle  named  Tanacetin ,  a  tannic  acid, 
etc.  There  are  no  official  preparations,  but  a  fluid  extract  may  be  pre¬ 
pared  according  to  the  general  rule  and  administered  in  doses  of  TTpx-oj. 
The  dose  of  the  volatile  oil  (Oleum  Tanaceti)  is  1  to  3  drops.  An  infu¬ 
sion  (Tansy  Tea)  may  be  made  in  the  proportion  of  gj  to  the  pint,  and 
used  in  doses  of  gj-ij. 

Physiological  Action  and  Therapeutics. 

Tansy  is  emmenagogue,  diuretic  and  anthelmintic,  an  aromatic  bitter  • 
and  an  irritant  narcotic.  Fatal  results  have  frequently  followed  upon 
overdoses  of  the  oil  (gss-j),  or  strong  decoctions,  preceded  by  clonic 
spasms,  disturbed  respiration  and  cessation  of  the  heart’s  action.  It  is  a 
useful  remedy  in  amenorrhoea,  but  is  in  popular  repute  as  an  abortifacient, 
a  virtue  which  it  does  not  possess  except  in  quantity  dangerous  to  life. 


TARAXACUM,  Dandelion  , — is  the  root,  gathered  in  autumn,  of 
Taraxacum  Dens-leonis ,  an  herbaceous  plant  of  the  nat.  ord.  Compositae, 
with  a  perennial  fusiform  root,  long,  sinuate-toothed  or  runcinate  leaves, 
and  slender  peduncles,  each  bearing  a  single  head  of  yellow  flowers.  All 
parts  of  the  plant  contain  a  bitter,  milky  juice,  exuding  from  any  break 
or  wound.  Its  constituents  are  a  bitter  amorphous  principle  named 
Taraxacin ,  a  crystalline  principle  Taraxacerin ,  with  potassium  and  cal¬ 
cium  salts,  inulin,  and  resinoid  bodies,  etc.  The  French  name  for  the 
plant  is  “  Pissenlit.” 


3  §4 


TEREBINTHINA. 


Preparations. 

Extractum  Taraxaci , — Dose,  gr.  v-xxx. 

Extr actum  Taraxaci  Fluidum, — Dose,  £  j-  5  j. 

Physiological  Action  and  Therapeutics. 

Taraxacum  is  a  bitter  tonic,  a  diuretic  and  an  aperient  It  has  been, 
supposed  to  act  especially  on  the  liver,  and  is  chiefly  used  in  dyspepsia 
with  hepatic  torpor.  As  found  in  the  shops  it  is  usually  inert.  The  ex¬ 
tract  is  probably  only  of  value  as  an  excipient  for  pills. 


TEREBINTHINA,  Turpentine,  — means  a  vegetable  exudation, 
liquid  or  concrete,  which  consists  of  resin  combined  with  a  peculiar 
essential  oil  named  Oil  of  Turpentine  (C10H16),  and  generally  procured 
from  various  species  of  the  nat.  ord.  Coniferae  (cone-bearers).  Of  the 
many  turpentines  two  only  are  official,  viz  :  — 

Terebinthina,  Turpentine, — a  concrete  oleoresin  obtained  from  Pimts 
australis ,  the  Yellow  Pine,  and  from  other  species  of  Pinus ,  nat.  ord. 
Coniferae.  Occurs  in  tough,  yellowish  masses,  brittle  when  cold,  crummy- 
crystalline  interiorly,  of  terebinthinate  odor  and  taste.  Dose,  gr.  v-xxx 
as  a  stimulant,  antispasmodic  or  diuretic;  3 ij— iv  as  an  anthelmintic. 

Terebinthina  Canadensis,  Canada  Turpentine,  Balsam  of  Fir, — a 
liquid  oleoresin  obtained  from  Abies  balsamea ,  the  Silver  Fir,  or  Balm  of 
Gilead,  a  tree  of  the  nat.  ord.  Coniferae.  A  yellowish,  transparent,  viscid 
liquid,  of  agreeable,  terebinthinate  odor,  and  a  bitterish  and  slightly  acrid 
taste,  slowly  drying  on  exposure,  forming  a  transparent  mass ;  completely 
soluble  in  ether,  chloroform  or  benzol.  Dose,  gr.  x-xxx. 

[For  Pitch  and  its  preparations,  see  ante ,  page  315.] 

Preparations. 

Oleum  Terebinthince,  Oil  of  Turpentine,  Spirits  of  Turpentine, — is  a  volatile  oil  distilled 
from  Turpentine,  any  variety  furnishing  it.  Dose,  as  a  stimulant  or  diuretic,  rr^v-xv,  in 
emulsion,  3  to  6  times  daily ; — as  a  cathartic  or  anthelmintic  ^  ss  or  more,  combined  with 
other  cathartics.  A  little  glycerin  and  oil  of  gaultheria  will  disguise  the  taste. 

A  thin,  colorless  liquid,  of  characteristic  odor  and  taste,  having  the  sp.  gr.  0.855  to 
0.870,  soluble  in  6  of  alcohol,  mixes  with  other  volatile  and  fixed  oils,  and  dissolves  resins, 
wax,  sulphur,  phosphorus  and  iodine.  Bromine  and  powdered  Iodine  act  violently  on  it, 
and  when  brought  into  contact  with  a  mixture  of  Nitric  and  Sulphuric  Acids  it  takes  fire. 
It  is  isomeric  with  a  number  of  volatile  oils,  has  the  formula  C10H16 — but  constantly 
absorbs  oxygen  from  the  air  when  exposed,  becoming  thicker  and  less  active,  from  forma¬ 
tion  of  resin.  It  is  a  mixture  of  several  hydrocarbons,  each  having  the  same  formula  as 
itself,  viz. : — C10II16. 

Linimentum  Terebinthince ,  Turpentine  Liniment, — has  35  parts  of  the  oil  with  65  of 
Resin  Cerate. 

Linimentum  Cantharidis,  contains  the  oil  in  the  proportion  of  85  per  cent.,  the  other 
15  being  Cantharides;  making  a  very  powerful  and  unmanageable  application  unless 
closely  watched.  See  ante,  page  15 1. 

Unofficial  Turpentines. 

Chian  Turpentine , — from  the  Pistacece  Terebinthus ,  a  small  larch  tree  growing  in  the 
islands  of  Chio  and  Cyprus ,  a  thick,  tenacious,  greenish-yellow  liquid,  concreting  on 
exposure  to  the  air  into  a  translucent  solid.  Dose,  gr.  iij-v  in  emulsion. 


TEREBINTHINA. 


385 


Venice  Turpentine , — procured  in  Switzerland  from  the  Larix  Europcea  or  European 
Larch ; — a  viscid  liquid  of  the  consistence  of  honey,  does  not  concrete  on  exposure,  and 
is  entirely  soluble  in  alcohol.  The  Venice  Turpentine  of  commerce  is  usually  prepared 
by  dissolving  Resin  in  Oil  of  Turpentine. 

Thus  Americanum ,  Common  Frankincense,  (B.  P.), — the  concrete  turpentine  which 
is  scraped  off  the  trunks  of  Pinus  australis  and  Finns  Tceda ,  Southern  States  of  N. 
America.  An  ingredient  of  the  Emplastrum  Picis  of  the  B.  P. 

Analogues  of  Turpentine. 

Oleum  Succini,  Oil  of  Amber, — a  volatile  oil  obtained  by  the 
destructive  distillation  of  Amber  (Succinum),  a  fossil  resin,  occurring  in 
alluvial  deposits  in  Bohemia,  etc.,  and  thought  to  be  the  exudation  of 
Pinites  succinifer ,  an  extinct  coniferous  tree.  Dose,  gtt.  v-x.  See  ante , 
page  377. 

Oleum  Thuj^e, — a  volatile  oil,  which  is  given  in  doses  of  ny-v.  A 
saturated  tincture  may  be  used  in  drachm-doses.  Obtained  from  Thuja 
occidentalism  the  Arbor  Vitae,  a  coniferous  tree.  See  infra ,  page  388. 

Derivatives  of  Turpentine. 

Resina,  Resin,  Colophony, — is  the  residue  left  after  distilling  off  the 
volatile  oil  from  turpentine ;  the  portion  of  turpentine  which  is  fixed  by 
oxidation ;  consisting  in  greater  part  of  Abietic  anhydride  (C44H6204). 
See  ante ,  page  334. 

Terebene,  C10H16, — is  a  hydrocarbon  obtained  by  the  oxidation  of  oil 
of  turpentine  by  means  of  sulphuric  acid.  A  colorless  liquid,  of  hot 
taste,  soluble  in  alcohol.  Dose,  npv-xx  on  sugar,  or  suspended  in  5ss  of 
water  by  the  aid  of  gr.  xx  of  light  carbonate  of  magnesium. 

Terebinthene,  C10H16, — another  isomeric  hydrocarbon,  obtained  by 
distilling  oil  of  turpentine  with  an  alkali.  This  by  hydration,  is  con¬ 
verted  into  Terpine ,  commonly  called  “  Hydrate  of  Terpine  f  instead  of 
Hydrate  of  Terebinthene ,  a  solid,  crystalline  body,  soluble  in  glycerin. 
Acting  on  this  by  an  acid,  we  get  an  oily  body,  named  Terpinolm  the  dose 
of  which  is  gr.  ij-v,  while  that  of  Terpine  is  gr.  v-x.  None  of  these 
bodies  are  soluble  in  water,  but  all  are  in  alcohol. 

Sanitas, — is  a  disinfecting  solution  obtained  by  the  action  of  water 
upon  oxidized  turpentine,  its  active  principle  being  Peroxide  of  Hydrogen. 
It  is  not  poisonous,  and  does  not  stain  the  linen, — two  qualities  which 
strongly  recommend  it. 


Physiological  Action. 

Turpentines  are  stimulant,  diuretic,  anthelmintic,  and  hemostatic  ; 
in  large  doses  laxative  and  irritant,  and  externally  used  are  rubefacient 
and  antiseptic.  Their  virtues  depend  entirely  on  the  volatile  oil. 

Oil  of  Turpentine  in  small  doses  causes  a  sense  of  heat  at  the  epigas¬ 
trium,  burning  in  the  mouth,  and  by  reflex  action  salivation.  In  moderate 

25 


386 


TEREBINTHINA. 


doses  it  at  first  stimulates  the  vaso-motor  nervous  system,  afterwards 
paralyzing  these  centres,  thus  causing  a  rise  and  then  a  fall  of  the  arterial 
tension.  It  lowers  the  functions  of  the  brain,  spinal  cord  and  medulla  in  the 
order  stated,  causing  diminution  of  voluntary  movement  and  reflex  action, 
dilatation  of  the  vessels,  lowered  blood-pressure,  and  slowed  respiration, 
the  latter  often  becoming  spasmodic.  The  pulse  is  sometimes  slowed,  some¬ 
times  quickened.  Large  doses  produce  gastro-enteritis,  with  vomiting  and 
diarrhoea,  suppression  of  urine,  pain  in  the  lumbar  regions,  burning  in 
the  urethra,  hematuria,  and  strangury.  The  muscular  power  is  diminished, 
coordination  impaired,  and  a  state  of  intoxication  induced.  Toxic  doses 
cause  complete  muscular  relaxation,  profound  insensibility,  with  abolished 
reflexes,  dilated  pupils,  cyanosed  face,  labored  and  stertorous  breathing 
and  death  by  paralysis  of  respiration.  It  is  excreted  by  the  various  organs 
of  excretion,  all  of  which  are  highly  irritated,  the  kidneys  suffering  par¬ 
ticularly.  Its  vapor  inhaled  produces  nasal  and  renal  irritation,  frontal 
headache,  and  frequently  strangury  and  hematuria.  Locally  to  the  skin 
it  is  rubefacient,  and  even  vesicant  if  applied  for  any  length  of  time  or  if 
evaporation  be  prevented. 

Turpentine-oil  when  exposed  to  the  air  readily  absorbs  oxygen  in  the 
form  of  ozone,  which  it  retains  tenaciously.  This  Ozonized  Oil  of  Tur¬ 
pentine  is  an  antidote  to  Phosphorus,  preventing  the  formation  of  phos¬ 
phoric  acid,  and  converting  the  phosphorus  into  an  insoluble  substance 
resembling  spermaceti.  Worn  about  the  neck  in  an  open  vial  it  is  believed 
to  prevent  necrosis  of  the  jaw  and  steatosis  of  the  organs  in  workmen 
exposed  to  phosphorus-fumes.  It  is  also  supposed  to  dissolve  gall-stones. 

Antagonists. 

In  cases  of  poisoning  the  stomach  should  be  emptied,  anodynes  and  demulcents  admin¬ 
istered,  elimination  favored,  and  special  symptoms  met  as  they  arise. 

Therapeutics. 

The  Oil  of  Turpentine  is  employed  externally  as  a  rubefacient  and 
counter-irritant  in  many  conditions  producing  pain  and  inflammation. 
Cloths  wrung  out  of  hot  water  and  then  sprinkled  with  the  oil  (turpen¬ 
tine  stupes),  are  useful  applications  in  sciatica  and  other  neuralgiae,  lum¬ 
bago,  chronic  rheumatism,  chronic  bronchitis,  peritonitis  with  tympanites, 
pleurisy,  renal  colic,  etc.  It  is  one  of  the  most  efficient  agents  in  hos¬ 
pital  gangrene  applied  in  full  strength  to  the  part  affected.  The  liniment 
is  in  constant  use  for  sprains,  neuralgia,  and  other  slight  local  affections. 

Internally  it  is  best  employed  in  ulceration  and  hemorrhage  of  the 
intestines  and  in  hemorrhages  of  a  passive  character  from  other  organs. 
Active  bleeding  with  a  plethoric  condition  and  hematuria  are  states  in 
which  it  is  contraindicated.  It  is  often  used  with  Ether  (i  to  3)  in  biliary 
and  flatulent  colic,  as  an  anodyne  and  antispasmodic.  As  a  vermifuge, 


THEOBROMtE  OLEUM. 


387 


against  tape-worm  it  must  be  employed  in  large  doses  (Sss-ij),  with 
Castor  oil  to  promote  its  rapid  passage  through  the  intestinal  canal.  The 
French  acid  oil,  which  is  old  and  contains  ozone,  is  used  in  phosphorus 
poisoning.  It  is  well  employed  as  a  stimulant  to  the  heart  and  vaso¬ 
motor  system  in  puerperal  fever,  yellow  fever,  traumatic  erysipelas,  pneu¬ 
monia,  capillary  bronchitis,  etc.  It  is  also  useful  in  chronic  bronchial 
catarrh,  chronic  cystitis,  subacute  gonorrhoea  and  similar  affections  of 
the  mucous  surfaces  generally. 

Inhalations  of  the  vapor  or  atomized  oil  are  extremely  beneficial  in 
chronic  affections  of  the  larynx  and  bronchi.  The  pure  vapor  is  too  irri¬ 
tating  for  inhalation,  but  it  may  be  diluted  with  steam  from  a  steam  atom¬ 
izer. 

Chian  Turpentine  is  one  of  the  many  remedies  which  have  been  used 
for  cancer. 

Terebene  has  been  extensively  used  by  Dr.  Murrell,  with  excellent  re¬ 
sults,  as  a  remedy  for  obstinate  winter-cough  and  emphysema  of  the  lungs, 
in  flatulence,  and  flatulent  dyspepsia,  also  in  cystitis  and  in  gleet.  He  has 
employed  it  with  benefit  as  a  spray  in  phthisis  and  post-nasal  catarrh,  also 
with  Cocaine  in  solution  as  a  spray  for  coryza  and  hay-fever.  Other 
observers,  of  several  years’  experience  with  this  remedy  in  England, 
praise  it  highly  as  an  inhalant  remedy  in  phthisis,  bronchiectasis,  chronic 
bronchitis,  and  other  pulmonary  affections  characterized  by  profuse,  puru¬ 
lent  expectoration.  Dr.  Rieu  employs  it  extensively  in  bronchitis  and 
bronchorrhoea,  in  doses  internally  of  gr.  xv-xxx  per  diem, — but  says  that 
it  does  not  affect  the  muco-purulent  expectoration  of  phthisis  (. Bull .  Gen. 
de  Therapy  April  30,  1 886).  It  probably  has  no  superior  efficacy  to 
Creasote,  Venice  Turpentine,  etc.,  except  that  it  is  without  much  odor, 
and  has  no  taste. 

Terpine  Hydrate  is  praised  very  highly  in  chronic  and  recurrent 
bronchitis,  night-cough  from  habit,  cold,  catarrhs  and  kindred  affections. 
In  fact,  all  acute  and  many  chronic  affections  of  the  respiratory  passages 
form  the  field  for  the  therapeutical  action  of  this  preparation. 

THEOBROMiE  OLEUM,  Oil  of  Theobroma,  Cacao-but¬ 
ter, — is  a  fixed  oil  expressed  from  the  seed  of  Theobroma  Cacao ,  the 
Chocolate-tree,  nat.  ord.  Sterculiacese,  growing  in  Mexico,  the  West 
Indies  and  South  America.  The  oil  is  a  yellowish-white  solid,  of  faint 
odor,  bland  taste  and  neutral  reaction,  and  melting  at  86°  to  950  F. 

The  seeds  are  oval,  about  the  size  of  almonds,  and  consist  of  shells  and  kernels,  in 
both  of  which  is  found  the  alkaloid  Theobromine  CTH8N402,  which  closely  resembles 
Caffeine,  the  latter  being  its  methyl  derivative.  Chocolate  is  prepared  by  roasting  the 
seeds,  removing  the  shells,  then  crushing  or  grinding  the  kernels  to  a  smooth  paste,  which 
is  cast  in  molds. 

Cacao-butter  consists  chiefly  of  Stearin  with  a  little  Olein.  Its  action 


388 


THUJA. 


is  demulcent,  and  it  does  not  become  rancid  on  exposure  to  the  air.  Its 
chief  use  is  as  a  basis  for  making  suppositories.  A  cerate  is  prepared  by 
melting  together  Cacao-butter  35,  White  Wax  35,  Oil  of  Almond  30, 
adding  a  drop  of  Oil  of  Rose  and  coloring  with  a  minute  quantity  of 
Carmine  previously  triturated  with  a  drop  of  Water  of  Ammonia.  This 
is  known  as  Red  Lip-salve. 

Theobromine  has  the  same  action  and  uses  as  Caffeine.  (See  ante , 
page  140.) 


THUJA,  Arbor  Vitae, — the  fresh  tops  of  Thuja  occidentalis ,  a  tree 
of  the  nat.  ord.  Coniferse,  commonly  though  incorrectly  called  White 
Cedar,  and  growing  in  swampy  ground  in  Canada  and  the  northern  U.  S. 
Its  twigs  are  flattish  and  two-edged,  with  scale-like  leaves  appressed  and 
closely  imbricate  in  four  rows,  rhombic-ovate,  obtusely  pointed,  having  a 
roundish  gland  upon  the  back;  of  a  balsamic,  somewhat  terebinthinate 
odor,  and  a  pungently  aromatic,  camphoraceous  and  bitter  taste.  They 
contain  a  volatile  oil,  tannin,  wax,  resin,  etc.  ;  also  Pinipicrin ,  C22H180n, 
a  bitter  principle,  and  Thujin ,  C20H22O12,  a  yellow,  astringent  and  crystal- 
lizable  coloring  principle,  which  is  separable  into  glucose  and  Thujetin , 
C14H1408. 

Preparations. 

There  are  none  official.  The  dose  of  a  saturated,  fresh  tincture  or  fluid  'extract  is 
3  j  3-6  times  daily.  The  Volatile  Oil  may  be  given  in  doses  of  rt\j-v. 

Physiological  Action. 

Thuja  resembles  Savine  in  action  very  closely.  It  is  stimulant,  irritant, 
astringent,  also  aromatic,  diuretic  and  emmenagogue.  The  oil  is  a 
gastro-intestinal  irritant,  and  produces  epileptiform  convulsions  in  warm¬ 
blooded  animals,  and  paralysis  in  cold-blooded  ones.  It  causes  rhythmi¬ 
cal  contraction  and  dilatation  of  the  vessels,  lowers  the  temperature,  and 
is  anthelmintic.  Thuja  is  indirectly  an  abortifacient  when  given  in  doses 
sufficient  to  cause  violent  gastro-enteritis,  and  is  reported  to  have  pro¬ 
duced  an  acute  urethritis  resembling  gonorrhcea. 

Therapeutics. 

Thuja  in  decoction  has  been  usefully  employed  in  coughs,  rheumatic 
and  arthritic  pains,  dropsy  and  amenorrhoea.  It  has  also  been  given  with 
benefit  in  intermittent  fever  and  as  an  alterative  blennorrhetic  in  chronic 
catarrh  and  bronchorrhoea.  It  is  highly  praised  by  Dr.  Phillips  for  the 
cure  of  warts  with  narrow  base  and  pendulous  body,  a  strong  tincture 
being  applied  locally  and  given  internally  at  the  same  time  in  5 -minim 
doses  twice  daily.  Dr.  Piffard  speaks  strongly  in  its  favor  as  a  valuable 
agent  for  non-syphilitic  warts  (condylomata  acuminata)  of  the  penis  and 


THYMI  OLEUM. 


389 


vulva,  for  papillomatous  growths  in  general,  and  for  gleets  dependent 
on  granular  urethritis.  It  has  been  used  in  chronic  gonorrhoea  and  pros¬ 
tatitis  with  asserted  success,  and  is  said  to  have  cured  epithelioma.  The 
oil  has  been  employed  as  a  vermifuge. 


THYMI  OLEUM,  Oil  of  Thyme, — is  a  volatile  oil  distilled 
from  Thymus  vulgaris ,  Garden  Thyme,  a  common  shrub  of  the  nat.  ord. 
Labiatae,  indigenous  in  France  but  cultivated  in  our  gardens.  The  oil  is 
a  pale  yellow  or  colorless,  thin  liquid,  having  a  strong  odor  of  thyme,  a 
warm,  pungent  and  afterward  cooling  taste,  and  a  neutral  reaction,  of  sp. 
gr.  about  0.880,  and  readily  soluble  in  alcohol.  It  consists  of  two  por¬ 
tions,  the  more  volatile  being  a  mixture  of  the  hydrocarbons  Cymene  and 
Thymene ,  the  less  volatile  being  chiefly  Thymol ,  which  is  official. 

Thymol,  C10H13HO, — is  a  stearoptene  contained  in  Oil  of  Thyme  and 
in  the  volatile  oils  of  several  other  plants.  It  occurs  in  large,  colorless, 
hexagonal  crystals,  of  aromatic  odor,  pungent  taste  and  neutral  reaction  ; 
soluble  in  1200  of  water,  900  of  boiling  water,  and  in  1  of  alcohol  at  590 
F.,  freely  in  fats  and  oils,  solutions  of  chloral  and  alkalies,  ether,  chloro¬ 
form,  etc.  It  liquefies  with  camphor.  Dose,  gr.  ss-ij. 

Unofficial  Preparations. 

Thymol  Solution , — for  antiseptic  spray,  1  in  1000. 

Thymol  Gauze , — contains  1  per  cent,  of  Thymol. 

Thymol  Oint?nents , — vary  from  5  to  30  grains  to  the  ^ . 

Thymol  Inhalation , — Thymol  gr.  xx,  Alcoholis  3  iij,  Magnesium  Carbonate  gr.  x, 
Water  to  ^  iij.  A  teaspoonful  to  a  pint  of  water  150°  F.  for  each  inhalation. 

Volkmann' s  Antiseptic  Fluid , — has  of  Thymol  I,  Alcohol  10,  Glycerin  20,  and  Water 
100  parts. 

Physiological  Action. 

Oil  of  Thyme  has  the  same  properties  as  the  oils  of  other  mints,  and 
containing  a  large  quantity  of  Thymol  it  is  similar  to  the  latter  in  action. 

Thymol  in  its  action  stands  between  Carbolic  Acid  and  Oil  of  Tur¬ 
pentine.  Like  the  former  it  is  a  powerful  antiseptic  and  disinfectant.  It 
is  a  local  irritant  and  anaesthetic  to  the  skin  and  mucous  membranes, 
paralyzing  the  end-organs  of  the  sensory  nerves.  When  absorbed  it  para¬ 
lyzes  the  nerve-centres  in  the  spinal  cord  and  in  the  medulla,  lessening 
reflex  action,  slowing  respiration,  lowering  the  temperature  and  the 
arterial  tension,  and  in  poisonous  doses  causing  weakness,  coma  and 
death.  Internally  administered  in  doses  of  20  to  30  grains  per  diem  it 
produces  a  sensation  of  epigastric  heat,  sweating,  singing  in  the  ears, 
deafness,  a  sense  of  constriction  in  the  forehead,  and  increase  of  the 
urinary  discharge,  which  assumes  a  dark,  greenish  hue.  It  is  eliminated 
by  the  respiratory  and  urinary  organs  which  it  irritates  considerably 
during  the  process  of  its  excretion.  As  an  antiseptic  it  is  much  more 
powerful  and  permanent  than  Carbolic  Acid  and  much  less  poisonous. 


390 


TIGLII  OLEUM. 


Therapeutics. 

Thymol  is  chiefly  employed  in  lieu  of  Carbolic  Acid  as  an  antiseptic 
for  dressing  wounds ;  as  a  gargle,  spray  or  inhalation  in  laryngitis  and 
diphtheria ;  as  an  ointment  in  ringworm,  eczema  and  psoriasis,  and  as  an 
injection  in  ozsena.  A  solution  of  i  part  in  1000  is  the  strength  usually 
employed.  Internally  it  has  been  used  with  success  in  diphtheria,  typhoid 
fever,  and  other  intestinal  affections,  diabetes,  phthisis  and  vesical  catarrh. 
Its  fragrant  odor  renders  it  a  very  agreeable  antiseptic  application  for 
ulcerated  conditions  of  the  mo'uth  and  fauces,  but  makes  it  very  attractive 
to  flies;  which  fact,  together  with  its  high  price,  will  prevent  it  becoming 
a  favorite  in  hospital  practice.  A  solution,  used  as  a  mouth-wash,  is  very 
efficient  in  removing  the  odor  of  tobacco  from  the  breath. 


TIGLII  OLEUM,  Croton  Oil, — is  a  fixed  oil  expressed  from  the 
seed  of  Croto7i  Tiglium ,  a  small  tree  of  the  nat.  ord.  Euphorbiaceae,  a 
native  of  India.  The  oil  is  of  a  pale  or  brownish-yellow  color,  somewhat 
viscid  and  slightly  fluorescent,  of  fatty  odor,  acrid  taste  and  slightly  acid 
reaction;  sp.  gr.  0.940  to  0.955,  soluble  in  60  of  alcohol,  freely  in  ether, 
chloroform,  or  carbon  disulphide.  Its  composition  is  very  complex  and 
has  not  been  thoroughly  made  out,  but  it  is  known  to  contain  the  gly¬ 
cerides  of  several  fatty  acids,  also  a  peculiar  acid  named  Tiglinic  Acid , 
C5H802,  which  is  isomeric  with  Angelic  Acid.  Dose  of  the  oil,  rr^  ^<3— ij, 
in  pill,  emulsion  or  tincture. 

Physiological  Action. 

Externally  Croton  Oil  is  highly  irritant,  producing  a  pustular  eruption 
which  heals  by  scabbing  and  may  leave  unsightly  cicatrices.  Internally 
it  is  a  powerful  drastic  cathartic,  producing  in  one  or  two  hours  copious 
watery  stools,  in  overdoses  causing  great  congestion  of  the  intestinal  canal 
and  perhaps  death  from  gastro-enteritis.  Vomiting  usually  occurs  after 
large  doses,  so  that  the  irritant  hyper-catharsis  is  not  always  observed.  It 
is  absorbed  into  the  blood,  and  produces  glandular  hyperaemia  as  well  as 
direct  inflammation  of  the  intestinal  mucous  membrane,  together  with  in¬ 
creased  peristaltic  action.  Its  cathartic  power  is  increased  by  the  addi¬ 
tion  of  an  alkali,  and  is  manifested,  though  in  less  degree,  when  applied 
to  the  integument. 

Therapeutics. 

Croton  Oil  is  used  as  a  hydragogue  carthartic  when  a  speedy  and  com¬ 
plete  evacuation  of  the  bowels,  diminution  of  arterial  pressure  and  prompt 
derivative  action  are  desired,  as  in  apoplexy,  impaction  of  the  intestines, 
dropsy,  lead  constipation,  paralysis,  etc.  It  is  contraindicated  where 
there  is  debility,  organic  obstruction,  and  inflammatory  conditions  of  the 


TONGA - TRAGACANTHA. 


391 


stomach  and  bowels.  The  smallness  of  the  dose  makes  it  a  very  easily 
administered  and  manageable  purgative.  A  considerable  fraction  of  a 
drop  is  absorbed  by  a  pellet  of  sugar,  and  may  be  given  thus  in  repeated 
doses  until  the  desired  effect  is  obtained.  It  has  been  used  as  a  vermi¬ 
fuge  against  tapeworm. 

Externally  it  is  used  as  a  counter-irritant  in  ovaritis,  bronchitis,  pleu¬ 
risy,  rheumatism,  neuralgia,  glandular  swellings,  and  in  laryngeal  and 
pulmonary  diseases.  The  Linimentum  Crotonis  of  the  British  Pharma¬ 
copoeia  contains  1  part  of  the  oil  in  3)4  each  of  Alcohol  and  Oil  of  Caju- 
put,  and  is  a  useful  pustulant  preparation,  being  more  manageable  than 
the  oil  itself. 


TONGA  (Unofficial)  , — is  a  mixed  drug  said  to  be  obtained  from  the 
Fiji  Islands,  consisting  of  thin  barks,  root-fibres  and  leaves  tied  into  long 
bundles.  The  fibrous  material  is  believed  to  be  derived  from  Rhaphido- 
phora  vitiensis,  a  creeping  plant  of  the  nat.  ord.  Aracese,  containing  starch, 
potassium  chloride  and  a  volatile  alkaloid  Tongine.  The  barky  portion  is 
referred  to  Premna  t atiensis ,  a  shrub  or  tree  of  the  nat.  ord.  Verbenaceae, 
and  contains  a  little  volatile  oil,  sugar,  pectin,  etc.  A  fluid  extract  is 
prepared  by  Parke,  Davis  &  Co.  of  Detroit,  and  may  be  given  in  doses 
of  npxxx-3j  thrice  daily. 

Tonga  was  introduced  by  Dfs.  Ringer  and  Murrell  as  a  remedy  for  neu¬ 
ralgia  in  1880,  stating  that  they  had  used  it  with  gratifying  results.  Since 
then  reports  have  differed  considerably  in  regard  to  its  efficacy,  and  from 
the  fact  that  Dr.  Ringer  does  not  mention  it  in  the  last  edition  of  his 
Handbook  of  Therapeutics,  it  may  be  inferred  that  his  further  experience 
with  it  has  not  borne  out  the  claims  first  made. 


TRAGACANTHA,  Tragacanth,  — is  a  gummy  exudation  from 
Astragalus  gummifer  and  from  other  species  of  Astragalus,  shrubs  of  the 
nat.  ord.  Leguminosae,  growing  chiefly  in  the  mountainous  regions  of 
Asia  Minor  and  Persia.  It  occurs  in  shell-like,  curved  or  contorted 
bands,  translucent,  faintly  yellowish,  horn-like,  tough,  swelling  with  water 
to  a  gelatinous  mass,  which  is  tinged  blue  by  test-solution  of  iodine,  and 
consists  of  a  mixture  of  Arabia,  or  gum-arabic,  which  is  soluble  in  water, 
and  Bassorin,  a  gum  which  is  insoluble  in  water  but  swells  up  in  it,  also 
a  little  starch. 

Preparation. 

Mucilago  Tragacanthce , — Tragacanth  6,  Glycerin  18,  Water  to  100  parts.  Dose,  3  j 
or  more. 


Physiological  Action  and  Therapeutics. 

Tragacanth  is  demulcent,  but  in  large  quantities  it  may  cause  indiges¬ 
tion.  It  is  chiefly  employed  to  suspend  resins  and  heavy  powders  in 


392 


TRLTICUM — ULMUS — UVA  URSI. 


emulsion.  The  mucilage  may  be  used  as  a  vehicle  for  active  agents  in 
gargles  for  pharyngitis,  and  to  cause  cohesion  in  the  preparation  of  pills, 
troches,  etc.  It  is  a  constituent  of  13  of  the  16  official  troches,  and  is  a 
better  agent  than  acacia  for  making  emulsions  of  cod-liver  oil. 


TRITICUM,  Couch-grass, — is  the  rhizome,  gathered  in  the  spring 
and  deprived  of  its  rootlets,  of  Triticum  repens ,  the  Couch-grass,  a  peren¬ 
nial  plant  of  the  nat.  ord.  Graminaceae,  abounding  in  meadows  and  cul¬ 
tivated  grounds,  where  it  ranks  as  a  weed,  though  of  the  same  genus  as 
wheat.  The  rhizome  is  very  long,  but  as  met  with  in  the  shops  is  cut  into 
two  sections  about  J-ths  inch  in  length  and  y1^  inch  thick,  creeping, 
smooth,  hollow  in  the  centre,  of  straw  color,  and  sweet  taste.  It  contains 
much  sugar  and  a  gum-like  principle  Triticin.  Dose,  5j-oj>  in  infusion  or 
decoction. 

Preparation. 

Extractum  Tritici  Fluidum , — Dose,  3 j- 3  j,  well  diluted. 

Couch-grass  is  demulcent,  emollient  and  a  feeble  diuretic.  It  is  chiefly 
used  in  cystitis  and  irritable  bladder.  The  infusion  is  a  popular  fever- 
drink  in  Europe,  and  has  had  of  old  a  considerable  reputation  in  dysuria. 


ULMUS,  Elm,  Slippery  Elm  , — is  the  inner  bark  of  Ulmus  fulva , 
and  indigenous  tree  of  the  nat.  ord.  Urticaceae,  and  occurs  in  flat  pieces 
of  various  sizes,  having  a  slight,  peculiar  odor  and  a  mucilaginous,  insipid 
taste.  It  contains  a  large  quantity  of  mucilage  which  it  readily  parts  with 
to  water. 

Preparation . 

Mucilago  Ulmi, — Elm  6,  Boiling  Water  100  parts,  macerated  for  two  hours  and 
strained.  Dose,  ad  libitum. 

Slippery-elm  bark  is  demulcent,  slightly  astringent  and  somewhat  tonic. 
It  is  used  internally  in  diarrhoea,  dysentery  and  affections  of  the  urinary 
passages,  and  externally  in  the  form  of  poultice  as  an  emollient  applica¬ 
tion  in  cases  of  inflammation.  It  is  also  employed  in  the  dilatation  of 
fistulae,  strictures  and  the  os  uteri. 


UVA  URSI,  Bearberry,  — the  leaves  of  Arctostaphylos  Uva-urst,  a 
low,  evergreen  shrub,  of  the  nat.  ord.  Ericaceae,  inhabiting  the  northern 
latitudes  and  high  mountains  of  Europe,  Asia  and  America.  The  leaves 
are  small,  obovate,  nearly  sessile,  shining,  reticulated  beneath,  of  a  faint 
but  hay-like  odor,  and  a  strongly  astringent  taste.  They  contain  Tannic 


VALERIANA. 


393 


and  Gallic  Acids  and  3  principles,  viz. — Arbutin,  C24H32014,  a  bitter 
glucoside,  neutral,  crystalline,  soluble  in  warm  water  and  resolvable  into 
glucose  and  Hydroquinone ,  C6H602 ; — Ericolin ,  C34H5602,  bitter  and 
amorphous  ; — Ursone ,  C20H34O2,  resinous,  neutral,  crystalline  and  tasteless. 
The  Californian  Manzanita  (Arctostaphylos  glauca)  is  an  allied  plant 
and  also  contains  Arbutin  and  Tannin.  Dose  of  the  powdered  leaves, 
gr.  x-3j  in  infusion  or  decoction. 

Preparations. 

Extr actum  Uvoe-ursi  Fluidum, — Dose,  tr^x-  3  j. 

Infusum  Uvce-ursi  (Unofficial), —  ^j-Oj.  Dose,  ^j-ij. 

Arbutinum,  Arbutin  (Unofficial), — Dose,  gr.  iij-v. 

Physiological  Action  and  Therapeutics. 

Uva-ursi  is  astringent,  tonic  and  feebly  diuretic.  Used  in  large  quan¬ 
tity  it  produces  vomiting  and  purging,  and  is  alleged  to  have  oxytocic 
power.  Arbutin  is  an  efficient  diuretic,  and  is  decomposed  in  the  body, 
yielding  Hydroquinone  which  is  excreted  by  the  kidneys  as  Hydroqui- 
none-sulphuric  Acid.  This  is  non-toxic,  imparts  a  brown  color  with 
antiseptic  and  slightly  irritant  qualities  to  the  urine. 

Bear-berry  was  formerly  used  in  all  calculous  affections  and  chronic 
disorders  of  the  urinary  passages.  It  has  some  reputation  as  an  antilithic, 
and  is  no  doubt  useful  in  gravel,  chronic  nephritis,  cystitis,  urethritis, 
and  kindred  diseases.  It  relieves  incontinence  of  urine,  dysuria  and 
strangury,  and  has  proved  serviceable  even  in  uterine  hemorrhages.  Ar¬ 
butin  has  been  successfully  employed  in  cardiac  dropsy  as  a  diuretic, 
also  in  urethritis. 


VALERIANA,  Valerian,  — is  the  rhizome  and  rootlets  of  Valeri¬ 
ana  officinalis ,  a  large,  herbaceous  plant  of  the  nat.  ord.  Valerianacese, 
having  small,  white,  or  rose-colored  flowers,  and  opposite  pinnate  leaves 
on  an  erect,  round  and  channeled  stem.  The  plant  is  a  native  of 
Europe  but  is  cultivated  in  Vermont  and  New  York.  The  root  is  peren¬ 
nial,  its  rhizome  about  an  inch  long,  upright,  truncate  at  both  ends, 
internally  whitish  or  pale-brownish  with  a  narrow  circle  of  white  wood 
under  the  thin  bark.  Odor  peculiar,  taste  camphoraceous  and  bitter.  It 
contains  a  complex  Volatile  Oil,  from  which  are  developed  by  oxidation 
Valerene  C10H16,  which  is  a  terpene,  Valerol  or  Baldrian  Camphor, 
C12H20O,  and  Valerianic  Acid,  C5H10O2,  which  occurs  also  in  many  other 
plants  and  in  cod-liver  oil.  The  Valerianic  Acid  of  pharmacy  is  obtained 
as  a  product  of  oxidation  of  Amylic  Alcohol,  and  from  it  are  formed 
the  various  Valerianates.  It  is,  however,  not  identical  with  the  natural 
acid.  Dose  of  the  powdered  root,  gr.  x-xxx. 


394 


VALERIANA. 


Preparations  of  Valerian. 

Abstractum  Valeriana, — Dose,  gr.  v-xx. 

Extr actum  Valeriana  Fluidu?n, — Dose,  ffpx-xxx. 

Tinctura  Valeriana , — Strength  20  per  cent.  Dose,  ^  ss-ij. 

Tinctura  Valeriana  Ammoniata, — Valerian  20,  Aromatic  Spirit  of  Ammonia  to  100 
parts.  Dose,  3  ss-ij. 

Oleu?n  Valeriana , — the  volatile  oil,  sp.  gr.  about  0.950,  a  greenish  or  yellowish,  thin 
liquid,  having  the  odor  of  valerian,  an  aromatic  taste  and  a  slightly  acid  reaction,  readily 
soluble  in  alcohol.  Dose,  rrpij-v. 

The  Oil  is  by  far  the  best  preparation  for  use,  as  the  tinctures  are  extremely  nauseous 
and  the  fluid  extract  is  too  bulky.  The  taste  is  best  covered  by  Cinnamon. 


Preparations  of  Valerianic  Acid. 

Ammonii  Valerianas,  Valerianate  of  Ammonium,  NH4C3H902, — described  on  page 
94.  Dose  gr.  ij-x. 

Ferri  Valerianas,  Valerianate  of  Iron,  Fe2(C5H902)6, — described  on  page  217.  Dose, 

Quinina  Valerianas ,  Valerianate  of  Quinine,  C20H24N2O2C5Hl0O2.H2O, — described  on 
page  177.  ^  Dose,  gr.  j-iij. 

Zinci  Valerianas,  Valerianate  of  Zinc,  Zn(C5H902)2.H20, — described  on  page  404. 
Dose,  gr. 

The  Valerianates  are  made  with  the  acid  produced  from  Amylic  Alcohol,  and  do  not 
represent  the  action  of  the  plant,  but  rather  that  of  the  bases  from  which  they  are  pre¬ 
pared. 

Physiological  Action. 

Valerian  is  antispasmodic,  and  a  gentle  stimulant  to  the  nervous  and 
circulatory  systems.  It  is  sedative  to  reflex  excitability,  antagonizing  the 
action  of  Strychnine,  Brucine,  Thebaine,  etc.,  and  is  laxative,  diapho¬ 
retic  and  anthelmintic. 

Its  taste  and  odor  are  very  disagreeable,  but  cats  are  extravagantly 
fond  of  it.  In  these  animals  it  greatly  excites  the  sexual  appetite,  prob¬ 
ably  from  a  resemblance  between  its  odor  and  theirs  when  under  vene¬ 
real  excitement.  After  a  time  it  produces  in  them  violent  spasms  and 
convulsions. 

In  full  doses  it  increases  the  action  of  the  heart  and  raises  the  tempera¬ 
ture,  in  most  persons  producing  exhilaration  (in  some,  slight  mental  dis¬ 
turbance),  with  formication  of  the  hands  and  feet.  Long  used  it  induces 
a  condition  of  low  melancholy  and  hysterical  depression.  Large  doses 
cause  hiccough,  diarrhoea,  nausea  and  vomiting,  frequent  micturition 
with  tenesmus  of  the  bladder  and  lithates  in  the  urine,  mental  disturb¬ 
ance  even  to  delirium,  reduced  motility  and  sensibility,  and  lessened 
reflex  excitability.  The  oil  in  large  doses  is  paralyzant  to  the  brain  and 
the  spinal  cord,  lowers  the  blood-pressure  and  slows  the  pulse. 

The  Valerianates  follow  their  bases  in  general  action,  but  are  sup¬ 
posed  to  combine  therewith  some  of  the  sedative  qualities  of  the  acid. 

Therapeutics. 

Valerian  was  formerly  much  used  in  epilepsy,  but  it  was  probably  only 
useful  in  the  hysterical  form  of  that  disease  (hystero-epilepsy).  It  is  a 
valuable  remedy  in  all  forms  of  hysteria,  especially  when  occurring  in 


VANILLA - VERATRUM  VIRIDE. 


395 


young  and  delicate  women.  It  is  also  useful  in  flatulence  of  infants 
and  in  that  of  hypochondriacal  and  hysterical  subjects,  and  in  coughs  of 
nervous  type,  whooping-cough,  diabetes  insipidus,  convulsions  due  to 
worms  and  in  delirium  with  vital  depression.  In  the  coma  of  typhus 
fever  the  oil  proved  remarkably  efficient  in  a  series  of  135  cases  out  of 
172  cases  treated  by  it. 

Valerianate  of  Ammonium  is  used  in  the  same  class  of  disorders  as  is 
Valerian.  It  is  often  a  good  remedy  for  nervous  headache,  administered 
in  10-grain  doses  and  in  an  elixir. 

Valerianate  of  Zinc  has  been  supposed  to  combine  the  antispasmodic 
power  of  valerian  with  the  nerve-tonic  effect  of  a  zinc  salt.  It  has  been 
used  in  cholera,  epilepsy  and  neuralgia,  frequently  with  considerable 
success. 

The  Valerianates  of  Iron  and  Quinine  are  used  as  the  salts  of  their 
respective  bases. 


VANILLA  , — is  the  fruit  of  Vanilla  planifolia ,  a  perennial,  climbing 
plant  of  the  nat.  ord.  Orchidaceae,  a  native  of  the  West  Indies  and  trop¬ 
ical  America,  but  cultivated  in  Java,  etc.  It  has  dark  green,  tough  leaves, 
pale  greenish-yellow  sessile  flowers,  and  long  pods  (6  to  10  inches), 
wrinkled,  warty,  one-celled,  containing  a  blackish-brown  pulp  with 
numerous  small  seeds  and  acicular  crystals,  of  peculiar  and  fragrant  odor 
and  taste.  Its  characteristic  odorous  principle  is  Vanillin ,  or  the  methyl- 
ether  of  protocatechuic  aldehyd,  which  oxidizes  slowly  in  damp  air  to 
Vanillic  Acid ,  and  may  be  resolved  into  methyl  chloride  and  proto¬ 
catechuic  acid.  Vanillin  may  be  made  synthetically  from  Coniferin 
or  from  Eugenol.  Dose,  indefinite. 


Preparations. 

Tinctura  Vanilla, — 10  per  cent.  Dose,  a  few  drops  according  to  the  strength  of  flavor 
desired. 

Trochisci  Ferri, — contain  about  ^  per  cent,  of  Vanilla. 

Vanilla  is  an  aromatic  stimulant,  with  considerable  influence  on  the 
nervous  system.  It  is  chiefly  employed  as  a  perfume  and  for  flavoring 
purposes,  but  has  been  used  in  hysteria  and  low  fevers. 


VERATRUM  VIRIDE,  American  Hellebore, — is  the  rhizome 
and  rootlets  of  Veratrum  viride ,  or  Indian  Poke,  Poke-root,  Swamp 
Hellebore,  an  indigenous  plant  of  the  nat.  ord.  Melanthaceie,  having 
a  solid,  round  stem,  furnished  with  bright  green  leaves,  and  terminating 
in  a  panicle  of  greenish-yellow  flowers.  The  root  is  perennial,  upright, 


396 


VERATRUM  VIRIDE. 


externally  blackish-gray,  internally  grayish-white,  2  to  3  inches  long,  with 
numerous,  shriveled  rootlets,  inodorous  but  sternutatory  when  powdered, 
taste  bitter  and  very  acrid.  It  contains  several  alkaloids,  fervine , 
C26H43N02,  Pseudo-jervine ,  C29H43N07,  Cevadine ,  C32H49N09,  a  very  little 
Rubijervine ,  C26H43N02,  and  traces  of  Vera/rine,  C37H53NOn,  and  Vera- 
tralbine ,  C28H43N05.  Veratroidine ,  formerly  regarded  as  one  of  its  alka¬ 
loids,  is  now  thought  to  be  Rubijervine  and  Resin.  Veratrum  Viride 
also  contains  Gallic  Acid  and  Sugar. 

Allied  Plants. 

Veratrum  Album,  White  Hellebore, — is  a  native  of  the  mountainous 
regions  of  continental  Europe,  and  so  closely  resembles  V.  Viride  in 
appearance  and  characteristics  that  it  may  be  considered  a  variety  of 
the  same  plant.  The  rhizome  was  official  in  the  U.  S.  P.  1870.  It  con¬ 
tains  the  alkaloids  Jervine ,  Pseudo-jervine ,  Rubijervine ,  traces  of  Cevadine ,' 
and  another  powerful  alkaloid  Veratralbine ,  C28H43N05. 

Veratrum  Sabadilla,  Cevadilla,  Asagraea  officinalis, — is  a  bulbous 
plant  of  the  nat.  ord.  Melanthaceae,  indigenous  in  Mexico  and  Central 
America.  It  contains  the  alkaloids  Cevadine  (formerly  called  Veratrine), 
Cevadilline  and  Veratrine ,  with  Veratric  and  Sabadillic  or  Cevadic  Acids. 
It  is  the  source  of  the  official  Veratrine  (see  below).  The  seeds  are 
official  in  the  Br.  Phar.  under  the  title  Sabadilla. 

Preparations. 

-  Extractum  Veratri  Viridis  Fluidum , — Dose,  Tty-iv. 

Tindura  Veratri  Viridis , — 50  per  cent.  Dose,  rtpij-x. 

Nonvood' s  Tindure  of  Veratrutn  Viride ,  has  a  very  high  reputation  for  efficiency, — 
Dose,  11\v,  increased  by  TT\j  every  3  hours,  until  pulse  is  down  to  65,  when  the  original 
dose  will  hold  it  there. 

Veratrina ,  Veratrine, — is  an  alkaloid  or  mixture  of  alkaloids  prepared  from  the  seeds 
of  Asagrcea  officinalis  (see  above).  A  white,  or  grayish-white,  amorphous  powder,  highly 
irritant  to  the  nostrils,  of  very  acrid  taste,  producing  tingling  and  numbness  of  the  tongue 
and  constriction  of  the  fauces;  slightly  soluble  in  cold  water,  soluble  in  3  of  alcohol  at 
590  F.,  in  6  of  ether,  2  of  chloroform,  96  of  glycerin  and  in  56  parts  of  olive  oil.  Dose, 

<rr  1  _  1 
Sr-  70  To- 

Unguentum  Veratrince , — Veratrine  4,  Alcohol  6,  Benzoinated  Lard  96  parts.  For 
local  use. 

Oleatiun  Veratrince , — Veratrine  2,  Oleic  Acid  98  parts.  For  local  use. 

Physiological  Action. 

Veratrum  Viride  is  in  action  closely  allied  to  Aconite,  being  a  pow¬ 
erful  cardiac  depressant  and  spinal  paralyzant.  It  differs  from  Aconite  in 
affecting  the  respiration  to  a  much  less  degree, — in  being  a  systemic 
emeto-cathartic — in  paralyzing  the  motor  system  centrally,  impairing  the 
reflexes,  but  leaving  sensation  unimpaired, — and  in  having  little  or  no 
diaphoretic  or  diuretic  action.  It  causes  great  depression,  but  is  seldom 
fatal ;  when  death  does  result  from  its  use  it  usually  occurs  by  paralysis  of 
the  heart. 


VERATRUM  VIRIDE. 


397 


In  small  doses  Veratrum  reduces  the  force  of  the  pulse,  but  does  not  at 
first  affect  its  rate.  If  continued  for  some  time,  the  pulse  becomes  very 
slow,  soft  and  compressible  ;  rising,  on  the  least  exertion,  to  be  very 
rapid  and  feeble.  At  the  same  time  there  is  great  muscular  weakness, 
and  frequently  nausea  and  vomiting.  Large  doses  increase  these  symp¬ 
toms  very  much,  the  pulse  becoming  very  rapid  and  so  small  as  to  be 
almost  imperceptible  ;  the  skin  is  cold  and  clammy,  and  constant  vomit¬ 
ing,  extreme  debility,  giddiness,  impaired  vision,  and  partial  unconscious¬ 
ness  ensue. 

Jervine  represents  in  part  the  depressant  action  on  the  circulation  and 
on  the  central  nervous  system.  It  does  not,  however,  affect  the  vagus, 
and  but  very  slightly  the  voluntary  muscles  or  the  motor  nerves.  It  irri¬ 
tates  the  motor  centres  in  the  brain,  causing  convulsions  ;  and  lowers  the 
functions  of  the  cord,  of  the  centres  in  the  medulla,  especially  the  vaso¬ 
motor,  and  those  of  the  cardiac  ganglia, — slowing  the  heart  by  direct 
depression  either  of  the  cardiac  muscle  or  its  motor  apparatus.  It  always 
causes  salivation,  but  never  vomiting  or  purging;  and  kills  by  asphyxia, 
the  heart  beating  after  respiration  has  ceased. 

Veratroidine,  on  the  contrary,  always  causes  emeto-catharsis,  and 
produces  less  violent  convulsions.  It  stimulates  the  vagus  centre  and 
paralyzes  the  vagus  ends,  depresses  the  cord,  and  paralyzes  the  respiratory 
centre, — but  at  the  same  time  increases  the  excitability  of  the  vaso-motor 
centre.  The  result  is  great  slowing  of  the  pulse-rate  and  of  respiration, 
and  lowering  of  blood-pressure,  until  the  carbonized  blood  irritates  the 
vaso-motor  centre,  when  the  blood-pressure  rises  greatly.  It  probably 
consists  of  Rubijervine  and  a  toxic  resin. 

Veratrum  Album  contains  a  very  powerful  alkaloid,  Veratralbine ,  and 
also  an  irritant  poisonous  resin  (?).  Its  general  action  is  similar  to  that 
of  its  congener,  but  it  is  much  more  irritant  to  the  gastro-intestinal 
mucous  membrane,  causing  violent  vomiting  and  purging,  intense  abdom¬ 
inal  and  oesophageal  pain,  greatly  reduced  temperature  and  pulse,  collapse, 
and  death  from  cardiac  and  respiratory  paralysis. 

Veratrine  is  an  acrid,  intensely  irritant  powder,  probably  consisting 
of  a  mixture  of  alkaloids.  It  causes  violent  sneezing,  a  burning  sensa¬ 
tion,  and  free  salivation.  It  affects  the  heart  and  circulation  similarly  to 
the  other  Veratrise  and  in  addition  seems  to  be  a  direct  poison  to  muscular 
tissue,  and  to  cause  violent  convulsions  before  the  muscular  paralysis  sets 
in.  The  alkaloids  Jervine  and  Rubijervine  both  depress  the  circulation, 
while  the  latter  produces  the  emeto-catharsis. 

Antagonists  and  Inco?npatibles. 

Alcohol,  Opium,  Belladonna  and  Ammonia  counteract  the  cardiac  depression.  Mor¬ 
phine  and  Atropine  should  be  administered  hypodermically,  or  Laudanum  internally  with 
alcoholic  stimulants,  the  recumbent  position  should  be  enforced,  and  dry  heat  applied  to 
the  body.  Caustic  alkalies  are  incompatible,  as  they  decompose  the  alkaloids. 


39s 


VERBASCUM. 


Therapeutics. 

Veratrum  Viride  is  inferior  to  Aconite  in  most  of  the  fevers  and 
inflammations,  by  reason  of  its  lacking  power  over  excretion.  It  renders 
good  service,  however,  in  the  early  stages  of  many  parenchymatous  and 
serous  inflammations  when  occurring  in  sthenic  subjects,  especially  in 
pneumonia.  It  is  highly  esteemed  in  puerperal  fever  and  in  many  cardiac 
disorders,  as  simple  hypertrophy,  irritable  heart,  etc.  It  has  been  used 
with  remarkably  good  results  in  many  cases  of  acute  mania  and  puerperal 
convulsions,  and  it  is  of  service  in  aneurism  to  depress  the  circulation  to 
the  lowest  point,  but  in  this  case  the  recumbent  position  must  be  strictly 
observed  in  order  to  secure  safety.  It  should  always  be  administered  in 
small  doses  and  its  effects  carefully  watched. 

In  puerperal  eclampsia  large  doses  have  been  administered  without 
danger  and  with  decided  benefit,  as  much  as  20  drops  of  Norwood’s 
tincture  having  been  administered  every  hour  for  5  consecutive  days  and 
nights  in  one  case,  the  patient  making  a  good  recovery.  The  same  pre¬ 
paration  may  be  given  hypodermically,  in  doses  of  npij-iv. 

Veratrum  Album  is  the  “  Hellebore  ”  of  the  ancient  physicians,  and 
was  much  used  by  them  as  a  derivative  in  insanity.  It  is  rarely  used  at 
present  except  by  the  homceopathists,  who  give  it  in  the  cold  stage  of 
cholera,  in  colic,  in  the  vomiting  and  purging  of  summer  diarrhoea,  in 
whooping-cough  and  asthma. 

Veratrine  is  chiefly  used  externally.  The  ointment  or  oleate  may  be 
used  with  benefit  in  many  cases  of  superficial  neuralgia,  myalgia  and 
headaches,  a  small  quantity  being  rubbed  in  over  the  seat  of  the  pain.  It 
may  be  absorbed  through  an  abrasion  of  the  cuticle  and  give  rise  to  dan¬ 
gerous  symptoms.  Internally  it  has  been  employed  as  a  cardiac  sedative 
in  fevers  and  inflammation,  also  in  acute  articular  rheumatism,  dropsies, 
dysmenorrhoea  and  various  nervous  affections,  but  its  uncertainty  of  action 
and  the  dangerous  depression  which  it  may  produce  have  caused  it  to  lose 
favor  as  an  internal  remedy. 


VERBASCUM,  Mullein  (Unofficial), — the  leaves  of  Verbascuni 
Thaspus ,  the  Mullein-weed,  a  common  plant  of  the  nat.  ord.  Scrophu- 
lariacse,  having  large  woolly  leaves  and  yellow  flowers  in  dense  spikes. 
Its  chief  constituent  is  mucilage,  though  the  flowers  contain  an  essential 
oil  in  very  small  proportion.  An  infusion  of  q\v  of  fresh  leaves  to  the 
pint  of  milk  is  the  form  in  which  it  has  generally  been  given ;  this  quan¬ 
tity  to  be  taken  thrice  daily. 

Physiological  Action  and  Therapeutics. 

Mullein  is  emollient  and  demulcent,  perhaps  also  slightly  anodyne. 
It  has  long  been  a  popular  Irish  remedy  in  pulmonary  affections,  as  under 


VIBURNUM - VIOLA  TRICOLOR. 


399 


its  use  the  weight  steadily  increases  in  phthisis  and  other  wasting  dis¬ 
orders,  while  expectoration  is  rendered  more  easy,  cough  is  palliated  and 
the  general  condition  improved.  It  is  also  recommended  in  cystitis, 
irritable  bladder,  and  diarrhoea,  and  is  employed  as  an  enema  in  dysen¬ 
tery  and  as  a  poultice  for  hemorrhoids.  The  dried  leaves  may  be  smoked 
with  benefit  in  aphonia  from  laryngeal  irritation. 


VIBURNUM,  Black  Haw  , — is  the  bark  of  Viburnum prunifolium , 
an  indigenous  shrub  or  small  tree  of  the  nat.  ord.  Caprifoliacese,  having 
sharply  serrulate  leaves,  and  small,  white  flowers  in  terminal  cymes.  The 
bark  occurs  in  glossy,  purplish-brown,  thin  pieces  or  quills  covered  with 
scattered  warts  and  minute  black  dots;  inner  surface  whitish  and  smooth, 
inodorous,  somewhat  astringent  and  bitter.  It  contains  tannic,  oxalic, 
citric  and  malic  acids,  sulphates  and  chlorides  ;  also  two  resins,  one  of 
which  is  named  Viburnin ,  and  Viburnic  Acid,  which  is  identical  with 
Valerianic  Acid. 

Preparation. 

Extradum  Viburni  Fluidum , — Dose,  3  ss-ij. 

Physiological  Action  and  Therapeutics. 

Viburnum  is  considered  to  possess  nervine,  antispasmodic,  astringent, 
diuretic  and  tonic  properties,  and  to  be  especially  useful  in  preventing 
abortion  in  the  nervous  diseases  of  pregnancy,  and  in  dysmenorrhoea.  It 
may  be  administered  with  cannabis  indica,  morphine,  nerve-sedatives  or 
simple  aromatics.  No  exact  observations  have  been  made  regarding  its 
action,  and  its  therapeutical  claims  are  denied  by  many  who  have  used  it. 
It  often  excites  nausea  and  vomiting. 

Viburnum  Opulus,  Cramp-bark ,  Cranberry-tree , — another  shrub  of 
the  same  genus,  is  highly  valued  by  many  practitioners  as  a  remedy  in 
uterine  and  other  abdominal  pains,  but  is  not  official.  The  so-called 
“  Viburnum  Compound  of  Dr.  Hayden  ,”  is  stated  by  its  manufacturers  to 
consist  of  “  the  active  principles  of  the  Viburnum  Opulus,  Dioscorea  Vil- 
losa,  Scutellaria  Lateriflora,  and  a  combination  of  aromatics,  prepared  by 
a  process  peculiar  to  ourselves.”  This  they  call  publishing  the  formula 
of  the  preparation. 


VIOLA  TRICOLOR,  Pansy,— is  the  wild-grown,  flowering  herb 
of  Viola  tricolor ,  the  Heart’s-ease  Pansy,  a  plant  of  the  nat.  ord.  Violaceae, 
native  in  Europe,  but  naturalized  in  the  southern  U.  S.  It  has  an  angu¬ 
lar  and  nearly  smooth  stem;  leaves  alternate,  petiolate,  ovate  or  oblong 
and  crenate ;  flowers  with  an  obtuse  spur  and  variegated  petals,  inodor¬ 
ous,  taste  somewhat  bitter  and  acrid.  It  contains  an  active  alkaloid 


400 


VISCUM — VITELLUS. 


Violine ,  allied  in  many  respects  to  Emetine,  and  poisonous.  There  are 
no  official  preparations.  Dose,  gr.  x-5j,  in  decoction. 

Physiological  Action  and  Therapeutics. 

Viola  is  mucilaginous,  emollient,  expectorant  and  slightly  laxative.  Its 
active  principle  is  emeto-cathartic,  but  exists  in  very  small  quantity  in  the 
plant.  A  decoction  of  the  fresh  herb  in  milk,  with  a  poultice  of  the 
same  was  formerly  highly  recommended  in  crusta  lactea  and  impetigo.  It 
is  used  with  benefit  in  some  forms  of  eczema,  especially  in  that  of  the 
head  and  face,  and  has  had  some  reputation  in  bronchitis  and  constitu¬ 
tional  syphilis. 

Viola  Cucullata,  the  common  Violet,  is  used  in  Pennsylvania  with 
success  as  an  internal  antidote  against  rattlesnake  venom.  The  leaves 
are  eaten,  and  a  poultice  of  salt  and  indigo  is  applied  to  the  wound. 


VISCUM,  Mistletoe  (Unofficial), — occurs  in  two  species  (i)  Vis¬ 
cum  album ,  the  European  Mistletoe,  a  small,  parasitic,  evergreen  shrub, 
of  the  nat.  ord.  Loranthaceae,  growing  chiefly  on  deciduous-leaved  trees, 
and  (2)  Viscum  flavescens,  the  American  species,  growing  on  oaks,  elms, 
etc.  They  contain  mucilage,  starch,  fixed  oil,  resin,  salts,  etc.,  and 
Viscin ,  or  Bird-lime,  which  occurs  also  in  Ilex  aquifolium,  Gentiana 
lutea  and  other  plants.  Dose,  gr.  x-5j  in  decoction,  or  npv-xxx  of  a 
ten  per  cent,  tincture. 

Physiological  Action  and  Therapeutics. 

The  berries  of  the  mistletoes  have  produced  emeto-catharsis,  with  great 
thirst,  tenesmus,  bloody-stools,  convulsions  and  even  death  in  young  chil¬ 
dren.  The  leaves  and  twigs  have  been  used  in  epilepsy,  hysteria,  chorea, 
asthma  and  other  nervous  affections.  The  American  plant  is  asserted  to 
possess  qualities  similar  to  those  of  Digitalis,  and  to  incite  uterine  con¬ 
tractions.  It  has  been  used  in  cardiac  affections,  dropsies,  uterine 
hemorrhages  and  amenorrhoea,  also  as  an  abortifacient. 


VITELLUS,  Yolk  of  Egg, — is  the  yolk  of  the  egg  of  the  domes¬ 
tic  fowl,  Gal/us  Bankiva ,  var.  do?nesticus.  It  is  a  viscid,  reddish-yellow, 
opaque  liquid,  of  bland  taste,  alkaline  reaction,  odorless,  and  may  be  re¬ 
garded  as  a  dense  emulsion  of  oil  suspended  in  water  by  means  of  albu¬ 
men.  It  is  coagulated  by  heat  or  by  alcohol  and  contains  Vitellin,  which 
is  a  proteid  related  to  casein,  Cholesterin  and  Albumin ,  besides  fat,  inor¬ 
ganic  salts,  sugar,  etc. 

Preparation. 

Glycerituni  Vitelli ,  Glycerite  of  Yolk  of  Egg,  Glyconin, — consists  of  Vitellus  45,  Gly¬ 
cerin  55  parts  rubbed  together  until  thoroughly  mixed. 


XANTHOXYLUM. 


401 


Physiological  Action  and  Therapeutics. 

Yolk  of  Egg  is  highly  nutritive  and  forms  a  useful  article  of  diet  in 
exhausted  conditions  of  the  system,  but  its  chief  use  in  medicine  is  for 
emulsionizing  oils  and  camphors.  The  Glycerite  has  the  consistence  of 
honey  and  forms  an  opaque  emulsion  with  water.  It  is  a  very  good 
vehicle  for  cod-liver  oil  (see  ante ,  page  282),  and  an  excellent  protective 
application  for  burns,  erysipelas,  fissure  of  the  nipples  and  many  cutane¬ 
ous  disorders.  It  is  also  used  as  a  cosmetic,  and  may  be  employed  as  an 
aliment. 


XANTHOXYLUM,  Prickly  Ash,— is  the  bark  of  Xanthoxylum 
fraxineum ,  the  northern  species,  and  of  Xanthoxylum  carolinianum ,  the 
southern  species  of  an  indigenous  shrub  of  the  nat.  ord.  Rutacem,  having 
small,  greenish  flowers,  alternate  unequally  pinnate  leaves,  leaflets  punc¬ 
tate  with  pellucid  dots,  stems  and  leafstalks  armed  with  prickles.  The 
bark  of  both  species  comes  in  curved  or  quilled  fragments,  of  a  brownish- 
gray  color  externally  with  whitish  patches,  and  minute  black  dots,  faintly 
furrowed,  inodorous,  bitter  and  pungent.  That  of  X.  fraxineum  is  about 
Jg-  inch  thick,  has  several  two-edged  spines  each  %  inch  long,  the  bark 
of  X.  carolinianum  is  twice  as  thick  as  the  other  and  is  marked  by  many 
conical,  corky  projections,  and  by  stout  brown  spines,  arising  from  corky 
bases.  It  contains  a  volatile  oil,  a  fixed  oil,  resin,  gum,  coloring  matter 
and  an  alkaloid,  Xanthoxyline ,  which  is  identical  with  Berberine  (see  ante, 
page  130).  Dose,  of  the  powdered  bark,  gr.  x-xxx. 

Preparations. 

Extraction  Xanthoxyli  Fluidum , — Dose,  3  ss-j. 

Decoctum  Xanthoxyli  (Unofficial), —  to  the  quart.  Dose,  a  pint  during  24  hours  in 

divided  doses. 

Physiological  Action. 

Xanthoxylum  is  a  stimulant  and  aromatic  bitter,  a  local  and  systemic 
sialagogue,  diaphoretic,  diuretic  and  emmenagogue.  Its  taste  is  aromatic, 
soon  becoming  acrid  and  bitter  and  causing  profuse  salivation,  tingling  in 
the  tongue  and  increased  secretion  from  stomach,  intestines,  liver  and 
pancreas.  It  also  increases  the  cardiac  action  and  raises  the  arterial  ten¬ 
sion,  and  is  classed  among  the  vegetable  alteratives,  with  Mezereum, 
Guaiac,  Stillingia,  etc. 

Therapeutics. 

Xanthoxylum  has  a  high  reputation  in  chronic  rheumatism,  myalgia, 
lumbago  and  similar  disorders,  also  in  jaundice  from  catarrh  of  the  bile- 
ducts,  in  dropsies,  chronic  pharyngitis  and  constitutional  syphilis.  In 
old  cases  of  pharyngitis,  the  mucous  membrane  being  glazed  and  dry,  the 
decoction  should  be  used  as  a  gargle  and  np x-xxx  of  the  fluid  extract 
26 


402 


ZEA  MAYS. 


taken  internally  thrice  daily.  The  bark,  used  as  a  masticatory,  is  a  popu¬ 
lar  remedy  for  toothache,  and  has  been  frequently  successful  in  paralysis 
of  the  tongue. 


ZEA  MAYS,  Maize,  Indian  Corn. — This  well-known  species  of 
the  nat.  ord.  Graminacese,  though  itself  unofficial,  is  the  source  of  two 
drugs  one  of  which  is  official,  viz.: — 

Ustilago,  Corn  Smut, — Ustilago  Maydis,  nat.  ord.  Fungi,  grown  upon 
the  stems,  the  pistils  and  the  male  inflorescence  (tassel)  of  Zea  Mays.  It 
occurs  in  irregular,  globular  masses,  sometimes  6  inches  thick,  and  con¬ 
sisting  of  a  blackish  membrane,  inclosing  numerous  globular,  minute 
spores,  their  surfaces  covered  with  echinulate  warts.  Its  odor  and  taste 
are  unpleasant,  and  it  contains  fixed  oil,  resin,  pectin,  gluten,  sugar,  an 
acid  resembling  the  Sclerotic  Acid  of  Ergot,  and  a  volatile  principle 
called  Secaline,  which  is  supposed  to  be  identical  with  Trimethylamine. 


Preparation. 

Extraction  Ustilaginis  Flnidum  (Unofficial), — may  be  made  according  to  the  general 
rule.  Dose,  rr^xv-^j. 

Stigmata  Maydis,  Stigmata  of  Maize,  Corn  Silk  (Unofficial), — 
should  be  gathered  when  the  tassel  has  well  shed  its  pollen.  Its  active 
principle  is  said  to  be  Maizenic  Acid. 


Preparation. 

Extraction  Stigviatarum  Alaydis  Fluidum  (Unofficial), — made  by  the  general  rule  for 
fluid  extracts.  Dose,  gj-ij- 

Physiological  Action  and  Therapeutics. 

The  properties  of  Ustilago,  so  far  as  examined,  resemble  those  of 
Ergot  and  Nux-vomica  combined.  It  is  a  spinal  excitant,  exalts  sensibil¬ 
ity  and  reflex  action,  producing  tonic  convulsions  on  the  least  irritation 
of  the  skin.  It  slows  the  heart  by  stimulation  of  the  pneumogastric, 
dilates  the  pupils,  causes  muscular  paresis,  and  death  by  tetanus  of  the 
respiratory  muscles  or  by  exhaustion.  Experiments  on  its  reputed  oxy¬ 
tocic  action  have  not  substantiated  the  claims  made  for  it  in  this  respect, 
though  it  is  said  to  have  produced  abortion  in  cows  and  other  animals, 
after  they  had  eaten  the  diseased  grain.  As  a  therapeutic  agent  Ustilago 
has  been  very  little  used,  and  when  employed  it  has  been  as  a  substitute 
for  Ergot. 

Stigmata  Maydis  is  a  certain  but  mild  diuretic  when  given  in  full 
doses  at  short  intervals.  It  is  by  some  observers  considered  demulcent 
and  anodyne,  and  is  generally  believed  to  have  a  specific  or  alterative 
influence  over  many  disorders  of  the  genito-urinary  passages  and  the 


ZINCUM. 


403 


urinary  bladder.  It  has  been  used  with  considerable  success  in  inconti¬ 
nence  of  urine,  uric  and  phosphatic  gravel,  gout,  rheumatism,  urethritis, 
pyelitis,  acute  and  chronic  cystitis,  cardiac  dropsy  and  obstructive  valvu¬ 
lar  disease  of  the  heart. 


ZINCUM,  Zinc,  Zn, — is  metallic  Zinc,  in  the  form  of  thin  sheets,  or 
irregular,  granulated  pieces,  and  is  a  bluish-white  metal,  having  the  sp. 
gr.  6.9.  It  occurs  native  as  a  Sulphide  ( Blende ),  as  a  Carbonate  and  a 
Silicate  ( Calamine ),  as  a  Red  Oxide  (Zincite),  and  as  a  mixture  of  Zinc 
Oxide  with  Oxide  of  Iron  and  Manganese  (. Franklinite ).  Zinc  is  soluble 
in  the  weakest  acids,  and  therefore  should  never  be  used  for  culinary  ves¬ 
sels.  Its  salts  are  all  more  or  less  active  poisons.  Metallic  Zinc  is  not 
employed  as  a  medicine. 


Zinc  Compounds  and  their  Preparations. 

Zinci  Acetas,  Acetate  of  Zinc,  Zn(C2H320)2.3H20, — soft,  white,  micaceous  or  pearly, 
six-sided  tablets  or  scales,  somewhat  efflorescent  in  dry  air,  of  faintly  acetous  odor,  sharp 
metallic  taste  and  a  slightly  acid  reaction;  soluble  in  3  of  water  and  in  30  of  alcohol  at 
590  F.,  in  1  yz  of  boiling  water  and  in  3  of  boiling  alcohol.  Used  locally  as  an  astrin¬ 
gent  in  solution  of  gr.  j  or  ij  to  ^j,  or  internally  in  doses  of  gr.  ij. 

Zinci  Carbonas  Prcecipitatus ,  Precipitated  Carbonate  of  Zinc,  (ZnC03)2.3Zn(H0)2, — 
a  white,  impalpable  powder,  permanent  in  the  air,  odorless  and  tasteless,  insoluble  in 
water  or  alcohol,  but  soluble  in  acids  with  copious  effervescence.  When  strongly  heated 
it  loses  water  and  carbonic  acid  gas,  leaving  a  residue  of  oxide  of  zinc.  Used  locally 
as  a  protective. 

Zinci  Chloridum,  Chloride  of  Zinc,  ZnCl2, — a  white,  crystalline  powder,  deliquescent, 
odorless,  of  caustic,  saline,  and  metallic  taste  and  acid  reaction,  very  soluble  in  water  and 
in  alcohol,  forming  a  clear  or  only  faintly  opalescent  solution.  Tonic  and  escharotic.  For 
internal  use  a  solution  in  Spirit  of  Ether  is  the  most  convenient  form,  of  the  strength 
of  ^ss-^iij,  of  which  from  4  to  8  drops  maybe  given  twice  daily.  Strength  of  injec¬ 
tions  and  collyria,  gr.  j-ij  ad  ^j. 

Liquor  Zinci  Chloridi, — an  aqueous  solution  of  Zinc  Chloride  containing  about  50  per 
cent,  of  the  salt.  A  clear,  colorless,  odorless  liquid,  of  a  very  astringent,  sweetish  taste 
and  an  acid  reaction.  A  powerful  disinfectant  for  sinks,  drains,  etc.  Used  also  as  an 
injection  in  gonorrhoea,  leucorrhoea,  etc.,  in  dilute  solution,  yz  to  I  per  cent.  Burnett's 
Disinfecting  Fluid  is  similar  to  the  above  but  slightly  stronger. 

Zinci  Iodidum,  Iodide  of  Zinc,  Znl2, — a  white,  granular  powder,  very  deliquescent, 
odorless,  of  sharp,  saline  and  metallic  taste  and  acid  reaction,  very  soluble  in  water  and 
in  alcohol.  Dose,  gr.  ss-ij  in  syrup. 

Zinci  Oxidum,  Oxide  of  Zinc,  ZnO, — a  soft,  pale-yellowish  powder,  permanent  in  the 
air,  odorless  and  tasteless,  insoluble  in  water  or  alcohol,  but  soluble  in  acids  without  effer¬ 
vescence.  Dose,  gr.  j-x,  in  pill. 

Unguentum  Zinci  Oxidi , — strength  20  per  cent.,  made  with  Benzoinated  Lard,  thor¬ 
oughly  mixed. 

Zinci  Sulphas ,  Sulphate  of  Zinc,  ZnS04,7H20, — small  colorless  prisms  or  acicular 
needles,  slowly  efflorescing  in  dry  air,  odorless,  of  sharp,  saline,  nauseous  and  metallic 
taste  and  acid  reaction,  soluble  in  0.6  of  water,  insoluble  in  alcohol.  Dose,  as  emetic, 
gr.  x-xxx, — as  a  tonic  and  astringent,  gr.  j^-ij,  in  pill.  For  Villate's  Solution ,  see  ante, 
page  195. 

Zinci  Valerianas,  Valerianate  of  Zinc,  Zn(C5H902)2.H20, — soft,  white,  pearly  scales, 
of  sweet  and  styptic  taste  and  acid  reaction;  soluble  in  100  of  water  and  in  40  of  alco¬ 
hol  at  590  F.  Dose,  gr.  4<j— ij>  in  pill. 

[The  Bromide  of  Zinc  is  described  under  Bromum,  see  page  133,  and  the  Phosphide 
under  Phosphorus,  on  page  305.] 


404 


ZINCUM. 


Physiological  Action  and  Therapeutics. 

Zinc  Salts  are  astringents,  but  milder  ones  than  the  salts  of  Lead.  Its 
soluble  compounds  (the  Chloride,  Iodide,  Sulphate  and  Acetate)  are  cor¬ 
rosive  poisons,  causing  violent  gastro-enteritis,  and  in  some  cases  pro¬ 
found  nervous  depression.  The  Chloride  is  a  very  powerful  and  pain¬ 
ful  escharotic  or  rather  mummifier  of  the  tissues,  having  great  affinity  for 
water,  coagulating  albumen  and  shrivelling  the  vessels.  It  is  a  very 
active  disinfectant.  The  Sulphate  is  also  escharotic  and  a  specific 
emetic,  acting  promptly  by  direct  irritation  of  the  stomach,  and  without 
much  depression  or  after-nausea.  In  small  doses  it  is  tonic  and  astrin¬ 
gent,  in  larger  it  would  be  a  severe  irritant  but  for  its  causing  prompt 
emesis.  The  Acetate  resembles  the  sulphate  in  action.  The  Oxide 
used  externally  is  a  mild,  soothing  astringent;  used  internally  it  enters 
the  blood  as  a  lactate  or  chloride,  and  acts  as  a  mild  astringent  and  as  a 
nervous  sedative.  Being  almost  insoluble  in  the  stomach,  it  has  but  feeble 
diffusive  power  and  consequently  but  slight  activity.  The  Carbonate 
resembles  the  Oxide  in  action.  The  Iodide  locally  is  a  powerful  eschar¬ 
otic  and  has  been  supposed  to  possess  some  alterative  powers  when  given 
internally  in  addition  to  its  astringent  qualities  as  a  zinc  salt.  The 
Valerianate  acts  as  a  nervous  sedative,  but  its  properties  are  in  all  proba¬ 
bility  due  to  its  base  and  not  to  the  acid  combined  with  it. 

Continued  use  of  zinc  salts  produces  symptoms  similar  to  those  of 
chronic  lead-poisoning,  but  of  much  less  gravity.  They  manifest  much 
less  tendency  to  accumulate  in  the  system  than  other  metallic  salts,  and 
are  excreted  much  more  rapidly.  Elimination  takes  place  chiefly  by  the 
liver  and  intestinal  glands. 

[The  actions  of  the  Bromide  and  Phosphide  are  described  respectively 
on  pages  134  and  305.] 

Antidotes  and  Incompatibles. 

Lime-water,  mucilaginous  drinks,  soap,  tannic  acid,  milk,  Potassium  and  Sodium  Car¬ 
bonates  if  given  early,  are  the  antidotes  in  poisoning  by  the  salts  of  zinc.  Incompatibles 
are — lime-water,  alkalies  and  their  carbonates,  nitrate  of  silver,  and  vegetable  astringents. 
Acetate  of  Lead  produces  double  decomposition  with  zinc  salts,  but  it  is  often  used  in 
solution  with  the  sulphate  as  an  injection. 


Therapeutics. 

Zinc  salts  are  chiefly  employed  in  weak  solution  as  mild  astringent 
applications  in  catarrhs  of  mucous  membranes,  such  as  conjunctivitis, 
gonorrhoea,  etc.,  and  as  unguents  and  lotions  in  skin-diseases,  particularly 
eczema,  impetigo,  herpes,  and  erythema.  The  Chloride  is  made  into  a 
paste  with  flour  and  glycerin  for  the  destruction  of  lupus,  epithelioma  and 
other  morbid  growths,  and  for  opening  abscesses  in  locations  where  punc¬ 
ture  or  incision  might  be  dangerous.  The  cuticle,  if  unbroken,  should 
be  removed  by  strong  water  of  ammonia  before  the  paste  is  applied,  as  it 


ZINGIBER. 


405 


will  not  act  through  the  epidermic  tissue.  It  is  a  commonly  used  disin¬ 
fectant  and  deodorant,  and  in  weak  solution  iij— v  of  the  Liquor  to  5j 
of  water)  makes  a  good  lotion  for  putrid  ulcers,  and  still  weaker  (gr.  j-ij  to 
the  pint),  is  an  excellent  injection  for  gonorrhoea.  The  Iodide  is  not  em¬ 
ployed  as  an  escharotic,  nor  has  it  ever  been  a  favorite  remedy  for  internal 
use.  It  is  chiefly  employed  in  solution  as  an  application  to  enlarged  tonsils, 
and  as  an  ointment  (1  part  to  8  of  lard)  for  the  reduction  of  glandular 
enlargements.  The  Sulphate  is  used  locally  as  an  astringent  to  mucous 
surfaces  generally,  internally  as  an  emetic  in  narcotic  poisoning  and  croup, 
and  in  small  doses  as  a  tonic  and  antispasmodic  in  convulsive  diseases,  as 
chorea,  hysteria,  epilepsy,  angina  pectoris,  asthma,  etc.  In  diarrhoeas 
and  dysentery  it  is  a  good  astringent,  and  is  frequently  combined  with 
Opium  and  Ipecac.  The  Acetate  is  used  for  the  same  purposes  as  the 
Sulphate,  but  is  usually  preferred  for  collyria.  The  Oxide  may  be  used 
as  a  dusting  powder  in  intertrigo,  and  as  an  ointment  in  eczema  and 
excoriated  surfaces  generally.  In  combination  with  Bismuth  and  Pepsin 
it  is  an  excellent  remedy  for  the  summer  diarrhoea  of  children,  and  with 
Aromatic  Powder  and  Morphine  it  is  very  efficient  in  gastralgia.  It  is  a 
good  remedy  in  3-grain  doses  for  the  night-sweats  of  phthisis,  and  has 
been  successfully  employed  in  epilepsy  and  neuralgia,  in  whooping-cough, 
hysteria,  nervous  headache  and  in  bronchorrhoea  to  check  the  profuse 
secretion.  It  is  much  employed  as  an  ingredient  of  cosmetics.  The 
Carbonate  is  by  some  preferred  to  the  oxide  for  local  use  in  skin  diseases. 
Calamine  Ointment ,  which  is  a  mixture  of  the  impure  carbonate  (cala¬ 
mine)  with  the  oxide  and  an  unguent  basis,  was  until  recently  a  favorite 
application  as  a  soothing  protective  to  abrasions  and  inflammations  of  the 
integument.  The  Valerianate  has  been  used  in  chorea,  epilepsy,  neu¬ 
ralgia  and  various  anomalous  nervous  affections,  such  as  the  nervous  head¬ 
ache  of  hysterical  women,  nervous  coughs  and  aphonia  due  to  uterine  and 
ovarian  irritation. 

[The  Bromide  and  Phosphide  are  used  entirely  with  reference  to  their 
respective  non-metallic  bases,  under  which  titles  their  therapeutics  are 
described.] 

ZINGIBER,  Ginger  , — is  the  rhizome  of  Zingiber  officinale ,  a  plant 
of  the  nat.  ord.  Zingiberaceae,  having  dingy-yellow  flowers  on  a  leafless 
flower-stalk,  and  long,  lanceolate  leaves  on  a  separate  stem.  The  plant  is 
a  native  of  Hindostan,  but  is  cultivated  in  Jamaica,  Sierra  Leone,  etc. 
The  rhizome  is  about  inch  broad,  flattish,  on  one  side  lobed  or  clavately 
branched,  of  a  pale-buff  color,  striate,  agreeably  aromatic  and  of  a  warm, 
pungent  taste.  It  breaks  with  a  mealy,  fibrous  fracture  showing  numerous 
small  resin-cells  and  fibro-vascular  bundles.  It  contains  an  aromatic,  vola¬ 
tile  oil  and  a  resin. 


406 


ZINGIBER. 


Preparations. 

Extraction  Zingiberis  Fluidum, — Dose,  ttpx-  g  ss. 

Tinctnra  Zingiberis , — 20  per  cent.  Dose,  rtpxx-  g  ij. 

Syrupus  Zingiberis , — has  of  the  fluid  extract  2  per  cent,  in  sugar  and  water.  Dose, 
3ss-ij. 

Trochisci  Zingiberis , — each  troche  contains  of  the  tincture  2  grains,  with  Tragacanth, 
Sugar  and  Syrup  of  Ginger. 

Oleoresina  Zingiberis , — contains  all  the  virtues  of  the  root,  and  is  extracted  by  ether. 
Dose,  rrp^-j,  well  diluted. 

Ginger  is  also  a  constituent  of  Pulvis  Aromaticus,  Pulvis  Rhei  Compositus  and  Vinum 
Aloes. 


Physiological  Action  and  Therapeutics. 

Ginger  is  sialagogue  when  chewed,  sternutatory  when  inhaled,  and 
externally  a  rubefacient.  Internally  it  is  a  grateful  stimulant  and  carmina¬ 
tive,  produces  a  sensation  of  warmth  at  the  epigastrium  and  promotes  the 
expulsion  of  flatus.  It  is  employed  as  a  carminative  in  colic,  as  a  masti¬ 
catory  to  increase  the  secretion  of  saliva  and  in  relaxed  conditions  of  the 
throat,  also  internally  in  atonic  dyspepsia,  to  relieve  flatulence,  and  as  an 
adjunct  to  purgative  agents  to  correct  their  griping  properties.  The  syrup 
is  in  common  use  as  a  flavoring  adjuvant  in  prescriptions. 


PART  II. 


PHARMACY  AND  PRESCRIPTION  WRITING. 


Pharmacy  (<pdp[±azov,  a  medicament), — may  be  defined  as  the  art  of 
selecting  and  preserving  medicines,  and  preparing  them  for  administra¬ 
tion.  It  may  be  divided  into — 

Official  or  Galenical  Pharmacy , — dealing  with  the  processes  and  prepa¬ 
rations  of  the  Pharmacopoeia ;  and — 

Extemporaneous  or  Magistral  Pharmacy , — which  includes  the  opera¬ 
tions  of  compounding  and  dispensing  remedies  as  directed  by  the  prescrip¬ 
tions  of  physicians. 


Pharmacopoeias  and  Dispensatories. 

A  Pharmacopoeia  is  an  official  list  of  the  drugs  and  their  prepara¬ 
tions  recognized  by  the  medical  profession  of  a  certain  country.  In 
foreign  countries  the  Pharmacopoeias  are  published  under  government 
auspices  and  have  the  force  of  a  legal  standard  ;  in  the  United  States  its 
publication  is  left  to  the  medical  and  pharmaceutical  professions  and  is 
revised  every  ten  years  by  a  convention  called  for  that  purpose.  The 
principal  official  Pharmacopoeias,  with  their  dates  of  latest  revision  or 
additions,  are  the  following,  viz. — 

Pharmacopoeia  of  the  United  States  of  America,  1882. 

British  Pharmacopoeia ,  1885. 

Pharmacopoeia  Germanica ,  1882. 

Codex  Medicamentarius  (. Pharmacopke  Franfaisef  1884. 

Besides  the  above  there  are  the  Russian  (P.  Rossica,  1880) ;  the  Austrian  (P.  Austriaca, 
1869);  the  Swedish  (P.  Suecica,  1869);  the  Norwegian  (P.  Norvegica,  1879);  the 
Danish  (P.  Danica,  1868,  1874,  1876);  the  Belgian  (P.  Belgica,  1881);  the  Swiss 
(P.  Helvetica,  1872,  1876);  the  Spanish  (F.  Espanola,  1865);  the  Portuguese  (P. 
Portugueza,  1876);  the  Hungarian  (P.  Ilungarica,  1871);  the  Netherlands  (P.  Neer- 
landica,  1871);  the  Roumanian  (P.  Romana,  1862);  the  Finnish  (P.  Fennica,  1863); 
the  Greek  (P.  Hellenica,  1868);  the  Mexican  (Nueva  Farmacopea  Mexicana,  1884); 
and  the  Pharmacopoeia  of  India,  1868,  1869.  Italy,  Chili  and  Japan  are  each  about 
to  issue  a  national  pharmacopoeia. 

A  Dispensatory  is  a  commentary  on  one  or  more  pharmacopoeias, 
giving  in  extenso  the  physical  and  medicinal  history  of  the  drugs  and 

407 


408 


THE  CONSTITUENTS  OF  VEGETABLE  DRUGS. 


preparations,  together  with  their  doses,  physiological  action  and  therapeu¬ 
tics,  and  includes  similar  information  about  many  drugs  which  are  not 
official  in  any  pharmacopoeia,  but  are  of  occasional  use  or  general  interest. 
A  dispensatory  is  a  private  publication,  of  authority  according  to  the 
reputation  of  its  author.  The  principal  dispensatories  are  veritable  drug- 
encyclopaedias,  so  elaborately  do  they  deal  with  every  subject  embraced 
therein.  Those  of  acknowledged  value  are — 

The  Dispensatory  of  the  United  States  of  America,  by  Drs.  Wood  and  Bache,  of  Phila¬ 
delphia,  1 6th  edition,  edited  by  Wood,  Remington  and  Stadtler.  Philadelphia,  The  J.  B. 
Lippincott  Company.  1888. 

The  National  Dispensatory ,  edited  by  Drs.  Stille  and  Maisch.  4th  edition.  Philadel¬ 
phia,  Lea,  Bros.  &  Co.  1887. 

The  American  Dispensatory ,  by  King  &  Lloyd,  Cincinnati,  is  the  recognized  authority 
of  the  “  eclectic  ”  practitioners. 

A  Companion  to  the  U.  S.  Pharmacopoeia ,  by  Drs.  Oldberg  and  Wall.  2d  edition,  New 
York,  Wm.  Wood  &  Co. — is  an  excellent  book,  but  not  so  exhaustive  as  the  others  in  its 
method  of  treating  the  subjects  embraced  in  it. 

A  Companion  to  the  British  Pharmacopeia,  by  Peter  Squire,  is  the  standard  student’s 
text-book  on  drugs  in  England,  but  in  no  degree  compares  with  the  United  States  or 
National  Dispensatories. 


THE  CONSTITUENTS  OF  VEGETABLE  DRUGS. 

The  constituents  of  vegetable  drugs  may  be  classified  as  soluble  and  in¬ 
soluble,  the  first  group  containing  those  ingredients  which  maybe  extracted 
by  suitable  menstrua,  the  second  such  as  resist  the  action  of  all  ordinary 
solvents. 

The  Soluble  Constituents  comprise  both  inert  and  active  principles , 
the  inert  being  chiefly  starch,  gum  and  pectin,  which  may  be  readily 
separated  by  water.  The  active  principles  are  alkaloids,  acids,  salts,  glu- 
cosides  and  other  neutral  principles,  volatile  oils,  resins,  etc.  Some  few 
of  these  may  be  extracted  by  Water  alone  (<?.  g.  Morphine),  and  in  some 
cases  the  addition  of  acids  or  alkalies  to  the  water  will  effect  the  chemical 
solution  of  many  ingredients  which  are  insoluble  in  water  alone.  As  a 
rule,  however,  Alcohol  is  the  most  generally  applicable  of  all  simple  sol¬ 
vents,  but  from  its  hardening  the  cell-membranes  instead  of  softening 
them  it  prevents  the  osmosis  of  their  contents.  Drugs  subjected  to  alco¬ 
holic  or  ethereal  menstrua  should  have  their  cells  thoroughly  broken  or 
torn,  so  that  the  solvent  may  be  brought  into  actual  contact  with  the 
principles  contained  in  them.  The  degree  of  disintegration  required 
depends  upon  the  size  of  the  cells,  ducts,  tubes,  intercellular  spaces,  etc., 
in  which  the  active  principles  are  enclosed.  A  very  finely  powdered  state 
is  however  open  to  objection  from  the  packing  of  the  particles  together 
into  an  almost  impenetrable  mass  when  treated  by  the  solvent.  The 
average  size  of  vegetable  cells  is  about  -g-J-y  of  an  inch,  while  resin  cells 
and  other  cavities  are  larger,  averaging  perhaps  about  inch.  The 
Pharmacopoeia  prescribes  in  each  instance  the  degree  of  fineness  of  the 


THE  CONSTITUENTS  OF  VEGETABLE  DRUGS. 


409 

powdered  drug  employed  in  making  certain  of  its  preparations,  or  its 
bruising,  slicing, 'etc.,  when  such  operations  will  answer.  [Compare  the 
article  on  Comminution  in  the  following  section.] 

Alkaloidea ,  Alkaloids,  (termination,  — ina ,  — ine, )  are  natural  principles 
existing  in  plants,  and  extracted  therefrom  by  chemical  art.  They  are 
organic  bases,  forming  salts  with  acids, and  regarded  as  compound  ammonias, 
products  of  albuminous  decomposition  in  the  plant-cells  during  the  process 
of  growth.  Like  ammonia,  they  all  contain  N,  with  C  and  H;  most  of 
them  also  contain  ing  O,  though  a  few  are  devoid  of  the  latter  element,  occur¬ 
ring  as  oily  liquids, — e.  g.  Nicotine,  Coniine,  Sparteine,  Piperidine,  Lupu- 
line,  Lobeline,  Muscarine.  Alkaloids  are  generally  insoluble  in  water, 
but  soluble  in  alcohol ;  and  their  salts  are  more  soluble  in  water  than  in 
any  other  liquid.  They  are  easily  decomposed  by  alkalies  or  alkaline  car¬ 
bonates  ;  and  are  precipitated  from  their  solutions  by  a  solution  of  Iodine 
in  Iodide  of  Potassium,  by  Potassio-mercuric  Iodide,  and  by  Picric,  Phos- 
pho-molybdic  and  Phospho-tungstic  Acids.  They  generally  have  a  power¬ 
ful  physiological  action,  and  their  official  names  always  end  in  — ina , 
( — ine). 

There  are  15  alkaloids  official,  either  under  their  own  names  or  under 
those  of  one  or  more  of  their  salts.  Of  the  latter  there  are  8  Sulphates,  4 
Hvdrochlorates,  and  1  each  Bisulphate,  Acetate,  Hydrobromate,  Salicylate 
and  Valerianate.  The  official  alkaloids  are  as  follows,  viz. — 


Apomorphina. 

Codeina. 

Piperina. 

Atropina. 

Hyoscyamina. 

Quinidina. 

Caffeina. 

Morphina. 

Quinina. 

Cinchonidina. 

Physostigmina. 

Strychnina. 

Cinchonina. 

Pilocarpina. 

Veratrina. 

but  Important  Alkaloids  are  the  following,  viz. — 

Aconitine. 

Colchicine. 

Gelsemine. 

Antifebrine. 

Coniine. 

Homatropine. 

Antipyrine. 

Curarine. 

Katrine. 

Berberine. 

Daturine. 

Muscarine. 

Chinoline. 

Duboisine. 

Pelletierine. 

Cocaine. 

Emetine. 

Thalline. 

Glucosidea, Glucosides,  (terminations,  — inum ,  — in), — are  organic  com¬ 
pounds,  belonging  to  the  group  of  Neutral  Principles  which  exist  in  plants  ; 
and  which  are  resolved  m\.o  glucose  and  some  other  principle,  by  the  action 
of  reagents  or  natural  ferments.  Few,  if  any,  of  these  compounds,  con¬ 
tain  any  N, — but  among  them  are  some  very  active  agents.  The  official 
glucosides  number  six,  and  like  other  neutral  principles,  are  designated  by 
titles  which  end,  in  Latin  in  — inum ,  (English,  — in),  viz. — 


4io 


OFFICIAL  OPERATIONS. 


Chrysarobinum,  (Chrysarobin).  Picrotoxinum,  (Picrotoxin). 

Elaterinum,  (Elaterin).  Salicinum,  (Salicin). 

Glycyrrhizinum,  (Glycyrrhizin).  Santoninum,  (Santonin). 

Besides  these,  there  are  several  other  substances  recognized  by  pharmacopoeial  names 
which  terminate  in  — inum ,  — in,  but  which  have  no  relationship  to  the  group  of  Gluco- 
sides.  They  are  the  following,  viz. — 

Benzinum,  Benzin, — A  distillate  consisting  of  hydrocarbons. 

Benzoinuin,  Benzoin, — A  balsamic  resin. 

Chinoidinum ,  Chinoidin, — A  mixture  of  Cinchona  alkaloids. 

Glycerinum ,  Glycerin, — A  liquid  obtained  from  fats  or  fixed  oils. 

Lupnlinum,  Lupulin, — A  glandular  powder  from  the  hop. 

Pepsinum,  Pepsin, — A  digestive  principle. 

Pyroxylinu?n,  Pyroxylin, — Soluble  gun-cotton. 

The  Insoluble  Constituents  are  cellulose,  lignin  and  sclerogen, 
which  make  up  the  cell-walls  of  vegetable  substances,  and  are  extremely 
intractable. 


OFFICIAL  PHARMACY. 

OFFICIAL  OPERATIONS. 

The  official  operations  are  those  processes  which  are  directed  in  the 
pharmacopoeia  to  be  used  in  the  preparation  of  medicines.  Many  of  them 
are  processes  which  are  common  to  both  chemistry  and  pharmacy,  as  pre¬ 
cipitation  and  crystallization, — while  others  are  peculiar  to  pharmacy,  as 
percolation,  trituration,  etc.  The  most  important  of  the  pharmaceutical 
operations  are  briefly  described  below;  for  full  details  of  the  various 
apparatus  used  the  student  is  referred  to  the  more  exhaustive  treatises  on 
Pharmacy. 

Vaporization  includes  the  various  operations  by  which  volatile  mat¬ 
ters  are  separated  from  fixed  substances  or  from  other  matters  which  are 
less  volatile,  heat  at  varying  temperatures  being  the  agent  used.  The 
operations  under  this  head  are — Evaporation ,  Distillation ,  Desiccation , 
and  Sublimation. 

Evaporation  in  Pharmacy  is  the  process  by  which  the  more  volatile 
constituents  of  a  liquid  are  driven  off  by  heat  for  the  purpose  of  reducing 
its  volume  or  of  purifying  it,  as  in  the  preparation  of  extracts  and  fluid 
extracts,  the  crystallization  of  salts,  etc.  The  vessels  used  should  be  shal¬ 
low  so  as  to  expose  a  large  surface  of  the  liquid  to  the  atmosphere.  The 
heat  used  may  be  regulated  by  a  water-bath,  a  steam-bath  or  sand-bath, 
and  ordinarily  should  be  kept  below  but  near  to  the  boiling  point  of  the 
liquid  treated.  As  organic  substances  are  usually  injured  by  long  heating, 
small  portions  only  of  vegetable  preparations  should  be  subjected  to  this 
process,  and  the  liquid  should  be  frequently  stirred  in  order  to  hasten  the 


OFFICIAL  OPERATIONS. 


41  I 

operation.  In  large  laboratories  vacuum-pans  are  employed  to  remove 
the  atmospheric  pressure,  enabling  the  evaporation  to  be  accomplished  at 
a  much  less  degree  of  heat  than  if  the  liquid  were  exposed  to  the  air. 
Ebullition  or  Boiling  is  a  form  of  evaporation. 

Spontaneous  Evaporation  is  the  evaporation  of  a  liquid  without  the  direct  applica¬ 
tion  of  strong  heat,  but  at  the  temperature  of  the  room  or  closet  used  for  the  purpose. 
It  is  especially  applicable  to  cases  in  which  the  residue  is  liable  to  injury  or  loss  from 
much  heat,  or  to  secure  finer  crystals  than  can  be  obtained  by  quick  evaporation  of  their 
solution. 

Distillation  consists  of  two  processes,  (1)  the  evaporation  of  a  liquid, 
(2)  the  condensation  of  the  vapor  into  a  liquid  in  a  separate  vessel.  The 
agent  used  in  the  first  part  of  the  operation  is  heat,  in  the  second  part 
cold.  Its  object  is  to  separate  mixed  volatile  and  fixed  substances,  or  to 
combine  volatile  substances  which  cannot  otherwise  be  mixed,  as  in  the 
preparation  of  some  of  the  official  Waters.  The  apparatus  used  is  of 
great  variety,  from  the  simple  retort  and  receiver  to  the  elaborate  and 
costly  stills. 

Destructive  or  Dry  Distillation  is  a  process  of  decomposing  an  organic  sub¬ 
stance  by  heat  into  volatile  products  which  are  collected  in  a  separate  vessel,  the  residue 
being  said  to  be  carbonized.  It  is  only  employed  by  large  manufacturers,  for  the  prepara¬ 
tion  of  Acetic  and  Succinic  Acids,  Oil  of  Amber,  Wood-tar,  etc. 

Fractional  Distillation  is  the  separation  by  distillation  of  substances  which  are 
volatile  at  different  temperatures,  each  being  separately  driven  over  and  received  in  a 
vessel  by  itself.  Different  degrees  of  heat  are  successively  employed  in  accordance  with 
the  volatilizing  points  of  the  substances  to  be  obtained. 

Sublimation  is  the  distillation  of  a  volatile  solid,  the  product  being 
termed  a  sublimate .  Its  objects  are  to  purify  volatile  solids  from  impuri¬ 
ties,  and  to  collect  such  as  result  from  chemical  action  at  high  tempera¬ 
tures.  The  operation  is  carried  on  in  iron,  glass  or  stoneware  retorts,  and 
results  in  cake  sublimates  or  powder  sublimates  according  as  the  temperature 
of  the  condensing  surface  is  high  or  low. 

Desiccation  is  the  process  of  removing  moisture  from  solids,  and  has 
for  its  object  either  the  preservation  of  the  substance,  the  reduction  of  its 
bulk  or  the  facilitation  of  its  comminution.  The  operation  should  be 
conducted  at  as  low  a  temperature  as  possible.  Roots,  leaves  and  seeds 
are  generally  dried  by  being  placed  in  trays  of  wire  net-work  and  exposed 
to  a  uniform  temperature  in  a  room  heated  by  steam.  A  better  method  is 
to  suspend  organic  substances  from  the  ceiling  of  an  attic  during  warm 
weather ;  a  slow  process,  but  one  which  does  not  result  in  much  loss  of 
the  active  volatile  principles.  Crystals  and  precipitates  require  a  higher 
temperature  and  are  usually  dried  on  a  water-bath.  When  the  water  of 
crystallization  is  to  be  expelled,  as  in  desiccating  Alum  and  Sulphate  of 
Iron,  a  temperature  of  about  400°  F.  is  required.  In  absorbing  water  from 
alcohol  Carbonate  of  Potassium  and  slaked  Lime  heated  are  employed, 
and  in  several  instances  Sulphuric  Acid  is  the  desiccator  used. 


412 


OFFICIAL  OPERATIONS. 


Fusion  is  the  process  of  liquefying  solids  by  the  application  of  high 
heat  without  the  use  of  a  solvent.  It  is  employed  in  making  ointments, 
plasters,  etc.,  in  purifying  resins,  and  for  the  purpose  of  decomposition. 
The  degree  of  heat  required  varies  from  a  temperature  of  90°  F.,  suffi¬ 
cient  to  melt  lard  in  an  open  vessel,  to  one  of  8oo°  F.,  employed  in  fusing 
Zinc  in  an  earthen  crucible ;  and  may  be  regulated  by  the  aid  of  the 
water-,  steam-  or  sand-bath.  The  two  former  appliances  limit  the  degree 
of  heat  applied,  while  the  sand-bath  prevents  sudden  changes  in  the  tem¬ 
perature.  Oil-baths  and  glycerin  baths  are  employed  in  fractional  distil¬ 
lation  on  a  large  scale. 

Exsiccation  or  Calcination  is  the  process  of  depriving  a  solid  of  its 
moisture  or  other  volatile  constituents  by  the  application  of  heat  without 
fusion.  The  term  Exsiccation  is  usually  applied  to  the  vaporization  of 
the  water  of  crystallization  from  a  crystalline  body,  Calcination ,  to  such 
operations  as  the  expulsion  of  carbonic  acid  and  water  from  carbonates, 
as  in  the  manufacture  of  Lime,  Magnesia,  etc. 

Carbonization  is  the  heating  of  organic  substances  without  exposure 
to  the  air  until  the  volatile  constituents  are  driven  off,  and  the  residue 
assumes  the  characteristic  appearance  of  carbon. 

Incineration  is  the  heating  of  organic  substances  with  access  of  air  until 
the  carbon  is  consumed,  the  ashes  remaining  being  the  product  desired. 

Ignition  in  pharmacy  means  the  process  of  strongly  heating  solids  or 
semi-solid  substances,  the  residue  left  being  the  product  desired.  It  is 
used  in  the  official  quantitative  tests  for  Phosphoric  Acid,  Phosphate  of 
Ammonium  and  purified  Sulphide  of  Antimony. 

Deflagration  is  the  heating  of  an  inorganic  substance  with  another 
which  yields  oxygen  (usually  a  nitrate  or  a  chlorate),  the  result  being  the 
decomposition  of  the  body,  with  violent  and  sudden  combustion. 

Torrefaction  or  Roasting  is  the  application  of  heat,  in  a  less 
degree  than  for  carbonization,  to  an  organic  substance  for  the  purpose  of 
modifying  some  of  its  constituents,  as  in  the  roasting  of  coffee  and 
rhubarb.  The  latter  substance  when  subjected  to  this  process,  loses  its 
cathartic  properties  but  retains  its  astringency,  and  is  known  as  Torrefied 
Rhubarb. 

Comminution  is  the  process  by  which  the  aggregation  of  the  particles 
of  a  solid  body  is  overcome,  and  the  body  is  reduced  to  pieces  of  varying 
sizes.  Its  object  is  to  increase  the  surface  exposed  to  the  action  of  solvents, 
and  it  includes  the  mechanical  operations  of  cutting,  rasping,  grating, 
crushing,  stamping,  grinding,  pulverizing,  triturating,  levigating,  elutriat- 


OFFICIAL  OPERATIONS. 


413 


ing,  granulating,  etc.  Apparatus  of  various  kinds,  as  cutters,  mortars  and 
pestles,  mills,  etc.,  are  used  for  the  comminution,  while  spatulas  are  em¬ 
ployed  to  loosen  the  particles,  and  sieves  to  sift  the  coarser  from  the  finer. 
These  last-named  contrivances  are  of  five  sizes,  designated  by  the  number 
of  their  meshes  to  the  inch,  80,  60,  50,  40  and  20,  respectively  permitting 
the  passage  of  powders  termed  very  fine,  fine,  moderately  fine,  moderately 
coarse  and  coarse. 

Trituration  is  the  comminution  of  a  solid  to  an  extremely  fine  powder 
by  continued  rubbing  in  a  wedgewood  mortar  with  an  inert  and  gritty 
powder,  Sugar  of  Milk  being  the  substance  directed  to  be  used.  The  pro¬ 
duct  is  called  a  Trituration  (see  that  title  under  Official  Preparations). 
The  surfaces  of  the  mortar  and  pestle-head  should  coincide  closely,  and 
the  thorough  comminution  of  the  trituration  is  best  accomplished  by  a 
circular  motion  of  the  pestle  in  gradually  increasing  circles,  until  the  side 
of  the  mortar  is  reached,  then  reversing  the  motion,  and  gradually  lessen¬ 
ing  the  circles  until  the  pestle  reaches  the  centre  again.  The  process  is 
greatly  facilitated  by  having  the  pestle  attached  to  a  long  handle  playing 
in  an  opening  made  in  a  piece  of  wood  which  is  nailed  at  a  convenient 
height.  A  weight  may  be  fixed  on  top  of  the  handle  if  a  greater  degree 
of  friction  be  desired. 

Pulverization  by  Intervention  is  only  another  name  for  trituration  when  performed 
in  a  mortar  and  with  solid  bodies,  the  foreign  substance  used  being  subsequently  removed. 
Potassium  Sulphate  may  be  employed  as  the  medium  for  the  pulverization  of  Gold,  and 
is  then  dissolved  out  with  water.  Alcohol  or  Chloroform  may  be  added  to  Camphor  to 
aid  its  pulverization,  and  then  removed  by  evaporation.  Phosphorus  may  be  pulverized 
by  placing  it  in  water,  gently  heating  the  latter  until  the  phosphorus  is  melted,  and  agitat¬ 
ing  the  whole  while  cooling. 

Levigation  is  trituration  of  a  substance  made  into  paste  with  water  or  some  other 
liquid,  and  resembles  the  old  process  of  grinding  oil-paints  by  hand  on  a  slab  of  stone  The 
process  is  used  for  coarse  materials,  as  chalk,  etc.,  where  the  refuse  is  rejected,  or  for  such 
substances  as  Red  Oxide  of  Mercury,  Oxide  of  Zinc,  etc.  When  performed  with  a  por¬ 
phyry  slab  and  muller  it  is  termed  Porphyrization. 

Elutriation  is  a  water-sifting  process  for  separating  the  coarser  particles  of  insoluble 
substances  from  the  finer.  The  substance  is  mixed  with  water  and  after  the  larger  par¬ 
ticles  have  fallen  to  the  bottom,  the  liquid  is  decanted  into  another  vessel,  in  which  the 
light  and  powdery  particles  are  collected. 

Solution  is  the  dissolving  of  a  solid  or  a  gaseous  substance  in  a  liquid, 
and  may  be  simple  when  the  substance  undergoes  no  alteration,  being 
recovered  unchanged  on  evaporation,  or  chemical ,  when  the  dissolved 
body  is  chemically  altered  by  the  solvent  of  some  other  substance  present, 
and  cannot  be  recovered  on  evaporation.  Simple  Syrup  is  an  instance 
of  simple  solution,  the  Syrup  of  Lime  one  of  chemical  solution.  The 
liquid  employed  is  termed  a  solvent  before  the  substance  is  added  to  it, 
after  the  operation  is  completed  the  combined  preparation  is  called  a  solu¬ 
tion.  If  fully  charged  with  the  dissolved  substance  so  that  it  will  retain 
no  more,  it  is  known  as  a  saturated  solution.  One  liquid  may  be  dissolved 
in  another,  or  a  gas  may  be  dissolved  in  a  liquid.  The  solution  of  solids 


414 


OFFICIAL  OPERATIONS. 


is  greatly  facilitated  by  pulverization  and  by  stirring  the  menstruum.  Heat 
generally  aids  solution,  most  substances  being  more  soluble  in  hot  liquids 
than  in  cold  ones.  A  saturated  solution  of  one  substance  may  still  be 
capable  of  dissolving  others.  Rapid  solution  of  solids  without  chemical 
change  causes  reduction  of  temperature,  while  chemical  solution  produces 
elevated  temperature.  Circulatory  Solution  is  performed  by  suspending 
the  substance  to  be  dissolved  near  the  surface  of  the  solvent  in  a  gauze  bag 
or  on  a  porous  shelf.  The  portion  first  acted  on  descends  and  produces 
a  circulatory  movement  in  the  fluid,  facilitating  the  solution  of  the  whole. 

Solvents  employed  are  chiefly  Water,  Alcohol,  Glycerin,  Acids  and  Oils.  Others  less 
frequently  used  are  Ether,  Chloroform,  Benzin  and  Carbon  Disulphide. 

Washing  is  a  simple  mechanical  process  for  separating  soluble  from 
insoluble  matter,  by  pouring  upon  it  a  liquid  which  will  dissolve  the  solu¬ 
ble  portion.  Various  methods  of  doing  this  is  in  vogue  and  are  often 
dignified  with  very  high-sounding  terms,  as  Lotion,  Affusion,  Ablution, 
etc.  An  ordinary  wash-bottle,  with  the  two  glass  tubes  perforating  the 
cork,  is  a  convenient  implement  for  directing  a  continuous  stream  upon  a 
precipitate,  while  for  continuous  washing  a  combination  of  bottles  with  a 
funnel  may  be  used. 

Decantation  is  the  pouring  or  drawing  off  a  supernatant  liquid  into 
another  vessel.  If  done  by  pouring,  a  guiding-rod  for  the  liquid  to  run 
on  is  an  effective  adjuvant ;  if  by  drawing,  the  siphon  in  some  form  is 
usually  employed. 

Colation,  or  Straining  is  another  very  simple  operation,  so  familiar 
to  every  one  of  ordinary  experience  as  to  be  scarcely  worth  describing. 
The  strainers  are  made  of  cotton  flannel,  fine  muslin,  gauze,  woollen  felt 
and  other  fabrics. 

Filtration  is  a  process  of  straining  through  a  medium  so  fine  as  to 
deliver  the  filtrate  in  transparent  condition.  The  filters  are  made  of  paper 
usually,  though  charcoal,  asbestos,  sand  and  other  articles  are  sometimes 
employed,  and  are  supported  in  a  funnel  of  glass  or  other  material  held  by 
the  ring  of  a  retort-stand.  The  best  filtering-paper  is  made  in  Sweden  by 
Munktell,  and  is  white;  but  a  good  paper  for  ordinary  use  is  the  “  Prat 
Dumas  White,”  which  should  always  be  employed  for  filtering  alkaline  or 
alkaloidal  solutions.  The  gray  French  papers  answer  well  enough  for 
fluid  extracts,  tinctures  or  colored  liquids,  but  should  never  be  used  for 
solutions  containing  free  alkali. 

Filtering-paper  is  folded  by  doubling  a  sheet  upon  itself,  and  then  folding  it  again 
directly  in  the  middle.  When  opened  four  distinct  sections  appear,  one  of  which  is 
separated  from  the  other  three,  and  the  filter  thus  formed  is  placed  in  a  funnel.  This 
arrangement  is  known  as  a  plain  filter,  which  by  repeated  creasing  is  converted  into 
the  plaited filter ;  the  latter  being  the  form  generally  used  in  pharmaceutical  operations 


OFFICIAL  OPERATIONS.  415 

of  small  extent.  In  large  laboratories  special  processes  of  filtration  are  employed  with 
apparatus  of  more  or  less  complexity  for  hot  filtration,  rapid  filtration,  etc. 

Clarification  is  the  separation  from  liquids  of  solid  matter,  which  pre¬ 
vents  their  being  transparent,  without  using  filters  or  strainers.  It  may 
be  effected  by  heat  (as  in  the  case  of  Mel  Despumatum),  by  adding 
a  lighter  liquid,  by  adding  albumen,  gelatin,  milk,  or  paper-pulp,  by  fer¬ 
mentation,  or  by  subsidence  of  the  particles  in  the  form  of  a  sediment 
through  long  standing. 

Decoloration,  or  the  removal  of  coloring-matter  from  liquids  or  from 
solids  in  solution,  is  effected  by  the  use  of  animal  charcoal,  which  in  small 
operations  may  be  arranged  in  a  funnel  or  a  percolator,  and  the  liquid 
placed  thereon.  It  should  not  be  forgotten  that  charcoal  absorbs  many 
other  principles  besides  coloring-matter,  especially  alkaloids,  bitters,  and 
astringents,  so  that  the  process  of  decoloration  may  be  one  of  serious 
injury  to  the  efficiency  of  the  preparation. 

Separation  of  liquids  which  do  not  mix  with  each  other  is  a  simple 
mechanical  process  performed  with  pipettes  of  various  forms,  or  with  fun¬ 
nels  having  stop-cocks  in  their  necks.  Special  forms  of  receivers  are  used 
for  the  separation  of  volatile  oils  from  the  water  which  may  accompany 
them  during  distillation. 

Precipitation  is  the  process  of  separating  solids  from  their  solutions, 
and  is  usually  effected  by  chemical  reaction,  though  it  may  be  accom¬ 
plished  by  other  methods,  as  by  adding  a  second  liquid  in  which  the  sub¬ 
stance  is  insoluble,  by  heating  albuminous  solutions,  or  by  exposing 
solutions  of  silver  salts  to  the  action  of  light.  The  most  familiar  example 
of  chemical  precipitation  is  the  addition  of  a  solution  of  Mercuric 
Chloride  to  one  of  Potassium  Iodide,  the  result  being  a  double  decompo¬ 
sition  of  the  salts  and  the  formation  of  Mercuric  Iodide,  which  falls  to 
the  bottom  of  the  vessel  as  a  brilliant,  red,  insoluble  and  crystalline  pow¬ 
der.  The  precipitate  is  the  separated  substance,  which  is  usually  thrown 
down,  but  it  remains  suspended  in  some  cases,  and  in  others  it  rises  to  the 
top.  The  precipitant  is  the  substance  which  is  added  to  produce  the  pre¬ 
cipitation.  A  magma  is  a  thick,  tenacious  precipitant  remaining  behind 
after  the  supernatant  liquid  is  removed  by  decantation  or  otherwise.  Pre¬ 
cipitates  are  termed  flocculent, gelatinous,  curdy ,  granular,  crystalline ,  etc., 
according  to  the  forms  assumed.  In  small  operations  they  are  usually 
collected  on  plain  filters,  and  washed  by  the  repeated  addition  of  water. 

Crystallization  is  the  process  which  bodies  undergo  in  passing  from 
the  liquid  or  the  gaseous  state  to  the  geometrical  forms  called  crystals. 
Six  systems  of  crystals  are  recognized  by  crystallography,  which  has 
assumed  the  dignity  of  a  separate  science.  Bodies  which  are  not  capable 


416 


OFFICIAL  OPERATIONS. 


of  crystallization  are  termed  amorphous.  Every  crystallizable  body 
assumes  its  own  peculiar  form,  or  some  other  form  directly  derived  from 
or  related  to  it.  The  process  of  crystallization  is  effected  (i)  by  fusion 
and  partial  cooling,  as  in  the  cases  of  some  metals  and  Sulphur ;  (2)  by 
sublimation,  as  Benzoic  Acid,  Mercuric  Chloride,  etc.  ;  (3)  by  deposition 
from  hot  saturated  solutions  while  cooling  ;  (4)  by  deposition  from  a  solu¬ 
tion  during  evaporation  ;  (5)  by  deposition  caused  by  passing  a  galvanic 
current  through  the  solution ;  (6)  by  precipitation,  as  in  the  case  of  the 
Mercuric  Iodide;  (7)  by  the  addition  to  the  solution  of  a  substance 
having  a  strong  affinity  for  water,  as  in  the  adding  of  Calcium  Chloride 
to  an  aqueous  solution  of  Sodium  Chloride,  or  Alcohol  to  a  solution  of 
Potassium  Nitrate,  or  to  an  aqueous  syrup.  In  a  few  cases  amorphous 
solids  may  crystallize  without  undergoing  liquefaction,  as  Sulphur,  Barley- 
sugar,  Iron  or  Brass  wire.  The  methods  most  frequently  employed  are 
those  by  deposition  from  supersaturated  solutions,  and  by  deposition  during 
evaporation.  The  more  slowly  the  process  is  carried  on  the  larger  and 
more  regular  will  be  the  crystals.  The  process  is  facilitated  by  use  of 
foreign  bodies  as  nuclei  around  which  the  crystals  are  deposited  ;  a  familiar 
instance  being  the  thread  in  the  centre  of  a  mass  of  rock-candy. 

The  IVater  of  Crystallization  is  the  H20  with  which  most  substances  combine  in  the 
act  of  crystallization,  and  the  number  of  molecules  thereof  differs  for  each  body  and  for 
the  same  body  frequently  under  different  conditions.  Exsiccation  is  the  driving  off  of  this 
combined  water  by  heat,  the  crystals  assuming  thereby  the  form  of  a  dry  powder.  Efflo-  * 
rescence  is  a  similar  process  occurring  spontaneously  on  exposure  of  the  crystals  to  the  air, 
the  effloresced  portion  appearing  as  a  dry  powder  on  the  surface  of  the  crystals.  Deliques¬ 
cence ,  on  the  other  hand,  is  the  act  of  absorbing  water  from  the  atmosphere,  a  property 
possessed  by  some  substances  which  are  therefore  said  to  be  hygroscopic. 

Granulation  is  a  process  of  reducing  a  coarsely  crystalline  substance 
to  a  granular  powder  by  dissolving  it  in  water  and  evaporating  the  solu¬ 
tion  with  constant  stirring  until  the  product  becomes  perfectly  dry.  Many 
salts  are  thus  treated  for  convenience  in  dispensing,  as  the  Bromide,  the 
Iodide,  the  Carbonate  and  the  Citrate  of  Potassium.  Sulphate  of  Iron, 
though  generally  dispensed  in  the  exsiccated  powder,  may  be  granulated 
into  minute  crystals  by  filtering  an  aqueous  solution  of  it  into  alcohol. 

Dialysis  is  a  process  by  which  crystallizable  substances  are  separated 
from  non-crystallizable  ones,  by  suspending  a  solution  containing  both 
upon  a  porous  diaphragm  having  its  under  surface  in  contact  with  water. 
The  crystalloids  pass  through  the  diaphragm,  while  the  non-crystalline 
remain  above  it,  and  are  termed  colloids.  Examples  of  the  latter  class  are 
gelatin,  gum,  glue,  starch,  dextrin,  albumen  and  extractive  matters,  which 
are  generally  the  inert  and  valueless  constituents  of  vegetable  drugs. 
Parchment-paper  and  bladders  are  used  for  the  diaphragm;  the  whole 
apparatus  being  termed  the  dialyzer ,  while  the  water  into  which  the  crys¬ 
talloids  pass  is  called  the  diffusate. 


OFFICIAL  OPERATIONS. 


4 17 


The  unofficial  preparation  known  as  Dialyzed  Iron  or  Ferrum  Dialysatum  is  a  col¬ 
loidal  substance  obtained  by  treating  Ferric  Chloride  in  solution  with  Ammonia,  whereby 
Ferric  Hydrate  is  precipitated  and  then  dissolved  by  agitation.  The  mixture  being  placed 
on  a  dialyzer,  the  crystalloids  formed  (Ammonium  Chloride  and  Ferric  Chloride),  together 
with  any  free  acid  present,  pass  into  the  diffusate,  leaving  the  neutral  colloidal  liquid 
(solution  of  Ferric  Oxychloride)  above  on  the  septum. 


Maceration  is  one  of  the  processes  of  extracting  the  soluble  princi¬ 
ples  from  drugs,  and  consists  in  steeping  or  soaking  the  comminuted  sub¬ 
stance  in  a  suitable  liquid  called  the  menstruum ,  generally  alcohol,  for  a 
period  varying  from  2  to  14  days,  during  which  it  is  occasionally  agitated. 
The  liquid  is  then  poured  off,  the  residue  is  expressed,  and  the  mixed 
liquors  are  filtered.  Several  of  the  official  tinctures  are  prepared  by  this 
method,  and  many  others  are  subjected  to  maceration  first  and  perco¬ 
lation  afterwards. 

Expression  is  the  forcible  separation  of  liquids  from  solids,  by  sub¬ 
jecting  them  to  pressure.  Hand-pressure  through  straining-cloths  may  be 
employed,  but  mechanical  presses  are  more  efficient  and  are  coming  into 
general  use.  Oils  obtained  in  this  manner  are  called  expressed  or  fixed 
oils ,  to  distinguish  them  from  the  volatile  oils  obtained  by  distillation. 

Percolation  or  Displacement  is  a  process  of  obtaining  the  soluble 
constituents  of  a  substance  in  powder  by  the  descent  of  a  solvent  through 
it.  Though  an  ancient  process  for  the  making  of  lye  from  wood-ashes 
(lixiviation),  it  has  only  within  the  last  forty  years  been  adopted  as  an 
official  process  in  pharmacy,  and  it  is  gradually  taking  the  place  of  macera¬ 
tion  as  a  means  of  extracting  the  soluble  principles  of  drugs.  The  vessel 
used  to  hold  the  powdered  drug  is  called  the  percolator ,  of  which  there 
are  many  forms  employed  by  the  manufacturers.  The  liquid  used  as  a 
solvent  is  called  the  menstruum ,  and  when  coming  from  the  percolator  it 
is  termed  the  percolate.  The  U.  S.  Pharmacopoeia  gives  the  following 
directions  concerning  this  process  :  — 

“  The  process  of  percolation,  or  displacement,  directed  in  this  Pharmacopoeia,  consists 
in  subjecting  a  substance,  or  substances,  in  powder,  contained  in  a  vessel  called  a  percolator, 
to  the  solvent  action  of  successive  portions  of  menstruum  in  such  a  manner  that  the  liquid, 
as  it  traverses  the  powder  in  its  descent  to  the  recipient,  shall  be  charged  with  the  soluble 
portion  of  it,  and  pass  from  the  percolator  free  from  insoluble  matter. 

“  When  the  process  is  successfully  conducted,  the  first  portion  of  the  liquid, or  percolate, 
passing  through  the  percolator  will  be  nearly  saturated  with  the  soluble  constituents  of  the 
substance  treated;  and  if  the  quantity  of  menstruum  be  sufficient  for  its  exhaustion,  the 
last  portion  of  the  percolate  will  be  destitute  of  color,  odor,  and  taste,  other  than  that 
possessed  by  the  menstruum  itself. 

“  The  percolator  most  suitable  for  the  quantities  contemplated  by  this  Pharmacopoeia 
should  be  nearly  cylindrical,  or  slightly  coriical,  with  a  funnel-shaped  termination  at  the 
smaller  end.  The  neck  of  this  funnel-end  should  be  rather  short,  and  should  gradually 
and  regularly  become  narrower  toward  the  orifice,  so  that  a  perforated  cork,  bearing  a 
short  glass  tube,  may  be  tightly  wedged  into  it  from  within  until  the  end  of  the  cork  is 
flush  with  its  outer  edge.  The  glass  tube,  which  must  not  protrude  above  the  inner  surface 
of  the  cork,  should  extend  from  one  and  one-eighth  to  one  and  one-half  inch  (3  to  4  cen¬ 
timeters)  beyond  the  outer  surface  of  the  cork,  and  should  be  provided  with  a  closely  fit- 
27 


4iS 


OFFICIAL  OPERATIONS. 


ting  rubber  tube,  at  least  one-fourth  longer  than  the  percolator  itself,  and  ending  in  another 
short  glass  tube,  whereby  the  rubber  tube  may  be  so  suspended  that  its  orifice  shall  be 
above  the  surface  of  the  menstruum  in  the  percolator,  a  rubber  band  holding  it  in  position. 

“  The  dimensions  of  such  a  percolator,  conveniently  holding  five  hundred  grammes  of 
powdered  material,  are  preferably  the  following:  Length  of  body,  fourteen  inches  (36 cen¬ 
timeters)  ;  length  of  neck,  two  inches  (5  centimeters) ;  internal  diameter  at  top,  four 
inches  ( 10  centimeters)  ;  internal  diameter  at  beginning  of  funnel-shaped  end,  two  and 
one-half  inches  (6.5  centimeters);  internal  diameter  of  the  neck,  one-half  inch  (12  milli¬ 
meters),  gradually  reduced  at  the  end  to  two-fifths  of  an  inch  (10  millimeters).  It  is  best 
constructed  of  glass,  but  unless  so  directed,  may  be  constructed  of  a  different  material. 

“  The  percolator  is  prepared  for  percolation  by  gently  pressing  a  small  tuft  of  cotton  into 
the  space  of  the  neck  above  the  cork,  and  a  small  layer  of  clean  and  dry  sand  is  then 
poured  upon  the  surface  of  the  cotton  to  hold  it  in  place. 

“The  powdered  substance  to  be  percolated  (which  must  be  uniformly  of  the  fineness 
directed  in  the  formula,  and  should  be  perfectly  air-dry  before  it  is  weighed)  is  put  into 
a  basin,  the  specified  quantity  of  menstruum  is  poured  on,  and  it  is  thoroughly  stirred  with 
a  spatula,  or  other  suitable  instrument,  until  it  appears  uniformly  moistened.  The  moist 
powder  is  then  passed  through  a  coarse  sieve — No.  40  powders,  and  those  which  are  finer, 
requiring  a  No.  20  sieve,  whilst  No.  30  powders  require  a  No.  15  sieve  for  this  purpose. 
Powders  of  a  less  degree  of  fineness  usually  do  not  require  this  additional  treatment  after 
the  moistening.  The  moist  powder  is  now  transferred  to  a  sheet  of  thick  paper  and  the 
whole  quantity  poured  from  it  into  the  percolator.  It  is  then  shaken  down  lightly  and 
allowed  to  remain  in  that  condition  for  a  period  varying  from  fifteen  minutes  to  several 
hours,  unless  otherwise  directed  ;  after  which  the  powder  is  pressed,  by  the  aid  of  a  plunger 
of  suitable  dimensions,  more  or  less  firmly,  in  proportion  to  the  character  of  the  powdered  sub¬ 
stance  and  the  alcoholic  strength  of  the  menstruum  ;  strongly  alcoholic  menstrua,  as  a  rule, 
permitting  firmer  packing  of  the  powder  than  the  weaker.  The  percolator  is  now  placed  in 
position  for  percolation,  and  the  rubber  tube  having  been  fastened  at  a  suitable  height,  the 
surface  of  the  powder  is  covered  by  an  accurately  fitting  disk  of  filtering  paper,  or  other 
suitable  material,  and  a  sufficient  quantity  of  menstruum  poured  on  through  a  funnel  reach¬ 
ing  nearly  to  the  surface  of  the  paper.  If  these  conditions  are  accurately  observed,  the 
menstruum  will  penetrate  the  powder  equally  until  it  has  passed  into  the  rubber  tube  and 
has  reached,  in  this,  the  height  corresponding  to  its  level  in  the  percolator,  which  is  now 
closely  covered  to  prevent  evaporation,  and  the  apparatus  allowed  to  stand  at  rest  for  the 
time  specified  in  the  formula. 

“  To  begin  percolation,  the  rubber  tube  is  lowered  and  its  glass  end  introduced  into  the 
neck  of  a  bottle  previously  marked  for  the  quantity  of  liquid  to  be  percolated,  if  the  per¬ 
colate  is  to  be  measured,  or  of  a  tared  bottle,  if  the  percolate  is  to  be  weighed ;  and  by 
raising  or  lowering  this  recipient,  the  rapidity  of  percolation  may  be  increased  or  lessened 
as  may  be  desirable,  observing,  however,  that  the  rate  of  percolation,  unless  the  quantity 
of  material  taken  in  operation  is  largely  in  excess  of  the  pharmacopoeial  quantities,  shall 
not  exceed  the  limit  of  ten  to  thirty  drops  in  a  minute.  A  layer  of  menstruum  must  con¬ 
stantly  be  maintained  above  the  powder,  so  as  to  prevent  the  access  of  air  to  its  interstices, 
until  all  has  been  added,  or  the  requisite  quantity  of  percolate  obtained.  This  is  conveni¬ 
ently  accomplished,  if  the  space  above  the  powder  will  admit  of  it,  by  inverting  a  bottle 
containing  the  entire  quantity  of  menstruum  over  the  percolator  in  such  a  manner  that  its 
mouth  may  dip  beneath  the  surface  of  the  liquid,  the  bottle  being  of  such  shape  that  its 
shoulder  will  serve  as  a  cover  for  the  percolator. 

“  When  the  dregs  of  a  tincture,  or  similar  preparation,  are  to  be  subjected  to  percola¬ 
tion,  after  maceration  with  all  or  with  the  greater  portion  of  the  menstruum,  the  liquid 
portion  should  be  drained  off  as  completely  as  possible,  the  solid  portion  packed  in  a  per¬ 
colator,  as  before  described,  and  the  liquid  poured  on,  until  all  has  passed  from  the  sur¬ 
face,  when  immediately  a  sufficient  quantity  of  the  original  menstruum  should  be  poured 
on  to  displace  the  absorbed  liquid,  until  the  prescribed  quantity  has  been  obtained.” 

Modification  of  the  above  Process. 

“  Authority  is  given  to  employ,  in  the  case  of  Fluid  Extracts,  where  it  may  be  applica¬ 
ble,  the  process  of  Repercolation,  without  change  of  the  original  menstruum.” 


Testing  is  directed  by  the  Pharmacopoeia  in  convenient  cases,  for  the 
purpose  of  ascertaining  the  identity  and  purity  of  its  preparations  ;  and 


OFFICIAL  PREPARATIONS. 


419 


a  List  of  Reagents  used  is  given  at  the  end  of  the  book,  which  is  divided 
into  three  parts, — (1)  Articles  used  in  Testing,  (2)  Test-solutions ,  (3)  Volu¬ 
metric  Solutions.  The  analysis  directed  under  the  title  of  each  prepara¬ 
tion  is  frequently  Qualitative,  but  often  Quantitative,  and  of  the  latter  both 
the  Gravimetric  and  the  Volumetric  methods  are  used.  Pharmacopoeial 
testing  and  volumetric  analysis  are  necessary  to  the  work  of  the  practical 
pharmacist,  and  as  the  apparatus  used  is  simple  and  the  operations  are 
those  in  the  line  of  his  daily  work,  he  should  be  familiar  therewith.  On 
the  other  hand  the  proximate  analysis  of  organic  substances  for  their  prin¬ 
ciples,  and  the  ultimate  analysis  of  the  same  bodies  for  their  elements, 
require  a  high  degree  of  skill  and  long  experience,  and  should  be  left  to 
the  professional  chemist. 

The  apparatus  used  in  testing  consists  of  graduated  flasks  and  jars, 
burettes,  pipettes,  funnels,  beakers,  test-tubes,  capsules,  crucibles,  reagent- 
bottles,  etc.  The  metric  system  is  directed  for  all  analytical  work,  and 
the  apparatus  employed  should  be  graduated  accordingly. 


OFFICIAL  PREPARATIONS. 

The  pharmacopoeial  preparations  may  be  presented  under  various 
methods  of  classification,  one  of  the  simplest  being  that  which  divides 
them  into  liquids  and  solids,  the  former  being  subdivided  into  groups 
named  after  their  principal  bases,  viz.  : — 

Liquid  Preparations. 

Aqueous , — Waters,  Solutions,  Infusions,  Decoctions,  Syrups,  Honeys,  Mucilages,  Mix¬ 
tures;  the  last  four  containing  sweet  or  viscid  substances. 

Alcoholic , — Fluid  Extracts,  Tinctures,  Wines,  Spirits,  Elixirs. 


Ethereal , — Oleoresins,  Collodions. 
Oleaginous , — Liniments,  Oleates. 
Acetous , — Vinegars. 

. 

Glycerines , — Glycerites. 

Extracts. 

Solid 

Preparations. 

Troches. 

Ointments. 

Abstracts. 

Confections. 

Cerates. 

Resins. 

Powders. 

Plasters. 

Masses. 

Triturations. 

Papers. 

Pills. 

Suppositories. 

In  the  following  descriptions  of  the  pharmacopoeial  groups  the  compo¬ 
sition  and  dosage  of  the  various  preparations  are  omitted,  as  they  are 
fully  detailed  in  the  section  on  Materia  Medica,  under  the  title  in  each 
case  of  the  principal  constituent. 


Aqueous  Preparations. 

Aquae,  Waters, — are  aqueous  solutions  of  volatile  substances,  which 
may  be  either  solids,  liquids,  or  gases,  dissolved  either  by  solution  in  cold 
or  hot  water,  by  filtration  through  an  absorbent  powder,  by  percolation 


420 


OFFICIAL  PREPARATIONS. 


through  cotton  saturated  with  the  substance,  or  by  distillation.  The  offi¬ 
cial  waters  number  15,  including  the  two  forms  of  Aqua  itself,  as  follows, 
viz.  :  — 


Aqua. 

Aqua  Destillata. 

Aqua  Ammoniae. 

Aqua  Ammoniae  Fortior. 

Aqua  Amygdalae  Amarae. 

Aqua  Anisi. 

Aqua  Aurantii  Florum. 

Aqua 


Aqua  Chlori. 

Aqua  Cinnamomi. 

Aqua  Creasoti. 

Aqua  Foeniculi. 

Aqua  Menthae  Piperitae. 
Aqua  Menthae  Viridis. 
Aqua  Rosae. 

orae. 


Of  the  above-named  two  are  made  by  simple  solution  (A.  Amygdalae 
Amarae  and  A.  Creasoti),  three  are  made  by  passing  gases  through  water 
(A.  Ammoniae,  A.  Ammoniae  Fortior,  and  A.  Chlori),  three  are  made  by 
distillation  (A.  Aurantii  Florum,  A.  Destillata  and  A.  Rosae),  and  the 
other  six  are  made  by  percolation  through  cotton  impregnated  with  the 
substance.  All  waters  deteriorate  when  long  kept,  microscopic  plants 
being  propagated  in  them  from  spores  from  the  atmosphere.  They  should 
be  prepared  only  in  such  quantities  as  are  needed  for  use  within  a  reason¬ 
able  time. 


Liquores,  Solutions, — comprise  all  aqueous  solutions  of  non-volatile 
substances  except  the  syrups,  infusions  and  decoctions,  which  naturally 
form  distinctive  classes.  Included  among  the  Liquores  is  the  Solution  of 
Gutta-percha,  the  solvent  of  which  is  Chloroform  ;  all  the  others  being 
made  with  water.  There  are  28  official  solutions,  as  follows, — the  first  n 
being  simple  aqueous  solutions;  the  next  16  being  chemical  aqueous  solu¬ 
tions,  in  which  the  properties  of  the  dissolved  substances  are  altered  by 
chemical  action  ;  and  the  last-named  being  a  solution  in  Chloroform. 


Liquor  Acidi  Arsenici. 

Liquor  Arsenii  et  Hydrargyri  Iodidi. 
Liquor  Calcis. 

Liquor  Ferri  et  Quininae  Citratis. 
Liquor  Iodi  Composilus. 

Liquor  Pepsini. 

Liquor  Plumbi  Subacetatis  Dilutus. 
Liquor  Potassae. 

Liquor  Sodae. 

Liquor  Sodii  Arseniatis. 

Liquor  Sodii  Silicatis. 

Liquor  Ammonii  Acetatis. 

Liquor  Ferri  Acetatis. 

Liquor  Ferri  Chloridi. 


Liquor  Ferri  Citratis. 

Liquor  Ferri  Nitratis. 
Liquor  Ferri  Subsulphatis. 
Liquor  Ferri  Tersulphatis. 
Liquor  Hydrargyri  Nitratis. 
Liquor  Magnesii  Citratis. 
Liquor  Plumbi  Subacetatis. 
Liquor  Potassae. 

Liquor  Potassii  Citratis. 
Liquor  Potassii  Arsenitis. 
Liquor  Sodae. 

Liquor  Sodae  Cnloratae. 
Liquor  Zinci  Chloridi. 
Liquor  Gutta-Perchae. 


Syrupi,  Syrups, — are  concentrated  solutions  of  Sugar  in  Water  or  in 
aqueous  liquids.  They  sometimes  contain  Acetic  Acid,  and  occasionally 
Alcohol ;  and  are  termed  simple ,  medicated  or  flavored ,  according  as  they 
are  simple  solutions  of  sugar  in  water  alone,  or  contain  soluble  medicinal 
substances,  or  flavoring  ingredients.  The  Sugar  used  should  be  very  dry. 


OFFICIAL  PREPARATIONS. 


421 


and  its  official  description  corresponds  with  the  granulated  sugar  of  com¬ 
merce.  The  permanency  of  these  preparations  chiefly  depends  on  their 
possessing  the  proper  relative  proportions  of  sugar  and  water.  They  are 
prepared  either  by  solution  with  heat,  by  agitation  without  heat,  by  add¬ 
ing  a  medicated  liquid  to  simple  syrup,  by  digestion  or  maceration,  or  by 
cold  percolation ;  these  processes  being  all  officially  directed  except  the 
last.  They  are  best  preserved  by  being  poured  while  hot  into  pint  bottles, 
which  should  be  corked  securely  while  full,  and  the  tops  dipped  into 
melted  sealing-wax.  Fermented  syrups  are  useless  for  dispensing  pur¬ 
poses.  The  number  of  official  syrups  is  34,  as  follows,  viz. — 


Syrupus. 

Syrupus  Acacise. 

Syrupus  Acidi  Citrici. 

Syrupus  Acidi  Hydriodici. 

Syrupus  Allii. 

Syrupus  Althese. 

Syrupus  Amygdalae. 

Syrupus  Aurantii. 

Syrupus  Aurantii  Florum. 

Syrupus  Calcii  Lactophosphatis. 
Syrupus  Calcis. 

Syrupus  Ferri  Bromidi. 

Syrupus  Ferri  Iodidi. 

Syrupus  Ferri  Quininae  et  Strychninae 
Phosphatum. 

Syrupus  Hypophosphitum. 

Syrupus  Hypophosphitum  cum  Ferro. 

Syrupus 


Syrupus  Ipecacuanhse. 

Syrupus  Krameriae. 

Syrupus  Lactucarii. 

Syrupus  Limonis. 

Syrupus  Picis  Liquidae. 

Syrupus  Pruni  Virginianae. 
Syrupus  Rhei. 

Syrupus  Rhei  Aromaticus. 
Syrupus  Rosae. 

Syrupus  Rubi. 

Syrupus  Rubi  Idaei. 

Syrupus  Sarsaparillae  Compositus. 
Syrupus  Scillae. 

Syrupus  Scillae  Compositus. 
Syrupus  Senegae. 

Syrupus  Sennae. 

Syrupus  Tolutanus. 

>eris. 


Mellita,  Honeys, — differ  from  syrups  merely  in  their  being  prepared 
with  honey  as  a  base.  The  Oxy?nel  and  Oxymel  Scillce  of  the  B.  P.  are 
similar  preparations,  containing  also  Acetic  Acid.  There  are  3  official 
Honeys,  including  two  forms  of  honey  itself,  viz. — 

Mel.  Mel  Despumatum.  Mel  Rosae. 


Mucilagines,  Mucilages, — are  thick,  viscid  liquids  prepared  by  dis¬ 
solving  gum  in  water,  or  by  extracting  with  water  the  mucilaginous  prin¬ 
ciples  from  certain  plants.  They  are  easily  spoiled  and  should  be  kept 
only  in  small  quantities.  The  official  Mucilages  number  5,  as  follows,  the 
three  first-named  being  prepared  without  heat,  the  two  last-named  with 
heat,  viz.: — 

Mucilago  Acaciae.  Mucilago  Sassafras  Medullae. 

Mucilago  Cydonii.  Mucilago  Tragacanthae. 

Mucilago  Ulmi. 

Misturae,  Mixtures, — in  official  pharmacy  are  aqueous  preparations  of 
insoluble  substances  held  in  suspension  by  a  suitable  vehicle.  In  extem¬ 
poraneous  pharmacy  the  term  mixture  has  a  wider  signification,  as  ex¬ 
plained  under  that  head.  They  are  generally  prepared  extemporaneously 
upon  prescriptions,  as  few  of  them  are  of  the  stability  necessary  to  insure 


422 


OFFICIAL  PREPARATIONS. 


their  preservation  beyond  a  few  days.  The  official  Mixtures  number  n, 
of  which  one  (Mistura  Ferri  et  Ammonii  Acetatis)  is  misnamed,  and 
should  be  entitled  a  Solution,  as  it  does  not  contain  any  insoluble  sub¬ 
stance.  Their  names  are  as  follows,  viz.:  — 


Mistura  Ammoniaci. 
Mistura  Asafcetidae. 
Mistura  Amygdalae. 
Mistura  Chloroformi. 
Mistura  Cretae. 


Mistura  Ferri  Composita. 

Mistura  Glycyrrhizae  Composita. 
Mistura  Magnesii  et  Asafoetidae. 
Mistura  Ferri  et  Ammonii  Acetatis, 
Mistura  Rhei  et  Sodae. 

Mistura  Potassii  Citratis. 


Of  the  above-named,  the  first  two  are  simple  gum-resin  emulsions,  the 
third  is  a  seed-emulsion,  the  fourth  an  egg-emulsion  ;  the  next  four  contain 
insoluble  powders  in  suspension  by  the  aid  of  gum  arabic,  sugar,  etc.,  the 
next  two  do  not  contain  insoluble  powders  in  suspension,  while  the  last  is 
an  effervescing  mixture. 


Infusa,  Infusions, — are  prepared  by  treating  vegetable  substances 
with  hot  or  cold  water  without  boiling.  Cold  water  is  preferred  when  the 
drug  contains  a  desirable  volatile  principle,  or  when  its  active  ingredient 
is  injured  by  heat.  The  drug  should  be  coarsely  comminuted,  sliced  or 
bruised,  and  treated  by  maceration  or  percolation  with  the  proper  quan¬ 
tity  of  water,  which  in  the  absence  of  specific  directions  to  the  contrary 
should  be  io  parts  by  weight  to  i  of  the  drug.  These  preparations 
should  be  freshly  made  when  required,  as  they  are  very  prone  to  decom¬ 
position.  The  number  of  official  Infusions  is  5,  viz.:  — 

Infusum  Brayerae.  Infusum  Digitalis. 

Infusum  Cinchonae.  Infusum  Pruni  Virginianae. 

Infusum  Sennae  Compositum. 

• 

The  proportions  of  drug  to  menstruum  in  the  official  infusions  vary  from 
1  y2  per  cent,  in  the  case  of  Digitalis  to  4  per  cent,  in  the  case  of  Wild 
Cherry  and  6  per  cent,  in  the  case  of  the  others.  Alcohol  is  an  ingre¬ 
dient  of  the  Infusion  of  Digitalis  to  prevent  decomposition. 

Many  dispensing  pharmaceutists  are  in  the  habit  of  making  infusions 
from  concentrated  alcoholic  tinctures  or  from  fluid  extracts.  It  is  a  very 
reprehensible  practice,  especially  in  those  cases  where  the  active  ingre¬ 
dients  are  of  a  resinous  nature  and  therefore  precipitated  when  the  alco¬ 
holic  solution  is  added  to  water. 


Decocta,  Decoctions, — are  made  by  boiling  vegetable  substances  with 
water.  As  very  few  drugs  contain  active  ingredients  which  are  not 
injured  by  heat,  these  preparations  have  never  obtained  favor  with  scien¬ 
tific  physicians.  There  are  only  2  official  Decoctions,  viz.:  — 


Decoctum  Cetrarise. 


Decoctum  Sarsaparilla;  Compositum. 


OFFICIAL  PREPARATIONS. 


423 


The  general  official  formula  prescribes  that  an  ordinary  decoction,  the 
strength  of  which  is  not  directed  by  the  physician,  nor  specified  by  the 
Pharmacopoeia,  shall  be  prepared  in  the  proportion  of  1  part  of  the  sub¬ 
stance  to  9  of  water.  Decoctum  Cetrariae  is  one-half  the  aforesaid  strength, 
while  the  Compound  Decoction  of  Sarsaparilla  is  of  the  full  strength  as  to 
its  chief  ingredient. 

Alcoholic  Preparations. 

Extracta  Fluida,  Fluid  Extracts, — are  permanent  concentrated  solu¬ 
tions  of  vegetable  drugs,  of  uniformly  definite  strength  if  the  crude  drugs 
are  so,  a  cubic  centimeter  (11^16.23)  in  each  case  representing  the  medi¬ 
cinal  powers  of  one  gramme  (gr.  15.43)  of  the  drug,  or  approximately  a 
minim  of  the  finished  preparation  representing  the  active  constituents  of  a 
grain  of  the  drug.  They  are  officially  directed  to  be  prepared  by  perco¬ 
lation  and  partial  evaporation,  the  menstrua  employed  being  usually  Alco¬ 
hol,  diluted  Alcohol,  or  Alcohol  and  Water  in  various  proportions,  though 
a  few  are  percolated  with  water,  the  alcohol  being  afterwards  added.  In 
several  instances  Glycerin  in  different  proportions  is  added  to  the  first 
menstruum,  -and  in  the  menstruum  used  for  the  extraction  of  Aconite 
root  Tartaric  Acid  is  an  ingredient.  In  the  preparation  of  the  fluid 
extract  of  Prunus  Virginiana,  the  extraction  is  preceded  by  maceration 
with  water  and  glycerin,  in  order  to  permit  of  the  formation  of  Hydro¬ 
cyanic  Acid  by  the  reaction  of  the  amygdalin  and  emulsin  of  the  bark  upon 
each  other,  which  takes  place  only  in  the  presence  of  water.  The  glycerin 
aids  to  keep  the  dissolved  matters  in  perfect  solution,  and  also  to  better  re¬ 
tain  the  acid  and  volatile  oil  formed  during  the  process.  The  fluid  extract 
of  Glycyrrhiza  is  prepared  with  a  first  menstruum  containing  Ammonia,  and 
that  of  Lactucarium  is  first  treated  with  Ether  and  then  put  through  an 
elaborate  process  in  order  to  obtain  a  preparation  which  will  make  a  clear 
mixture  with  water,  syrup  or  glycerin.  The  menstruum  directed  to  be 
used  in  each  case  is  intended  to  be  that  which  will  throughly  extract  all 
the  active  constituents  of  the  drug  and  at  the  same  time  will  leave  the  inert 
soluble  matters  behind  in  the  rejected  portion,  known  as  the  marc .  In 
manufacturing  fluid  extracts  on  a  large  scale,  modifications  of  the  official 
processes  are  necessary,  and  the  methods  used  are  generally  percolation 
and  maceration  with  hydraulic  pressure,  vacuum  maceration  followed  by 
percolation,  percolation  with  incomplete  exhaustion,  or  repercolation. 
The  number  of  official  Fluid  Extracts  is  79.  They  are  named  in  the  fol¬ 
lowing  list,  the  letters  following  each  one  in  parentheses  showing  the  char¬ 
acter  of  its  menstruum,  and  representing  Alcohol,  Diluted  Alcohol, 
Alcohol  and  Water,  or  Glycerin,  by  their  respective  initials. 


Extractum  Aconiti  Fluidum  (A). 
Ext.  Arnicae  Radicis  FI.  (HA). 
Ext.  Aromaticum  FI.  (A). 


Ext.  Aurantii  Amari  FI.  (A2Wj). 
Ext.  Belladonnae  FI.  (A). 

Ext.  Brayerae  FI.  (A). 


424 


OFFICIAL  PREPARATIONS. 


Ext.  Buchu  FI.  (A2WX). 

Ext.  Calami  FI.  (A). 

Ext.  Calumbae  FI.  (DA). 

Ext.  Cannabis  Indicae  FI.  (A). 

Ext.  Capsici  FI.  (A). 

Ext.  Castanese  FI.  (WA). 

Ext.  Chimaphilge  FI.  (DAgGx). 
Ext.  Chiratae  FI.  (DA9Gj). 

Ext.  Cimicifugae  FI.  (A). 

Ext.  Cinchonas  FI.  (DjA6Gj). 

Ext.  Colchici  Radicis  FI.  (A2WX). 
Ext.  Colchici  Seminis  FI.  (A2WX). 
Ext.  Conii  FI.  (DA). 

Ext.  Cornus  FI.  (DA4GX). 

Ext.  Cubebae  FI.  (A). 

Ext.  Cypripeaii  FI.  (A). 

Ext.  Digitalis  FI.  (A3WX). 

Ext.  Dulcamarae  FI.  (DA). 

Ext.  Ergotae  FI.  (A3W4). 

Ext.  Erythroxyli  FI.  (DA). 

Ext.  Eucalypti  FI.  (A). 

Ext.  Eupatorii  FI.  (DA). 

Ext.  Frangulae  FI.  (AXW2). 

Ext.  Gelsemii  FI.  (A). 

Ext.  Gentianae  FI.  (DA). 

Ext.  Geranii  FI.  (DA9GX). 

Ext.  Glycyrrhizae  FI.  (DA). 

Ext.  Gossypii  Radicis  FI.  (A3G7). 
Ext.  Grindeliae  FI.  (A3WX). 

Ext.  Guaranae  FI.  (A3WX). 

Ext.  Hamamelidis  FI.  (AXW2). 
Ext.  Hydrastis  FI.  (A3WX). 

Ext.  Hyoscyami  FI.  (A3WX). 

Ext.  Ipecacuanhae  FI.  (A). 

Ext.  Iridis  FI.  (A3WX). 

Ext.  Krameriae  FI.  (DA4GX). 

Extractum  Z 


Ext.  Lactucarii  FI.  (AXW3). 

Ext.  Leptandrae  FI.  (DAnG3). 

Ext.  Lobeliae  FI.  (DA). 

Ext.  Lupulini  FI.  (A), 

Ext.  Matico  FI.  (AX5W5G2). 

Ext.  Mezerei  FI.  (A). 

Ext.  Nucis  Vomicae  FI.  (AgWx). 

Ext.  Pareirae  FI.  (DA4GX). 

Ext.  Pilocarpi  FI.  (DA). 

Ext.  Podophylli  FI.  (A3WX). 

Ext.  Pruni  Virginianae  FI.  (W2GX). 
Ext.  Quassiae  FI.  (DA). 

Ext.  Rhei  FI.  (AjW)). 

Ext.  Rhois  Glabrae  FT  (DA9GX). 
Ext.  Rosae  FI.  (DA9GX). 

Ext.  Rubi  FI.  (A9W7G4). 

Ext.  Rumicis  FI.  (DA). 

Ext.  Sabinae  FI.  (A). 

Ext.  Sanguinariae  FI.  (A). 

Ext.  Sarsaparillae  Co.  FI.  (A5W6GX). 
Ext.  Sarsaparillae  FI.  (A3W6GX). 

Ext.  Scillse  FI.  (A). 

Ext.  Scutellariae  FI.  (AXW2). 

Ext.  Senegae  FI.  (A2WX). 

Ext.  Sennae  FI.  (A3W4). 

Ext.  Serpentariae  FI.  (A3WX). 

Ext.  Spigeliae  FI.  (DA). 

Ext.  Stillingiae  FI.  (DA). 

Ext.  Stramonii  FI.  (ASWX). 

Ext.  Taraxaci  FI.  (A2W3). 

Ext.  Tritici  FI.  (WA). 

Ext.  Uvae  Ursi  FI.  (DA9GX). 

Ext.  Valerianae  FI.  (A2WX). 

Ext.  Veratri  Virdis  FI.  (A). 

Ext.  Viburni  FI.  (A2WX). 

Ext  Xanthoxyli  FI.  (A). 

■is  Fluidum  (A). 


In  nine  instances  only  does  the  Pharmacopoeia  direct  the  making  of 
other  preparations  from  corresponding  fluid  extracts,  these  nine  being  the 
Syrups  of  Krameria,  Lactucarium,  Rubus,  Senega,  and  Ginger,  the  Extract 
of  Ergot,  the  Liniment  of  Belladonna,  the  Ointment  of  Mezereum,  and 
the  Mixture  of  Rhubarb  and  Soda.  Notwithstanding  this  fact  it  is  a  com¬ 
mon  practice  for  dispensing  pharmaceutists  to  make  tinctures,  syrups, 
infusions,  etc.,  from  fluid  extracts;  and  some  manufacturers  put  a  label 
on  the  bottles  containing  their  fluid  extracts,  giving  the  formulae  for  so 
preparing  other  preparations.  This  practice  is  illegitimate,  and  tends  to 
still  further  degrade  the  profession  of  pharmacy  into  a  mere  trade,  so  far 
as  all  dispensing  is  concerned. 

A  large  number  of  unofficial  fluid  extracts  are  manufactured  and  for  sale,  one  house 
alone  carrying  over  400  such  on  their  catalogue.  Normal  Liquids  are  a  class  of  superior 
fluid  extracts  introduced  by  Parke,  Davis  &  Co.,  which  are  claimed  to  be  adjusted  to  a 
maximum  strength  by  accurate  assays  for  alkaloidal  strength  made  at  each  stage  of  their 
manipulation,  irrespective  of  the  amount  of  material  required,  which  in  the  case  of  official 
fluid  extracts  is  prescribed  by  the  Pharmacopoeia,  regardless  of  the  varying  quality  of  drugs 
in  the  market.  This  firm  prepares  Normal  Liquids  of  Aconite,  Veratrum  Viride,  Bella¬ 
donna  (root  or  leaves),  Cannabis  Indica,  Cinchona  Calisaya,  Cinchona  Rubra,  Colchicum 


OFFICIAL  PREPARATIONS. 


42  5 


{root  or  seed),  Conium,  Ergot,  Digitalis,  Gelsemium,  Hyoscyamus,  Ipecacuanha,  Podo¬ 
phyllum,  Nux  Vomica,  Rhubarb,  and  Stramonium  (seed  or  leaves).  Of  these  prepara¬ 
tions  one  cubic  centimeter  is  equivalent  to  one  gramme  of  the  corresponding  drug  of 
standard  alkaloidal  strength.  A  fluid  extract  of  Belladonna  leaves  may  contain  .25  or 
.45  per  cent,  of  atropine,  according  to  the  quality  of  the  drug  employed  ;  a  Normal 
Liquid  will  contain  invariably  .4  per  cent,  of  the  alkaloid,  so  that  in  a  given  dose  it  may 
be  relied  upon  to  produce  a  certain  effect. 


Tincturse,  Tinctures, — are  alcoholic  solutions  of  medicinal  substances ; 
and  with  one  official  exception  (Tincture  of  Iodine),  are  made  from  non¬ 
volatile  bodies.  They  are  prepared  by  percolation,  maceration,  solution 
or  dilution  ;  the  menstrua  employed  being  chiefly  Alcohol,  and  diluted 
Alcohol  of  various  strengths,  though  in  a  few  cases  the  Aromatic  Spirit 
of  Ammonia,  and  mixtures  of  Alcohol,  Water  and  Glycerin  are  directed 
to  be  used.  The  Pharmacopoeia  prescribes  a  general  formula  for  Tinctures 
of  Fresh  Herbs ,  according  to  which,  when  not  otherwise  directed,  these 
preparations  are  to  be  made  by  macerating  50  parts  of  the  Fresh  Herb, 
bruised  or  crushed,  with  100  parts  of  Alcohol  for  14  days,  then  expressing 
the  liquid  and  filtering.  Of  the  72  official  Tinctures  2  are  made  with  5 
per  cent,  of  the  ingredient,  20  with  10  per  cent.,  9  with  15  per  cent.,  23 
with  20  per  cent.,  1  with  35  per  cent.,  1  (Aconite)  with  40  per  cent.,  3 
with  50  per  cent.,  and  1  (Soap)  with  65  per  cent.;  the  others  varying  in 
strength  from  0.4  per  cent,  in  the  case  of  Paregoric  to  26  per  cent,  in  that 
of  the  Compound  Tincture  of  Benzoin.  Fifty-four  are  made  by  percola¬ 
tion,  a  few  by  solution  or  dilution,  and  the  rest  by  maceration.  The  offi¬ 
cial  Tinctures  are  as  follows,  the  figures  placed  after  each  giving  the  num¬ 
ber  of  grains  of  the  active  ingredients  in  each  fluid-drachm,  viz. — 


Tinctura  Aconiti,  19. 

Tinctura  Aloes,  io{{. 

Tinctura  Aloes  et  Myrrhse,  10*4. 
Tinctura  Arnicse  Florum,  10)4 . 
Tinctura  Arnicse  Radicis,  5 
Tinctura  Asafoetidse,  10 
Tinctura  Aurantii  Amari,  io)4« 
Tinctura  Aurantii  Dulcis,  lolf. 
Tinctura  Belladonnse,  8^4. 

Tinctura  Benzoini,  io)4- 
Tinctura  Benzoini  Composita,  13^. 
Tinctura  Bryonise,  4^. 

Tinctura  Calendulse,  io)4- 
Tinctura  Calumbse,  5 y%. 

Tinctura  Cannabis  Indicse,  io)4- 
Tinctura  Cantharidis,  2y(. 

Tinctura  Capsici,  2)/(. 

Tinctura  Cardamomi,  8)4- 
Tinctura  Cardamomi  Composita,  2{{ 
Tinctura  Catechu  Composita,  10 
Tinctura  Chiratse,  54^. 

Tinctura  Cimicifugae,  io)4- 
Tinctura  Cinchonse,  10 
Tinctura  Cinchonse  Composita,  io)4 
Tinctura  Cinnamomi,  5  l/%. 

Tinctura  Colchici,  8)4- 


Tinctura  Conii,  8^. 

Tinctura  Croci,  5  l/%. 

Tinctura  Cubebse,  $l/%. 

Tinctura  Digitalis,  8)4* 

Tinctura  Ferri  Acetatis. 

Tinctura  Ferri  Chloridi. 

Tinctura  Gallae,  10)4* 

Tinctura  Gelsemii,  7 ]/2. 

Tinctura  Gentianse  Composita,  7 )4- 
Tinctura  Guaiaci,  10  'f. 

Tinctura  Guaiaci  Ammoniata,  lof. 
Tinctura  Humuli,  10 
Tinctura  Hydrastis,  \olf. 

Tinctura  Hyoscyami,  8)4- 
Tinctura  Ignatise,  gr.  ]/2  of  Extract. 
Tinctura  Iodi,  4. 

Tinctura  Ipecacuanhse  et  Opii,  io)4- 
Tinctura  Kino,  5  *4- 
Tinctura  Kramerise,  io^f- 
Tinctura  Lavendulse  Composita,  2 'f. 
Tinctura  Lobeliae,  lolf. 

Tinctura  Matico,  5)^. 

Tinctura  Moschi,  5  {4- 
Tinctura  Myrrhse,  10 
Tinctura  Nucis  Vomicse,  10)4- 
Tinctura  Opii,  S/4- 


426 


OFFICIAL  PREPARATIONS. 


Tinctura  Opii  Camphorata, 
Tinctura  Opii  Deodorata,  5 y2. 
Tinctura  Physostigmatis,  4 
Tinctura  Pyrethri,  10 1^. 
Tinctura  Quassise,  51^. 

Tinctura  Rhei,  7j£- 
Tinctura  Rhei  Aromatica,  16 ]/2. 
Tinctura  Rhei  Dulcis,  9. 
Tinctura  Sanguinavfce,  8j^. 
Tinctura  Saponis  Viridis,  36^. 


Tinctura  Scillse,  8 
Tinctura  Serpentarice,  5  l/%. 

Tinctura  Stramonii,  5  y$. 

Tinctura  Sumbul,  4^. 

Tinctura  Tolutana,  5  y%. 

Tinctura  Valerianae,  10 yf . 

Tinctura  Valerianae  Ammoniata,  ioj^ 
Tinctura  Vanillae,  5 y%. 

Tinctura  Veratri  Viridis,  24. 

Tinctura  Zingiberis. 


Vina,  Wines, — when  medicated  are  practically  the  same  as  Tinctures, 
White  Wine  brought  to  a  definite  alcoholic  strength  (Vinum  Album  For¬ 
tius),  being  the  menstruum  used.  The  official  Wines  number  14,  of  which 
3  are  not  medicated,  4  are  made  by  solution  or  admixture,  3  by  macera¬ 
tion  and  4  by  percolation.  They  are  as  follows,  viz. — 


Vinum  Album,  10-12. 

Vinum  Album  Fortius,  20-25. 
Vinum  Rubrum,  10-12. 
Vinum  Aloes,  6. 

Vinum  Antimonii,  0.4. 

Vinum  Aromaticum,  6. 

Vinum  Colchici  Radicis,  40. 


Vinum  Colchici  Seminis,  15. 
Vinum  Ergotse,  15. 

Vinum  Ferri  Amari,  8. 
Vinum  Ferri  Citratis,  4. 
Vinum  Ipecacuanha,  7. 
Vinum  Opii,  10. 

Vinum  Rhei,  10. 


The  figures  placed  after  the  first  three  show  the  percentage  of  absolute 
alcohol  which  is  required  in  each ;  those  placed  after  the  other  members 
of  the  group  show  the  quantity  of  the  active  ingredient  used  in  preparing 
100  parts  of  the  Wine. 


Spiritus,  Spirits, — are  alcoholic  solutions  of  volatile  substances,  which 
may  be  solids,  liquids  or  gases.  They  are  officially  prepared  either  by 
simple  solution,  by  solution  with  maceration,  by  gaseous  solution,  by 
chemical  reaction,  or  by  distillation.  The  number  of  official  Spirits  is 
22,  as  follows,  viz. — 


Spiritus  /Etheris. 

Spiritus  /Etheris  Compositus. 
Spiritus  Ammonise  Aromaticus. 
Spiritus  Anisi. 

Spiritus  Aurantii. 

Spiritus  Camphorm. 

Spiritus  Chloroformi. 

Spiritus  Cinnamomi. 

Spiritus  Gaultheriae. 

Spiritus  Juniperi. 

Spiritus  Juniperi  Compositus. 


Spiritus  Lavandulae. 
Spiritus  Myrciae. 

Spiritus  Myristicae. 
Spiritus  Odoratus. 

Spiritus  Limonis. 

Spiritus  Menthae  Piperitae. 
Spiritus  Menthae  Viridis. 
Spiritus  Ammoniae. 
Spiritus  Altheris  Nitrosi. 
Spiritus  Frumenti. 

Spiritus  Vini  Gallici. 


Of  these,  the  first  fifteen  are  prepared  by  simple  solution,  the  next  three 
by  solution  with  maceration,  the  next  one  by  gaseous  solution,  the  next 
one  by  chemical  reaction,  and  the  last  two  by  distillation. 


Elixiria,  Elixirs, — are  sweetened,  aromatic,  spirituous  preparations  con¬ 
taining  active  medicinal  substances  in  small  quantities.  There  is  but  one 
official  Elixir  (Elixir  Aurantii),  which  is  intended  as  a  type  of  the  class 


OFFICIAL  PREPARATIONS. 


427 


of  unofficial  elixirs  so  largely  employed  in  extemporaneous  pharmacy.  It 
is  practically  a  flavored  alcoholized  syrup,  designed  for  use  as  an  excipient 
with  extracts,  salts  and  tinctures. 

Ethereal  Preparations. 

Oleoresinae,  Oleoresins, — are  liquid  preparations  consisting  principally 
of  natural  oils  and  resins  extracted  from  vegetable  substances  by  percola¬ 
tion  with  Stronger  Ether.  They  differ  from  fluid  extracts  in  not  bearing 
any  uniform  relation  to  the  drug  of  gramme  to  cubic  centimeter,  in  con¬ 
taining  principles  which  though  soluble  in  ether  are  not  in  alcohol,  and  in 
some  instances  being  devoid  of  principles  which  are  insoluble  in  ether 
but  soluble  in  alcohol.  They  are  the  most  concentrated  liquid  prepara¬ 
tions  of  drugs  which  can  be  produced,  and  are  prepared  by  percolating 
the  powdered  drug  with  Stronger  Ether  until  exhausted,  recovering  the 
greater  part  of  the  ether  by  distillation,  and  exposing  the  residue  in  a 
capsule  to  spontaneous  evaporation  until  the  remaining  ether  has  evapo¬ 
rated.  There  are  6  official  Oleoresins,  viz. — 

Oleoresina  Aspidii  (10-15).  Oleoresina  Lupulini  (50). 

Oleoresina  Capsici  (5).  Oleoresina  Piperis  (5). 

Oleoresina  Cubebae  (18-25).  Oleoresina  Z'ngiberis  (6-8.) 

The  figures  in  parentheses  show  the  percentage  of  oleoresin  yielded  by 
each  drug. 


Collodia,  Collodions, — are  liquid  preparations  having  for  their  base 
a  solution  of  Pyroxylin  in  a  mixture  of  Ether  and  Alcohol.  They  are 
intended  for  external  use,  being  applied  to  the  skin  by  means  of  a  brush, 
and  producing  a  film  on  the  surface  after  the  evaporation  of  the  men¬ 
struum.  There  are  4  official  Collodions,  viz. — 


Collodium.  Collodium  Flexile. 

Collodium  cum  Cantharide.  Collodium  Stypticum. 

The  Flexible  Collodion  contains  5  per  cent,  of  Canada  Turpentine,  and 
3  per  cent,  of  Castor  Oil.  Styptic  Collodion  contains  20  per  cent,  of 
Tannic  Acid. 

Oleaginous  Preparations. 


Linimenta,  Liniments, — are  very  thin  ointments  for  external  applica¬ 
tion  and  intended  to  be  applied  with  friction  to  the  skin.  They  are  solu¬ 
tions  of  various  substances  in  oily  liquids  or  in  alcoholic  liquids  contain¬ 
ing  fatty  oils.  Of  the  following  to  official  Liniments  the  first  4  have 
Cotton-seed  Oil,  the  next  4  have  Alcohol  and  the  last  2  have  Oil  of  Tur¬ 
pentine  as  their  respective  bases. 


Linimentum  Ammoniae.  Linimentum  Belladonnae. 

Linimentum  Calcis.  Linimentum  Chloroformi. 

Linimentum  Camphorae.  Linimentum  Saponis. 

Linimentum  Plumbi  Subacetatis.  Linimentum  Sinapis  Comp. 

Linimentum  Cantharidis. 

Linimentum  Terebinthinae. 


428 


OFFICIAL  PREPARATIONS. 


Oleata,  Oleates, — are  liquid  solutions  of  metallic  salts  or  alkaloids  in 
Oleic  Acid,  intended  for  external  administration.  They  are  not  definite 
chemical  compounds,  though  the  term  is  also  employed  in  trade  to  desig¬ 
nate  certain  solid  preparations  which  are  claimed  to  be  chemical  com¬ 
pounds  of  the  same  acid  with  various  bases.  [See  under  Acidum  Olei- 
cum,  ante ,  page  71.]  There  are  2  official  Oleates,  as  follows,  viz. — 
Oleatum  Hydrargyri  (10  per  cent.).  Oleatum  Veratrinse  (2  per  cent.). 

Acetous  Preparations. 

Aceta,  Vinegars, — are  solutions  of  the  active  principles  of  certain 
drugs  in  Diluted  Acetic  Acid.  They  are  made  by  percolation  and  each 
contain  the  soluble  principles  from  10  per  cent,  of  drug.  Acidulous 
menstrua  form  soluble  salts  with  the  alkaloids  and  possess  antiseptic 
qualities.  The  official  Vinegars  number  4,  viz. — 

Acetum  Lobelise.  Acetum  Sanguinariae. 

Acetum  Opii.  Acetum  Scillae. 

Glycerin  Preparations. 

Glycerita,  Glycerites, — are  mixtures  of  medicinal  substances  with 
Glycerin.  In  the  U.  S.  Phar.  of  1870  there  were  5  official  Glycerites, 
which  were  solutions  of  Carbolic,  Gallic,  and  Tannic  Acids,  Tar,  and 
Sodium  Borate,  in  Glycerin.  They  were  very  useful  preparations  for  dis¬ 
pensing  purposes,  as  they  could  be  readily  diluted  with  water  or  alcohol 
without  precipitation.  Only  2  Glycerites  are  now  official,  viz. — 
Glyceritum  Amyli.  Glyceritum  Vitelli. 

Solid  Preparations. 

Extracta,  Extracts, — are  solid  or  semi-solid  preparations  obtained  by 
evaporating  solutions  of  vegetable  principles.  The  drug  is  first  powdered, 
then  percolated  with  the  appropriate  menstruum  to  exhaustion.  The  first 
third  of  the  percolate  is  reserved,  the  remainder  is  evaporated  at  a  tem¬ 
perature  not  above  1220  F.  until  its  weight  is  ten  per  cent,  of  that  of  the 
drug  used,  then  mixed  with  the  reserved  portion,  and  both  are  evaporated 
to  a  pilular  consistence.  The  above  is  the  general  rule,  but  in  several 
instances  maceration  is  directed  for  1  to  4  days  before  percolation  ;  and 
in  other  cases,  instead  of  reserving  a  portion  of  the  percolate,  the  whole 
quantity  is  distilled  until  the  alcohol  is  removed,  and  the  residue  is  evapo¬ 
rated  to  a  pilular  consistence.  The  menstrua  used  are, — in  5  cases 
Alcohol,  in  15  cases  Diluted  Alcohol  of  varying  strength,  in  8  Water,  in 
1  Water  with  5  per  cent,  of  Aqua  Ammoniae,  and  in  1  a  diluted  Acetic 
Acid.  One  extract  is  an  inspissated  juice  (Ext.  Taraxaci)  ;  one  is  made 
by  evaporating  a  fluid  extract  (Ext.  Ergotae),  and  one  by  mixing  extracts 
with  aromatics  (Ext.  Colocynthidis  Comp.).  Five  per  cent,  of  Glycerin 
is  added  to  10  to  prevent  their  becoming  hard.  The  official  Extracts 


OFFICIAL  PREPARATIONS. 


429 


number  32,  and  are  named  as  follows,  the  letters  in  parentheses  showing 
the  nature  of  the  menstruum  used  in  extraction  in  each  case,  viz. — 


Extractum  Aconiti  (A). 

Ext.  Aloes  Aquosum  (W). 

Ext.  Arnicae  Radicis  (DA). 

Ext.  Belladonnae  Alcoholicum  (A2WX). 
Ext.  Cannabis  Indicae  (A). 

Ext.  Cinchonas  (AgWj). 

Ext.  Colchici  Radicis  (W). 

Ext.  Colocynthidis  (DA). 

Ext.  Colocynthidis  Compositum. 

Ext.  Conii  Alcoholicum  (DA). 

Ext.  Digitalis  (A2W1). 

Ext.  Ergotae  (A3W4). 

Ext.  Euonymi  (DA). 

Ext.  Gentianae  (W). 

Ext.  Glycyrrhizae  (W). 

Ext.  Glycyrrhizae  Purum  (W). 


Extractum  Haematoxyli  (W). 

Ext.  Hyoscyami  Alcoholicum  (AAV.). 
Ext.  Iridis  (AgWj). 

Ext.  Juglandis  (A). 

Ext.  Krameriae  (W). 

Ext.  Leptandras  (AjWA. 

Ext.  Malti  (W). 

Ext.  Mezerei  (A). 

Ext.  Nucis  Vomicae  (AAV,). 

Ext.  Opii  (W). 

Ext.  Physostigmatis  (A). 

Ext.  Podophylli  (AgWj). 

Ext.  Quassias  (W). 

Ext.  Rhei  (A^Wj). 

Ext.  Stramonii  (DA). 

Ext.  Taraxaci. 


The  proximate  principles  which  are  generally  present  in  extracts, 
besides  the  peculiar  principles  of  plants,  are  sugar,  tannin,  extractive, 
chlorophyll,  coloring-matter,  and  salts.  When  an  alcoholic  solvent  is  used 
there  are  also  present  resins,  fats  and  often  volatile  oil,  and  when  the 
menstruum  is  not  purely  alcohol  there  is  more  or  less  gum  and  starch. 
One  of  these  ingredients,  named  Extractive  or  Apotheme,  is  a  deposit, 
soluble  in  water  and  alcohol,  which  has  the  singular  property  of  passing 
into  an  insoluble  substdnce  under  the  influence  of  the  atmospheric  air 
with  heat.  It  also  has  a  tendency,  when  precipitated  from  solutions,  to 
unite  with  other  principles  carrying  them  down  with  it.  It  is  frequently 
present  in  extracts,  hence  its  name. 


Abstracta,  Abstracts, — are  solid,  dry,  powdered  preparations,  con¬ 
taining  the  soluble  principles  of  the  drugs  from  which  they  are  made, 
and  each  representing  twice  the  strength  of  the  corresponding  drug  or  its 
fluid  extract.  They  are  prepared  by  spontaneous  evaporation  of  an  alco¬ 
holic  tincture  at  a  low  temperature  (not  exceeding  1220  F.),  mixing  with 
it  enough  dried  Sugar  of  Milk  to  make  the  product  weigh  one-half  the 
weight  of  the  drug,  and  then  reducing  it  to  a  fine  and  uniform  powder. 
They  are  permanent  and  portable  preparations,  not  subject  to  variation 
in  strength,  nor  to  become  hard  and  brittle.  They  were  first  introduced 
into  the  U.  S.  Pharmacopoeia  in  the  edition  of  1880,  and  are  n  in 
number,  viz. — 


Abstractum  Aconiti. 
Abstractum  Belladonnae. 
Abstractum  Conii. 
Abstractum  Digitalis. 
Abstractum  Hyoscyami. 


Abstractum  Jalapae. 
Abstractum  Podophylli. 
Abstractum  Senega?. 
Abstractum  Valerianae. 
Abstractum  Ignatiae. 


Abstractum  Nucis  Vomicae. 


The  menstrua  used  for  these  are  Alcohol  8,  Water  1  for  the  two  last-named, 


430 


OFFICIAL  PREPARATIONS. 


and  Alcohol  for  the  others ;  but  2  per  cent,  of  Tartaric  Acid  is  added  in 
the  case  of  Aconite,  and  6  per  cent,  of  HC1  in  the  case  of  Conium. 

Resinse,  Resins, — are  solid  preparations  obtained  by  precipitating  the 
resinous  principle  of  plants  from  their  alcoholic  solution  by  the  agency  of 
water.  They  differ  from  alcoholic  extracts  in  containing  only  those  prin¬ 
ciples  which  are  soluble  in  alcohol  and  insoluble  in  water,  while  the 
extracts  contain  all  principles  which  are  soluble  in  alcohol.  There  are  4 
official  Resins,  viz. — 

Resina  Copaibae.  Resina  Podopbylli. 

Resina  Jalapae.  Resina  Scammonii. 

M  assae,  Masses, — are  Pill-masses  prepared  as  described  in  the  next 
paragraph.  The  official  Masses  number  3,  viz. — 

Massa  Copaibae.  Massa  Ferri  Carbonatis. 

Massa  Hydrargyri. 


Pilulae,  Pills, — are  spherical  masses  composed  of  medicinal  agents  and 
intended  to  be  swallowed  whole.  The  “  mass  ”  consists  of  the  active 
ingredients  and  the  excipient ,  the  latter  being  the  substance  which  gives  to 
the  mass  its  adhesive  and  plastic  qualities.  In  official  pharmacy  the  excipi¬ 
ents  are  specified  both  as  to  composition  and  quantity  in  each  case,  and 
those  directed  to  be  used  in  the  preparation  of  the  3  official  Masses  and 
the  15  official  Pills  are  as  follows,  viz, — 

5  are  made  with  Soap  and  Water ,  viz. — Pil.  Aloes,  Pil.  Aloes  et  Asafoetidae,  Pil.  Asa¬ 
foetidae,  Pil.  Opii,  Pil.  Rhei. 

3  are  made  with  Water  alone,  viz. — Pil.  Aloes  et  Mastiches,  Pil.  Catharticae  Comp., 
Pil.  Rhei  Comp. 

3  are  made  with  Syrup ,  viz. — Pil.  Aloes  et  Myrrhae,  Pil.  Ferri  Comp.,  Pil.  Galbani 
Comp. 

I  with  Mucilage  of  Tragacanth ,  viz. —  Pil.  Antimonii  Comp. 

I  with  Acacia  and  Water,  viz. — Pil.  Ferri  Iodidi. 

I  with  Glycerin  and  Water,  viz. — Pilulae  Phosphori. 

1  with  Confection  of  Rose,  viz.  —  Pilulae  Aloes  et  Ferri. 

1  with  Honey  Syrup  and  Water,  viz. — Massa  Ferri  Carbonatis. 

I  with  Glycerm  and  Honey  of  Rose,  viz. — Massa  Hydrargyri. 

1  has  no  excipient,  viz. — Massa  Copaibae. 

The  pharmacopoeial  directions  for  the  formation  of  the  pill-mass  vary 
in  each  case,  but  in  general  they  prescribe  that  the  ingredients  shall  be 
mixed  intimately,  then  beaten  with  the  excipient  to  form  a  mass  and 
divided  into  a  certain  number  of  pills.  Two  of  the  official  pills  are 
directed  to  be  coated  with  an  ethereal  solution  of  the  Balsam  of  Tolu, 
viz. — Pilulae  Ferri  Iodidi  and  Pilulae  Phosphori.  Full  descriptions  of  the 
various  details  of  pill-making  are  given  in  the  section  on  Extemporaneous 
Pharmacy.  The  number  of  official  pills  is  15,  for  the  composition  of 
which  the  student  is  referred  to  their  several  titles  in  the  section  of  Materia 
Medica.  They  are  named  as  follows,  viz. — 


OFFICIAL  PREPARATIONS. 


431 


Pilulae  Aloes. 

Pilulae  Aloes  et  Asafoetidae. 

Pilulae  Aloes  et  Ferri. 

Pilulae  Aloes  et  Mastiches. 

Pilulae  Aloes  et  Myrrhae. 

Pilulae  Antimonii  Compositae. 

Pilulae  Asafoetidae. 

Pilulae  Rhei 


Pilulae  Catharticae  Compositae. 
Pilulae  Ferri  Compositae. 
Pilulae  Ferri  Iodidi. 

Pilulae  Galbani  Compositae. 
Pilulae  Opii. 

Pilulae  Phosphori. 

Pilulae  Rhei. 

Compositae. 


Trochisci,  Troches, — also  called  Pastilles,  Tablets  or  Lozenges, — are 
small  flattened  cakes  of  medicinal  substances,  prepared  from  a  mass 
made  with  a  basis  of  Sugar,  some  having  Mucilage  of  Tragacanth,  others 
Orange-flower  Water,  Syrup  of  Tulu,  etc.,  as  excipients.  They  are  con¬ 
venient  preparations  for  the  pocket-case,  and  are  especially  useful  when 
the  active  ingredients  are  intended  to  come  into  contact  with  the  mucous 
surface  of  the  throat.  There  are  16  official  Troches,  named  as  follows, 
viz. — 


Trochisci  Acidi  Tannici. 
Trochisci  Ammonii  Chloridi. 
Trochisci  Catechu. 

Trochisci  Cretae. 

Trochisci  Cubebae. 

Trochisci  Ferri. 

Trochisci  Glycyrrhizae  et  Opii. 
Trochisci  Ipecacuanhae. 


Trochisci  Krameriae. 

Trochisci  Magnesiae. 

Trochisci  Menthae  Piperitae. 
Trochisci  Morphinae  et  Ipecac. 
Trochisci  Potassii  Chloratis. 
Trochisci  Sodii  Bicarbonatis. 
Trochisci  Sodii  Santoninatis. 
Trochisci  Zingiberis. 


Confectiones,  Confections, — consist  of  medicinal  substances  formed 
into  a  mass  with  Sugar,  Honey,  Water,  etc.,  with  the  object  of  rendering 
them  palatable  and  of  preserving  them  from  change.  Electuaries  are 
similar  preparations,  but  this  term  is  now  obsolete.  There  are  only  two 
official  Confections,  viz. — 

Confectio  Rosae.  Confectio  Sennae. 


Pulveres,  Powders, — are  usually  prepared  extemporaneously,  but  a 
few  compound  ones  have  been  made  official,  the  ingredients  being  simply 
directed  to  be  rubbed  together  until  reduced  to  a  fine  powder  and  thor¬ 
oughly  mixed.  Special  directions  are  given  for  the  preparation  of  two, — 
the  Compound  Effervescing  Powder  and  the  Compound  Powder  of  Mor¬ 
phine.  There  are  9  official  Powders,  named  as  follows,  viz. — 

Pulvis  Antimonialis.  Pulvis  Glycyrrhizae  Compositus. 

Pulvis  Aromaticus.  Pulvis  Ipecacuanhae  et  Opii. 

Pulvis  Cretae  Compositus.  Pulvis  Jalapae  Compositus. 

Pulvis  Effervescens  Compositus.  Pulvis  Morphinae  Compositus. 

Pulvis  Rhei  Compositus. 

The  composition  of  each  of  these  preparations  will  be  found  in  the 
section  on  Materia  Medica,  and  under  the  title  from  which  its  name  is 
derived,  except  that  of  the  Compound  Effervescing  Powder  which  is 
placed  under  the  title  Potassium.  Pulvis  Ipecacuanhae  et  Opii  is  really 
a  trituration. 


432 


OFFICIAL  PREPARATIONS. 


Triturationes,  Triturations, — form  a  class  of  powders  having  for  their 
diluent  Sugar  of  Milk,  and  possessing  a  definite  relation  between  the 
active  ingredient  and  the  diluent.  The  Pharmacopoeia  prescribes  a  gen¬ 
eral  formula  for  these  preparations,  according  to  which  io  parts  of  the 
Substance  and  90  parts  of  Sugar  of  Milk  are  to  be  well  mixed  by  a  spatula, 
the  latter  being  added  in  successive  quantities,  and  both  triturated  in  a 
mortar  until  the  substance  is  intimately  mixed  with  the  diluent  and  finely 
comminuted.  There  is  but  one  official  Trituration  (Trituratio  Elaterini), 
though  the  Pulvis  Ipecacuanhae  et  Opii  practically  belongs  to  this  class, 
except  in  respect  of  the  proportions  prescribed.  For  a  further  discussion 
of  this  subject  see  the  article  Triturations  under  the  heading  Extempo¬ 
raneous  Preparations. 


Suppositoria,  Suppositories, — are  solid  bodies  containing  medicinal 
substances,  and  intended  for  introduction  into  the  vagina,  rectum  or  ure¬ 
thra.  There  are  no  official  suppositories  enumerated,  but  the  Pharma¬ 
copoeia  prescribes  a  general  formula  for  their  preparation,  according  to 
which  the  medicinal  portion  should  be  incorporated  with  Oil  of  Theo- 
broma  by  rubbing  them  together  at  a  temperature  of  95 0  F.  The  mixture 
should  then  be  poured  into  suitable  moulds,  and  cooled  on  ice  or  in  ice- 
cold  water.  Unless  otherwise  specified  they  shall  be  made  to  weigh  about 
15  grains  each. 


Unguenta,  Ointments, — are  soft,  fatty  mixtures  of  medicinal  agents 
with  a  basis  of  lard,  petrolatum,  or  fixed  oils  with  a  solid  fat  such  as  wax 
or  spermaceti.  They  are  intended  for  application  to  the  skin  by  inunc¬ 
tion,  and  have  a  melting  point  which  is  below  the  ordinary  temperature 
of  the  human  body.  Of  the  26  official  Ointments  1  is  prepared  by  chemi¬ 
cal  reaction,  viz. — Unguentum  Hydrargyri  Nitratis;  5  by  fusion  and  20 
by  incorporation  of  the  ingredients  with  each  other  by  mixing  them 
through  the  agency  of  a  spatula  and  a  porcelain  slab.  Unguentum  itself 
is  prepared  by  fusing  together  80  parts  of  Lard  and  20  of  yellow  Wax, 
and  is  the  basis  of  3  other  ointments,  while  16  have  Benzoinated  Lard  as 
their  basis. 


Unguentum. 

Unguentum  Acidi  Carbolici  (10). 
Unguentum  Acidi  Gallici  (10). 
Unguentum  Acidi  Tannici  (10). 
Unguentum  Aquae  Rosae. 
Unguentum  Belladonnae  (10). 
Unguentum  Chrysarobini  (10). 
Unguentum  Diachylon. 

Unguentum  Gallae  (10). 
Unguentum  Hydrargyri  (45). 

Ung.  Hydrargyri  Ammoniati  (10). 
Ung.  Hydrargyri  Nitratis. 

Ung.  Hydrargyri  Oxidi  Flavi  (10). 


Ung.  Hydrargyri  Oxidi  Rubri  (10). 
Unguentum  lodi  (4). 

Unguentum  Iodoformi  (10). 
Unguentum  Mezerei  (25). 
Unguentum  Picis  Liquidae  (50). 
Ung.  Plumbi  Carbonatis  (10). 

Ung.  Plumbi  Iodidi  (10). 

Ung.  Potassii  Iodidi  (12). 
Unguentum  Stramonii  (10). 
Unguentum  Sulphuris  (30). 

Ung.  Sulphuris  Alkalinum  (20). 
Unguentum  Veratrinae  (4). 
Unguentum  Zinci  Oxidi  (20). 


OFFICIAL  PREPARATIONS. 


433 


The  figures  in  parentheses  show  the  percentage  of  extract  or  other  active 
ingredient  in  the  ointment.  The  composition  of  each  may  be  found  in 
the  section  on  Materia  Medica  under  the  title  from  which  the  preparation 
is  named,  except  Unguentum ,  which  will  be  found  under  the  title  Adeps, 
and  Unguentum  Diachylon  under  Plumbum. 


Cerata,  Cerates, — are  unctuous  preparations  similar  to  ointments  but 
of  a  much  firmer  consistence.  They  all  contain  Wax  (Cera),  and  do  not 
melt  at  temperatures  below  104°  F.  They  are  intended  for  external  use, 
and  are  generally  spread  on  lint  before  being  applied.  There  are  8  official 
Cerates,  including  Ceratum  itself,  which  is  made  by  fusing  together  30 
parts  of  White  Wax  and  70  of  Lard.  The  composition  of  the  others 
may  be  found  in  the  section  on  Materia  Medica  under  the  appropriate 
titles,  but  the  figures  in  parentheses  below  give  the  percentage  of  drug  to 
basis  in  each.  Of  the  following-named  6  are  prepared  by  fusion  and  2  by 
incorporation. 


Ceratum. 

Ceratum  Camphoroe  (0.6). 
Ceratum  Cantharidis  (35). 
Ceratum  Cetacei  (10). 


Ceratum  Extracti  Cantharidis  (30). 
Ceratum  Plumbi  Subacetatis  (5). 
Ceratum  Resinse  (35). 

Ceratum  Sabinae  (25). 


Emplastra,  Plasters, — are  solid  compounds,  insoluble  in  water,  of  a 
tenacious  but  pliable  consistence  and  intended  for  external  application  to 
limited  areas  of  the  body  surface.  They  are  prepared  by  incorporating 
medicinal  substances  with  certain  bases,  which  are  usually  Lead  Plaster 
(Oleate  of  Lead),  a  Gum-resin,  or  Burgundy  Pitch.  The  heat  employed 
should  be  low  so  as  to  avoid  decomposing  the  active  agents,  and  should 
not  be  continued  long  enough  to  drive  off  any  volatile  constituents.  The 
plaster  mass  is  then  spread  evenly  on  chamois  skin,  kid  skin  or  muslin. 
The  constituents  of  the  following-named  17  official  Plasters  maybe  found 
in  the  section  on  Materia  Medica  under  their  appropriate  headings. 


Emplastrum  Ammoniaci. 

Emp.  Ammoniaci  cum  Hydrargyro. 
Emplastrum  Arnicas. 

Emplastrum  Asafoetidae. 
Emplastrum  Belladonnae. 
Emplastrum  Capsici. 

Emplastrum  Eerri. 

Emplastrum  Galbani. 


Emplastrum  Saponis. 


Emplastrum  Hydrargyri. 
Emplastrum  Ichthyocollae. 
Emplastrum  Opii. 

Emp.  Picis  Burgundicae. 
Emp.  Picis  Canadensis. 

Emp.  Picis  cum  Cantharide. 
Emplastrum  Plumbi. 
Emplastrum  Resinae. 


Of  the  foregoing  only  two  are  directed  to  be  spread,  viz. — Emp.  Cap¬ 
sici  upon  muslin,  and  Emp.  Ichthyocollae  upon  taffeta,  the  others  having 
no  pharmacopceial  prescription  for  the  material  to  be  used.  Plasters 
after  being  spread  should  remain  soft,  pliable  and  adhesive,  without  melt¬ 
ing  at  the  heat  of  the  body.  To  soften  the  surface,  if  old,  it  should  be 
brushed  with  a  small  portion  of  Tincture  of  Camphor. 

28 


434 


EXTEMPORANEOUS  PHARMACY. 


Chartae,  Papers, —  consist  of  strips  of  paper  medicated  by  impregna¬ 
tion  of  its  fibres  with  medicinal  substances,  or  by  being  coated  therewith. 
Of  the  3  official  Papers  2  are  made  with  sized  paper,  and  are  intended  for 
external  application  as  vesicants  or  counter-irritants;  the  third  (Charta- 
Potassii  Nitratis)  is  unsized  paper  impregnated  with  Nitre  and  intended 
for  the  inhalation  of  its  fumes  while  burning.  Those  officially  recognized 
are — 

Charta  Cantharidis.  Charta  Sinapis. 

Charta  Potassii  Nitratis. . 


EXTEMPORANEOUS  PHARMACY. 

This  is  the  most  important  division  of  the  whole  subject  of  Pharmacy, 
embracing  as  it  does  the  preparation  and  dispensing  of  those  medicines 
which  are  designed  for  immediate  use  and  which  are  compounded  on  the 
prescriptions  of  physicians.  Hence  it  comprises  the  chief  portion  of  the 
daily  work  of  the  pharmacist,  and  can  only  be  learned  at  the  dispensing 
counter  and  under  the  personal  supervision  of  a  competent  master.  In 
the  following  pages  are  given  the  most  important  of  the  general  directions 
pertaining  to  this  subject,  with  the  object  of  enabling  the  young  medical 
practitioner  to  familiarize  himself  with  the  compounding  and  dispensing 
of  drugs  so  far  as  the  limits  of  the  book  will  admit  of.  The  drug-store  of 
the  present  day  has  degenerated  so  far  from  its  legitimate  business  that  ere 
long  physicians  will  be  compelled  in  self-defence  to  dispense  their  own 
medicines,  thereby  protecting  themselves  and  their  patients  from  the 
patent-medicine  vending,  the  counter-prescribing,  and  the  many  other 
nefarious  methods  which  have  degraded  the  pharmacist  from  his  old  pro¬ 
fessional  position  to  that  of  a  mere  trader  in  drugs  and  nostrums.  The 
first  outfit  of  every  young  doctor  should  include  a  few  pharmaceutical 
instruments  and  a  small  stock  of  drugs.  By  daily  handling  of  these,  the 
tools  of  his  profession,  he  will  insensibly  become  familiar  with  the  tech¬ 
nique  of  the  art,  and  even  if  he  does  not  continue  to  dispense  his  medi¬ 
cines  in  after  years  he  will  never  regret  the  practical  knowledge  which 
such  a  course  will  give  him. 

Compounding  means  the  mixing  or  preparing  of  the  drugs  ordered 
in  a  prescription,  and  comprises  all  the  operations  of  official  pharmacy 
together  with  many  other  manipulations  which  will  be  described  in  their 
appropriate  places. 

Dispensing  is  the  operation  of  putting  up  and  issuing  the  drugs 
ordered  in  a  prescription,  and  may  apply  to  the  already  compounded  prepa¬ 
rations  of  official  pharmacy  as  well  as  to  those  prepared  extemporaneously. 


WEIGHTS  AND  MEASURES. 


435 


WEIGHTS  AND  MEASURES. 

The  working  formulae  of  the  U.  S.  Pharmacopoeia  are  constructed  on 
the  system  of  parts  by  weight  for  all  articles,  whether  solids  or  fluids,  ex¬ 
cept  in  the  case  of  fluid  extracts,  for  which  the  metric  weights  and  measures 
are  employed.  On  this  system  it  really  makes  no  difference  what  unit 
of  weight  is  adopted  in  official  pharmacy.  However,  the  weights  and 
measures  referred  to  by  physicians  in  prescribing  and  used  by  pharmacists 
in  dispensing  medicines  are  in  the  United  States  those  of  the  Apothe¬ 
caries’  or  Troy  System  of  Weights  (having  480  grains  to  the  ounce  and 
5760  grains  to  the  pound)  and  the  Wine  Measure,  or  those  of  the  Metric 
System.  On  the  other  hand,  the  British  Pharmacopoeia  recognizes  only 
the  Imperial  Standard  (Avoirdupois)  weights,  having  487^4  grains  to  the 
ounce  and  7000  grains  to  the  pound.  The  drachm  (60  grains)  and  the 
scruple  (20  grains)  are  intermediate  units  which  are  still  used  but  are  rap¬ 
idly  becoming  obsolete.  The  units  of  the  Wine  Measure  are  the  minim 
(up),  which  in.  water  at  its  maximum  density  equals  gr.  0.95;  the  flui- 
drachm  (60  minims)  and  the  fluidounce  (8  fluidrachms  or  480  minims). 
The  signs  used  to  denote  these  units  are  np  minim,  D  scruple,  5  drachm, 
%  ounce,  and  in  the  case  of  liquids  an  f  to  denote  fluid  is  often  placed 
before  the  sign,  thus  f5  for  fluidrachm,  f5  for  fluidounce.  The  relations 
between  these  units  of  weight  and  measure  are  as  follows:  — 


Measure.  Weight. 

lip  j,  One  minim  =  0.95  grains, 

f  3  j,  One  fluidrachm  =  56.96  “ 

f  ^j,  One  fluidounce  =  455.69  “ 


Weight. 

grain  j  = 

,3  J  = 

%  J  = 


Measure. 
1.05  minims. 
63.20  “ 

505.60 


Table  of  Troy 

or  Apothecaries'  Weight. 

• 

Pound. 

Ounce. 

Drachm.  Scruple. 

Grain. 

Libra. 

Uncia. 

Drachma.  Scrupulus. 

Granum. 

II 

£  ** 

II  If 

3  d 

96  =  288 

8  =  24 

1  =  3 

gr- 

=  5760 

=  480 

=  60 

1 

=  20 

Table  of  British  Pharviacopceial  Weight. 
Troy  grain,  Avoirdupois  ounce  and  pound. 

Pound 

Ounce. 

Grain. 

Libra. 

Uncia. 

Granum. 

It) 

I 

— 

H-J  O 

H  ^.N 

II  II 

gr- 

7000 

437^ 

The  Troy  ounce  contains  42)4  grains  more  than  the  avoirdupois  ounce, 
but  the  Troy  pound  contains  1240  grains  less  than  the  avoirdupois  pound. 
The  grain  is  the  only  unit  common  to  both. 


436 


WEIGHTS  AND  MEASURES. 


Table  of  Apothecaries'  or  Wine  Measure. 


Gallon. 

Pint. 

Fluidounce. 

Fluidrachm. 

Minim. 

Congius. 

Octarius. 

Fluiduncia.- 

Fluidrachma . 

Minimum. 

c. 

0. 

*3 

f3 

I  — 

8  = 

128 

=  1024  = 

61440 

1  = 

16 

—  128  = 

7680 

= 

1 

==  8  = 

480 

1 

60 

Table 

of  British  Imperial  or  Pharmacopceial  Measure. 

Gallon. 

Pint. 

Fluidounce. 

Fluidrachm. 

Minim. 

Congius. 

Octarius. 

Fluiduncia. 

Fluidrachma. 

Minimum. 

c 

O 

floz. 

fldr. 

min. 

I  = 

8  = 

l6o 

=  1280  = 

76800 

1  = 

20 

=  160  = 

9600 

I 

=  8  = 

480 

1  = 

60 

The  Metric,  or  Decimal  System  of  Weights  and  Measures, 

is  generally  used  on  the  continent  of  Europe,  and  also  by  French  and 
Germali  physicians  in  the  United  States.  Its  three  standard  units  are 
the  following,  viz. — 

A  Meter ,  the  standard  unit  of  linear  measure  and  also  of  the  whole  system,  is  the  ten- 
millionth  part  of  the  quadrant  of  the  earth,  i.  e.,  the  forty  millionth  part  of  the  earth’s 
circumference  around  the  poles.  One-tenth  of  the  meter  is  the  Decimeter,  one  hundredth 
is  the  Centimeter,  and  one-thousandth  is  the  Millimeter. 

A  Liter ,  the  unit  of  measure  of  capacity,  is  the  cube  of  a  decimeter.  One-thousandth 
of  a  liter  is  the  Cubic  Centimeter,  which  measure  of  pure  water  at  its  maximum  density 
weighs  one  Gramme 

A  Gramme ,  the  unit  of  weight,  is  the  weight  of  the  one  thousandth  part  of  a  liter  of 
water  at  its  maximum  density.  Its  tenth  is  the  Decigramme,  its  hundredth  is  the  Centi¬ 
gramme,  and  its  thousandth  part  is  the  Milligramme. 


The  metric  measures  above  noted  are  those  used  chiefly  in  pharmaceu¬ 
tical  practice,  but  the  system  embraces  many  other  terms  of  increase  which 
are  set  forth  in  the  following  table. 


1 0000 

Myriameter. 

10000 

Myrialiter.  10000 

Myriagramme. 

IOOO 

Kilometer. 

1000 

Kiloliter. 

1000 

Kilogramme. 

100 

Hectometer. 

100 

Hectoliter. 

100 

Hectogramme. 

IO 

Dekameter. 

10 

Dekaliter. 

10 

Dekagramme. 

I 

.1 

.01 

.001 

Meter. 

Decimeter. 

Centimeter. 

Millimeter. 

1 

Liter. 

.1  Deciliter. 

.01  Centiliter. 

.001  Cubic  Centimeter, 
or  Milliliter. 

1 

Gramme. 

.1  Decigramme. 
.01  Centigramme. 
.001  Milligramme. 

The  relations  between  the  Metric  Weights  and  Measures  and  the  Apothe¬ 
caries’  are  as  follows,  viz. — 

I  meter  =  39.370432  inches. 

1  liter  =  2.1 13433  pints. 

1  gramme  =  15.43234874  grains. 

1  grain  =  7  06479895  gramme. 

1  minim  =  0.0161613  cubic  centimeter. 


WEIGHTS  AND  MEASURES. 


437 


The  Metric  System  is  making  way  but  slowly  in  this  country  although 
its  progress  is  aided  by  every  process  of  forcing  which  scientific  bodies  can 
bring  into  action,  and  it  remains  to  be  seen  how  much  its  adoption  in  the 
last  edition  of  the  U.  S.  Pharmacopeia  will  influence  the  medical  profes¬ 
sion  in  its  favor. 

With  all  the  influence  brought  to  bear  in  its  favor  it  certainly  has  not 
yet  been  adopted  by  any  considerable  proportion  of  native-born  and 
home-educated  physicians  and  pharmaceutists.  Its  chief  disadvantage  is 
one  which  is  inherent  to  any  decimal  system,  viz. — that  the  number  ten 
cannot  be  divided  more  than  once  without  producing  a  fraction.  This  is 
partly  compensated  for  by  the  practice  of  dividing  five  into  the  three 
parts  of  2,  2  and  i,  and  on  this  principle  metric  weights  are  usually  con¬ 
structed.  In  writing  or  reading  prescriptions  it  is  sufficiently  accurate  to 
consider  a  gramme  as  equivalent  to  15  Troy  grains,  and  a  cubic  centi¬ 
meter  (milliliter)  as  equivalent  to  15  minims,  or  one-fourth  of  a  flui- 
drachm.  All  other  terms,  units  or  prefixes  belonging  to  the  metric 
system  maybe  wholly  ignored  by  the  physician  and  the  pharmacist.  The 
decimal  point  after  the  gramme  or  the  cubic  centimeter  should  always  be 
replaced  by  a  line,  so  as  to  avoid  errors  which  in  many  cases  might  prove 
serious,  from  the  misplacement  of  a  point,  the  dropping  of  a  spot  of  ink 
or  the  intrusion  of  a  fly-speck.  The  simplest  method  of  writing  a  metric 
prescription  for  one  not  practiced  in  the  system  is  to  first  write  for  one 
dose  of  the  medicine  in  grains  and  minims ,  then  by  substituting  the  same 
number  of  grammes  and  cubic  centimeters  ( fluidgrammes )  we  get  fifteen 
doses  in  metric  terms.  Of  course  when  a  mixture  or  solution  is  desired 
the  proper  quantity  of  vehicle  must  be  added  to  give  the  dosage  in  such 
measures  as  may  be  deemed  convenient  for  administration.  For  ex¬ 
ample, — 

One  dose.  15  doses  metric. 


R.  Quininae  Sulphatis,  . . gr.  j, 

Strychninae  Sulph., . gr.  ^  or  0.016, 

Ext.  Glycyrrhizae  FI., . rtpiv, 

Syrupi, . ir\>, 


1 


016 


4 

60 


This  gives  a  two-ounce  mixture  approximately,  of  which  the  dose  would  be  “  a  tea¬ 
spoonful  thrice  daily.” 


One  dose. 

R.  Quininae  Sulphatis, . gr.  j , 

Massae  Ferri  Carb., . gr.  ij. 

Ext.  Nucis  Vomicae, . gr.  ^  or  0.25, 


Ft.  pil.  No.  xv.  Sig. — One  pill  thrice  daily  after  meals. 


15  doses  metric. 


1 

2 


25- 


The  above  rule  will  answer  for  all  liquids  except  those  which  are  very 
heavy  (as  Syrups  and  Chloroform),  or  very  light  (as  Ether).  Measures 
may  be  entirely  discarded,  and  all  fluid  quantities  expressed  in  grammes. 
The  average  drop  of  water  may  be  considered  equivalent  to  0.05  cubic 
centimeter  (or  gramme),  the  average  teaspoonful  to  5  c.  c.,  the  tablespoon- 


438 


WEIGHTS  AND  MEASURES. 


ful  to  20  c.  c.,  the  Troy  %  to  30  grammes,  the  fluidounce  to  30  c.  c.,  and 
8  fluidounces  to  250  c.  c. 

In  prescribing  Syrups  or  Chloroform,  each  Troy  fluidounce  should  be 
reckoned  at  something  more  than  30  grammes — say  40 ;  and  if  this  be 
done,  the  difficulty  of  converting  one  scale  into  the  other  will  be  obviated. 
As  to  Syrups,  Chloroform,  etc.,  the  following  table  shows  the  actual 
weight  in  grammes  of  each  fluidounce  of  the  substances  named  : 


Fluid  Oz. 

Si- 

31U 

•31V\ 

5  viii. 


Water. 

(Grammes.) 

29.52 

59-°4 

118.08 

236.16 


Tinctures. 
(Grammes.) 
28.00 
56  OO 
I  12.00 
224.OO 


Syrup. 

(Grammes.) 

38.OO 

76.OO 

152.00 

304.OO 


Chloroform. 
(Grammes  ) 

4370 

84.40 

174.80 

349.60 


Ether. 

(Grammes.) 

22.14 

44.28 

88.56 

177.12 


A  table  of  equivalents  between  Apothecaries’  and  Metric  Weights  and 
Measures  will  be  found  in  the  Appendix. 


Approximate  or  Domestic  Measures  become  necessary  in  appor¬ 
tioning  doses  for  a  patient,  when  liquid  medicines  are  used.  Of  these 
the  measure  most  commonly  employed  is  the  teaspoonful,  which  is  gener¬ 
ally  taken  as  equivalent  to  a  fluidrachm,  though  in  most  cases  as  now 
manufactured  the  teaspoon  contains  about  75  minims,  or  25  per  cent, 
more  than  the  theoretical  quantity.  The  dessertspoonful  is  about  equal 
to  2  teaspoonfuls,  and  the  tablespoonful  to  about  4  teaspoonfuls  or  fgss, 
while  the  wineglass  is  supposed  to  contain  about  f^ij.  The  use  of  gradu¬ 
ated  medicine  glasses  is  strongly  recommended  instead  of  the  above 
approximate  measures.  They  may  be  obtained  at  a  trifling  cost  in  any 
well-stocked  drug-store. 


Drops  (Guttae)  are  very  variable  in  size,  though  popularly  supposed  to 
equal  minims,  the  variations  in  their  relative  dimensions  being  due  to  the 
viscidity  of  the  liquid,  the  shape  and  surface  of  the  orifice  from  which 
they  escape,  and  sundry  other  circumstances.  The  Syrups  and  Mucilages 
produce  large  drops  while  Bromine,  Chloroform  and  other  heavy  mobile 
liquids  produce  very  small  ones.  These  differences  are  well  illustrated  in 
the  following  table  which  gives  the  number  of  drops  in  a  fluidrachm  of 
several  liquids  of  certain  classes.  [See  the  Appendix  fora  fuller  table.] 


Syrupus  Acaciae,  44. 

Syrupus  Scillae,  75. 

Aqua,  60. 

Liquor  Potassae,62. 

Liquor  Hydrargyri  Nitrat.,  1 3 1 
Acetum  Opii,  90. 

Vinum  Opii,  100. 

Tinct.  Opii  Deodorat.,  no. 
Tinct.  Opii  Camph.,  no. 

Tinct.  Opii,  130. 

Tinct.  Iodi,  148. 

Tinctura  Aconiti,  146. 

Alcohol  Dilutum,  137. 

Alcohol,  146. 


Oleum  Ricini,  77. 

Oleum  Copaibae,  123. 

Oleum  Juniperi,  148. 
Spiritus  Camphorae,  143. 
Spiritus  Chloroformi,  150. 
Ext.  Digitalis  Fluid.,  134. 
Ext.  Ipecac.  Fluid.,  120. 
Ext.  Cinchonae  Fluid.,  138. 
Ext.  Zingiberis  Fluid.,  142. 
Ext.  Buchu  Fluid.,  150. 

Ext.  Hyoscyami  Fluid.,  160. 
ZEther  Fortior,  176. 

Bromum,  250. 

Chloroform  Purif.,  250. 


PRESCRIPTIONS. 


439 


Specific  Gravity  is  the  relative  weight  of  equal  bulks  of  different 
bodies.  The  specific  gravity  of  water  at  a  certain  temperature  (generally 
590  F.)  is  taken  as  i,  and  that  of  all  other  substances  is  expressed  in  terms 
of  this  unit.  The  Pharmacopoeia  gives  very  complete  tables  of  percentages 
and  specific  gravities  of  Alcohol,  Acetic,  Hydrobromic,  Hydrochloric, 
Nitric,  Sulphuric  and  Phosphoric  Acids,  and  of  aqueous  solutions  of  Po- 
tassa  and  Soda.  The  specific  gravity  of  any  substance  is  expressed  by  the 
quotient  obtained  by  dividing  the  weight  of  a  given  measure  of  the  sub¬ 
stance  by  the  weight  of  an  equal  measure  of  water.  In  pharmacy  the 
specific  gravity  of  solids  is  not  of  any  importance,  but  that  of  liquids  is  a 
matter  of  constant  value,  and  is  determined  in  most  cases  by  means  of  a 
specific  gravity  bottle  or  by  a  hydrometer,  instruments  which  are  described 
in  any  standard  work  on  chemistry  or  physics.  Modifications  of  the 
hydrometer  with  scales  adapted  to  particular  work  are  the  urinometer, 
saccharometer,  lactometer,  etc. 

Specific  Volume  is  the  relative  bulks  of  equal  weights  of  different 
bodies.  In  pharmacy  it  means  the  volume  of  the  weight  of  a  liquid  com¬ 
pared  with  the  volume  of  all  equal  weight  of  water  at  590  F.  The  specific 
volume  of  a  body  is  therefore  inversely  as  its  specific  gravity,  and  is  ex¬ 
pressed  by  the  quotient  obtained  by  dividing  unity  by  the  specific  gravity. 

—  Sp.  vol.  and  therefore  sp.  gr.  X  sp.  vol.  =  1. 

[A  table  of  the  specific  gravity  and  specific  volume  of  several  liquids 
will  be  found  in  the  Appendix.] 

PRESCRIPTIONS. 

Extemporaneous  Prescriptions  are  formulae  written  by  the  phy¬ 
sician  on  the  instant  (ex  tempore)  to  meet  the  requirements  of  individual 
cases.  A  prescription  should  begin  with  the  name  of  the  person  for  whom 
it  is  designed,  and  the  date  on  which  it  is  written.  Then  follows  the 
Latin  word  Recipe ,  usually  abbreviated  to  the  sign  R,  and  signifying 
“Take,”  or  “Take  thou;”  next  the  names  and  quantities  of  the  ingre¬ 
dient  to  be  used,  which  are  also  expressed  in  Latin;  then  the  directions 
to  the  compounder,  followed  by  the  directions  to  the  patient,  the  last 
being  now  usually  expressed  in  English  ;  and  finally  the  signature  of  the 
prescriber. 

A  prescription  then  consists  of  four  parts,  viz.  : — the 

Superscription, — consisting  of  the  name  of  the  party,  the  date  and  the  sign  R  . 
Inscription, — the  body  of  the  prescription,  which  may  consist  of  the — 

Basis, — or  chief,  active  ingredient. 

Adjuvant — to  assist  the  action  of  the  basis. 

Corrective , — to  correct  some  injurious  quality  of  the  other  ingredients. 

Vehicle  or  Excipient, — giving  it  a  suitable  form. 


440 


PRESCRIPTIONS. 


Subscription, — the  directions  for  the  compounder,  usually  expressed  in  contracted  Latin. 
Signature, — The  instructions  for  the  guidance  of  the  one  administering  the  medicine,  in 
English,  followed  by  the  signature  of  the  prescriber. 


A  prescription  may,  however,  contain  the  base  alone,  or  the  base  with 
the  adjuvant,  or  the  base  with  a  simple  vehicle  or  diluent,  etc.  A  single 
ingredient  may  serve  a  double  or  treble  office,  as  the  Syrupus  Rhei  Aro- 
maticus  with  Quinine,  in  which  case  the  syrup  serves  as  an  adjuvant  to 
increase  the  action  of  the  quinine,  as  an  excipient  to  cover  the  taste,  and 
as  a  vehicle  to  facilitate  the  administration  of  the  dose  directed.  The 
basis  may  not  need  any  aid  in  doing  its  work,  and  may  require  no  correc¬ 
tive  of  its  action  nor  any  special  vehicle.  On  the  other  hand  there  is  no 
limit  to  the  number  of  ingredients  which  may  be  used,  provided  the 
prescriber  has  a  clear  idea  of  something  to  be  accomplished  by  each  one, 
and  also  provided  that  there  is  no  chemical  or  medicinal  incompati¬ 
bility  between  them.  In  olden  times  prescriptions  were  very  complex, 
and  contained  a  great  many  curious  and  incongruous  ingredients.  As 
Dr.  Piffard  well  says,  “  the  tendency  of  the  present  age  is  toward  mono- 
rather  than  poly-pharmacy,  and  prescriptions  with  the  orthodox  adjuvans 
and  corrigens  are  less  frequently  seen  than  formerly.”  There  is  danger, 
however,  in  carrying  this  simplicity  too  far,  for  there  is  no  doubt  but  that 
proper  combinations  of  medicines  will  often  produce  effects  for  the 
patient’s  good,  which  could  not  be  obtained  from  the  use  of  any  one 
remedy. 

An  example  will  perhaps  make  the  foregoing  analysis  more  comprehen¬ 
sive,  and  at  the  same  time  serve  to  indicate  the  style  of  abbreviation 
usually  employed.  The  following  formula  is  that  of  the  Pharmacopoeia 
for  the  Compound  Infusion  of  Senna,  or  the  old-time  “Black  Draught,” 
except  that  approximate  weights  and  measures  are  substituted  for  the 
pharmacopoeial  parts  :  — 


For  Mrs.  Steele. 
Recipe ,  Take, — 


July  6th ,  1886. 


Senna ,  semiunciam , 

Of  Senna,  half  an  ounce; 

Magnesii  Sulphatis, 

Magnesium  Sulphate, 

Alanna,  ana  unciani  unam , 

Manna,  of  each  an  ounce; 

Fceniculi,  drachmam  una?n, 

Of  Fennel,  one  drachm  ; 

Aqua  Bullientis,  fluiduncias  octo, 

Of  Boiling  Water,  eight  fluid  ounces. 

Macera  per  horam  in  vase  clauso ,  deinde  cola. 

Macerate  for  an  hour  in  a  closed  vessel,  then  strain. 

Signa,  Mark,  or  Write  thus — A  wineglassful  every  four  hours  till  it 
operates. 

T.  F.  mod ,  M.D. 


} 


(Basis.) 

(Adjuvant.) 

(Corrective.) 

(Vehicle) 


l 

{ 

{ 

{ 


Superscription. 


Inscription. 


Subscription. 

Signature. 


Abbreviated  in  the  style  usual  with  physicians  the  above  prescription 
would  read  as  follows,  viz.  :  — 


PRESCRIPTIONS. 


441 


For  Mrs.  Steele.  July  6th,  1886. 

R 

Sennce ,  3  ss 

Mngnes.  Sulph., 

Matinee,  aa.3  j 

Fceniculi,  3  j 

Aq.  Bull.,  f  5  viij 

Mac.  per  hor.  in  vase  clauso ,  deinde  cola. 

Sig. — A  wineglassful  every  four  hours  till  it  operates. 

Wood. 

The  above  is  given  as  an  example  of  an  ordinary  compound  prescrip¬ 
tion,  but  as  the  result  is  nearly  identical  with  an  official  preparation,  we 
might  write  the  prescription  simply  as  follows, — 

R.  Infusi  Sennce  Compos.  3 viij. 

and  this  is  the  manner  of  prescribing  the  official  compound  preparations. 
It  will  be  noticed  that  the  term  “  basis  in  the  analysis  of  the  formula 
covers  two  ingredients  ;  but  either  of  the  two  might  be  considered  the 
principal  agent,  and  the  other  one  classed  as  an  adjuvant. 

As  Pareira  says,  “  These  four  parts  of  a  formula  are  intended  to  accom¬ 
plish  the  object  of  Asclepiades,  curare  cito ,  tute  et  jucunde ;  in  other 
words  to  enable  the  basis  to  cure  quickly ,  safely  and  pleasantly.  ’  ’ 


The  Principles  of  Combination  are  so  well  laid  down  by  Dr.  H. 
C.  Wood,  that  his  words  are  appended  verbatim ,  as  follows, — 

The  art  of  combining  medicines  is  not  a  difficult  one ;  but  in  practice  certain  principles 
should  not  be  lost  sight  of.  Chief  of  these  are,  to  prescribe  as  few  remedies  as  possible, 
and  to  use  no  powerful  drug  without  a  very  distinct  idea  of  what  it  is  intended  to  do. 
Whenever  it  is  desired  to  give  a  powerful  remedy  in  increasing  doses  until  its  physiological 
effect  is  produced,  it  should  always  be  given  by  itself.  Thus,  it  may  be  necessary  to  give 
arsenic  so  as  to  impress  the  system,  at  the  same  time  that  iron  is  indicated;  but  the  two 
remedies  should  be  given  separately,  so  that  the  dose  of  either  can  be  increased  or  dimin¬ 
ished  independently  of  the  other. 

The  principles  of  combination  formulated  below  were  long  ago  enunciated  by  Dr.  Paris, 
but  are  to-day  as  imperative  as  ever.  Medicines  are  combined — 

First.  To  augment,  correct,  or  modify  the  action  of  a  medicine.  Thus,  purgatives  act 
much  more  kindly  when  a  number  of  them  are  united  together.  The  chief  reason  of  this 
probably  is,  that  as  different  remedies  affect  different  portions  of  the  gut,  the  whole  intes¬ 
tine  is  best  reached  by  a  union  of  the  diverse  substances.  It  may  take  an  intense  irrita¬ 
tion  of  the  mucous  membrane  to  purge  as  actively  as  does  a  mild  irritation  of  both  the 
mucous  membrane  and  the  muscular  coat.  In  the  case  of  neurotics  the  principle  has  a 
very  limited  action,  because  so  many  of  this  class  of  remedies  are  physiologically  more  or 
less  antagonistic;  yet  sometimes  the  principle  can  be  advantageously  applied  ;  thus,  the 
anaesthesia  of  Chloroform  or  Ether  may  be  prolonged  by  a  hypodermic  injection  of  Mor¬ 
phia ;  and  Chloral  and  Morphia  certainly  make  a  mixture  which  is  much  more  powerfully 
hypnotic  than  is  either  of  the  substances  separately. 

Second.  To  obtain  the  joint  action  of  two  or  more  diverse  remedies.  Thus,  in  a  cough 
mixture  Morphia  may  be  included  to  quiet  the  cough,  whilst  Ipecacuanha  and  Squill  (in 
accordance  with  the  first  principle)  are  added  to  affect  the  mucous  membrane.  The 
application  of  this  principle  requires  caution,  or  the  practitioner  will  be  led  into  that  chief 
abomination — polypharmacy.  It  is  worse  than  futile  to  attempt  to  prescribe  for  every 
symptom.  It  is  the  underlying  cause  of  the  disorder  or  the  under-stratum  of  bodily  con¬ 
dition  which  must  be  sought  out  and  prescribed  for  simply. 

7 bird.  To  obtain  a  special  combination,  which  is  really  a  new  remedy,  or  which  expe- 


442 


PRESCRIPTIONS. 


rience  has  shown  acts  almost  as  a  new  remedy.  Thus,  when  to  Iodide  of  Potassium  in 
solution  Corrosive  Sublimate  is  added,  a  new  chemical  compound  is  formed,  which  expe¬ 
rience  has  shown  to  be  of  great  value  in  syphilitic  diseases.  Griffith’s  antihectic  mixture 
is  another  instance  of  the  use  of  chemical  changes,  the  Proto-carbonate  of  Iron  being 
formed  out  of  the  Sulphate  of  the  metal  and  the  Carbonate  of  Potassium.  In  the  famous 
Dover's  powder  no  chemical  change  occurs,  but  the  ordinary  action  of  Opium  upon 
the  skin  is  so  enhanced  that  the  combination  may  be  looked  upon  almost  as  a  new 
remedy. 

Fourth.  To  afford  a  suitable  form.  Thus,  Acacia  is  added  to  make  an  emulsion,  or 
Confection  of  Rose  to  make  a  pill.  In  the  choice  of  excipients  care  should  be  exercised 
to  select  a  substance  free  from  medical  properties,  having  no  chemical  incompatibility  with 
the  medicinal  agent,  and  of  suitable  physical  character.  Bread  crumbs  often  make  a  good 
basis  for  pills;  but  with  Nitrate  of  Silver  they  are  chemically  incompatible,  on  account  of 
the  chlorides  in  them.  When  writing  a  prescription,  the  utmost  care  should  be  taken  to 
use  such  excipients  that  the  combination  should  not  only  be  attractive  to  the  eye,  but  also 
as  little  repulsive  to  the  palate  as  may  be.  Whenever  possible,  the  pill-form  should  be 
employed  with  bitter  or  disagreeable  medicines.  The  pill  may  be  readily  coated  with 
silver-foil ;  tonic  pills  may  be  coated  with  Iron  by  shaking  or  rolling  them  in  Ferri  Pulvis 
whilst  soft  and  sticky.  Sugar-coated  pills  and  “compressed  pills”  are  apt  to  get  so  hard 
and  insoluble  that  their  use  requires  caution.  In  regard  to  mixtures,  flavoring  oils  should 
be  freely  used,  and  the  power  of  Glycerin  to  conceal  the  disagreeable  taste  of  many  sub¬ 
stances  should  be  remembered. 


In  Writing  an  Extemporaneous  Prescription,  the  first  step  is 
to  put  down  the  superscription,  consisting  of  the  name,  date  and  the 
sign  R .  Next  the  name  of  each  ingredient  should  be  written  in  Latin 
and  in  the  genitive  case,  each  one  on  a  separate  line.  Then  the  quantity 
of  each  article  sufficient  for  one  dose  should  be  mentally  determined  and 
multiplied  by  the  number  of  doses  which  the  mixture  is  to  contain,  and 
the  result  set  down  in  signs  and  Roman  numerals.  The  directions  to 
pharmacist  and  to  patient  being  added,  and  the  prescriber’s  name  or 
initials  affixed,  the  prescription  is  completed  ;  but  when  very  active  agents 
are  used,  it  is  a  good  plan  to  go  over  the  calculations  a  second  time  before 
letting  it  leave  the  hands  of  the  person  most  responsible  for  its  action. 
For  pills  or  powders  the  same  process  should  be  employed,  slightly  varied 
according  to  the  requirements  of  each  case.  Frequently  the  ingredients 
and  quantities  for  but  one  pill,  powder  or  suppository  are  named,  with 
instructions  to  make  a  certain  number  after  the  formula.  When  an 
unusually  large  dose  of  any  poisonous  drug  is  prescribed,  it  is  cus¬ 
tomary  to  underline  the  quantity,  so  as  to  call  the  attention  of  the 
compounder  to  the  fact  that  the  prescriber  is  aware  that  the  dose  is  above 
the  average. 

There  is  no  royal  road  to  prescription-writing  ;  practice,  care  and 
knowledge  of  the  whole  subject  is  necessary  to  enable  one  to  turn  out 
habitually  those  elegant  prescriptions  which  are  properly  termed  “  magis¬ 
tral,”  being  the  work  of  a  magister,  or  master  of  his  business.  A  fair 
knowledge  of  the  Latin  language  is  a  sine  qua  tion  to  every  professional 
man,  but  especially  to  the  physician.  It  is  pitiable  to  see  a  Doctor  write 
ignorantly  of  even  the  genitive  case-endings  of  the  drug-names  which  he 
uses.  The  teaching  of  Latin  is  not  within  the  scope  of  this  work,  and 


PRESCRIPTIONS. 


443 


hence  this  part  of  the  subject  will  be  dismissed  with  the  advice  to  the 
physician  who  is  ignorant  of  that  language  to  write  his  prescriptions 
wholly  in  English  if  he  cannot  write  them  in  decent  Latin. 


Abbreviations,  though  very  commonly  used  by  physicians  in  pre¬ 
scribing,  are  a  source  of  much  annoyance  to  the  compounder,  and  fre¬ 
quently  one  of  great  danger  to  the  patient.  Physicians  who  never  knew 
anything  of  the  Latin  grammar,  or  those  who  have  forgotten  its  rules, 
are  very  apt  to  use  abbreviations  to  conceal  their  ignorance  of  case-end¬ 
ings.  Many  others  use  them  through  sheer  laziness,  and  some  from  force 
of  habit.  The  educated  and  conscientious  man  will  take  pride  in  turning 
out  a  full  and  clear  prescription,  free  from  cabalistic  letters  and  all  ele¬ 
ments  of  uncertainty.  In  the  Appendix  will  be  found  a  list  of  the  Latin 
terms  used  in  prescriptions,  with  the  abbreviations  in  vogue,  and  the 
English  meaning.  Ambiguous  contractions  may  result  fatally  to  the 
patient,  as  is  readily  seen  by  studying  the  following  list,  which  gives  a 
few  examples  of  the  dangers  of  careless  abbreviation. 


Acid.  Hydroc. — may  mean 


{ 


A  conit. 
Ammon. 

Aq.  Chlor. 
Aq.  Fontis. 

Chlor. 

Hyd.  Chlor. 


j  Aconitine. 

\  Aconitum. 
f  Ammonia. 

\  Ammoniacum. 

Hydr. 

-< 

j  Aqua  Chlori. 

\  Aqua  Chloroform! 
j  Might  easily  be  read. 

\  Aqua  Fords. 

Sod.  Sulph. 

•* 

f  Chlorine. 

J  Chloral. 

[  Chloroform. 

Sulph. 

/* 

- 

'  Calomel. 

-  Corrosive  Sublimate. 
Hydrate  of  Chloral. 

Zinci  Phos. 

{ 

Acidum  Hydrochloricum. 

Acidum  Hydrocyanicum. 

Hydrargyrum. 
Hydras. 
Hydriodas. 
Hydrochloras. 
Hydrocyanas. 
Sodium  Sulphate. 
Sodium  Sulphite. 
Sodium  Sulphide. 
Sulphur. 

Sulphide. 
Sulphate. 
Sulphite. 

Zinc  Phosphate. 
Zinc  Phosphide. 


Prescription  Blanks.  After  many  years’  experience  in  prescribing 
on  blanks  furnished  by  druggists,  the  writer  has  come  to  the  conclusion 
that  it  is  much  better,  for  many  reasons,  for  the  physician  to  have  his  own 
blanks,  without  the  address  of  any  drug-store  thereon.  These  blanks 
should  be  furnished  with  stubs  on  which  to  write  the  prescription  at  first 
in  rough,  afterwards  copying  it  out  cleanly  on  the  main  blank.  A  care¬ 
ful  prescriber  always  writes  a  formula  twice  before  letting  it  go  out  of  his 
hands.  If  he  does  the  first  writing  on  the  stub  of  a  book  of  blanks  he 
will  always  have  a  copy  of  such  prescription  in  his  possession,  for  which 
he  will  often  be  thankful.  The  blank  used  by  the  writer  measures  4^ 
inches  by  3^,  joined  by  a  perforated  edge  to  a  stub  3^  inches  by  2^ 
inches.  On  the  main  blank  the  physician’s  name  and  address  are  printed, 
together  with  his  office  hours,  and  a  place  for  number  and  date,  also  the 
sign  R.,  and  a  line  for  signature.  On  the  stub  there  are  printed  the 


444 


PRESCRIPTIONS. 


words,  “  Copy  of  Pres  criptioji  No . 189  .  .  For . 

and  on  the  back  of  the  main  blank  occurs  the  following  printed  legend 
in  red  ink  : 

A  Prescription  written  on  this  side 

OF  THE  SHEET  MUST  NOT  BE  RENEWED 
UNDER  ANY  CIRCUMSTANCES  WHATEVER, 

WITHOUT  MY  ORDER. 

. ,  M.  D. 

These  blanks  are  bound  up  in  books  of  100  each,  with  a  flexible  morocco 
cover,  from  which  the  book  of  stubs  may  be  slipped  and  a  fresh  book  in¬ 
serted  as  required.  The  size  is  ample  for  all  ordinary  requirements,  and 
permits  of  the  book  being  carried  in  the  breast-pocket. 

Renewals. — It  would  be  advisable  for  physicians  to  always  write  the 
words  “  Non  Repetaturf  or  some  similar  direction,  on  all  prescriptions 
which  should  not  be  repeated  without  their  sanction.  By  so  doing  they 
would  doubtless  cut  off  a  good  many  renewal  charges  from  the  receipts 
of  druggists  who  would  fear  the  legal  consequences  of  disobeying  the 
mandate.  This  inconvenience  to  the  drug-seller  would  be  more  than 
compensated  for  in  the  protection  to  the  drug-taker,  who  too  frequently 
carries  in  his  pocket-book  a  stock  of  recipes  for  his  various  complaints  ; 
and  in  protection  to  the  physician,  who  by  giving  up  the  dispensing  of 
his  own  medicines  has  placed  it  in  the  power  of  the  druggist  to  connive 
at  a  direct  robbery  of  the  just  reward  of  professional  skill  and  knowledge. 

It  is  doubtless  a  fact  familiar  to  every  observer,  that  the  old-time  con¬ 
fidential  relations  between  the  professions  of  physician  and  pharmacist 
have  almost  passed  into  oblivion.  In  fact,  the  tendency  of  pharmacy 
now-a-days  is  towards  the  position  of  a  mere  money-making  trade,  instead 
of  in  the  exalted  direction  of  a  profession.  The  indiscriminate  renewing 
of  prescriptions,  the  open  sale  of  quack  nostrums  and  homoeopathic  pel¬ 
lets,  the  readiness  with  which  counter-prescribing  is  indulged  in,  the 
insinuations  too  frequently  made  over  the  drug-counter  in  reflection 
on  physicians,  and  many  other  similar  practices,  have  caused  the  non- 
combatant  profession  to  regard  the  average  druggist  with  suspicion.  If 
physicians  boldly  took  the  dispensing  of  medicines  more  into  their  own 
hands  many  of  these  evils  would  soon  eliminate  themselves  from  the  drug¬ 
stores.  Right  here,  it  may  be  said  that  there  is  nothing  unprofessional  or 
derogatory  in  the  dispensing  of  his  own  medicines  by  the  physician.  In 
England  it  has  been  the  universal  practice  for  centuries  in  all  places 
except  the  largest  cities,  and  it  has  only  been  given  up  by  a  part  of  the 
medical  profession  as  a  matter  of  convenience,  not  as  a  right.  The  homoeo¬ 
paths  fought  for  the  reclamation  of  this  practice  as  a  right  belonging  to 
the  medical  profession,  and  succeeded  in  its  legal  establishment,  but  not 
from  a  worthy  motive.  They  dispense  their  own  medicines  in  order  to 


PRESCRIPTIONS. 


/ 


445 


cover  up  the  many  frauds  of  which  they  are  daily  guilty,  and  to  give  them 
the  power  of  administering  full  doses  of  powerful  drugs  in  a  form  which 
is  apparently  “homoeopathic,”  with  no  tell-tale  prescription  on  file  in  a 
drug-store  to  give  mute  but  dangerous  evidence  against  their  honesty.  In 
this  way  they  administer  several  grains  of  Calomel  or  eighth-grain  doses 
of  Morphine,  or  correspondingly  large  quantities  of  active  alkaloids, 
triturated  with  sugar  of  milk,  or  dissolved,  as  many  of  the  latter  may  be, 
in  alcohol.  Chemistry,  by  isolating  the  active  principles  of  plants,  and 
furnishing  them  to  commerce  in  the  form  of  soluble  salts,  has  enabled  the 
homoeopath  to  practice  this  fraudulent  method  of  dispensing  drugs,  which 
the  innocent  and  ignorant  patient,  who  believes  in  the  power  of  the  mini¬ 
mum  dose,  supposes  to  be  infinitesimal  in  amount.  But  the  physician  of 
the  regular  profession  is  too  apt  to  think  that  if  he  adopts  a  practice  which 
charlatans  have  appropriated  to  themselves,  he  may  be  classed  with  them 
by  his  professional  competitors.  Hence,  many  regular  physicians  are 
absolutely  afraid  to  use  such  drugs  as  Aconite,  Belladonna,  Gelsemium, 
Arnica,  Rhus,  etc  ,  all  of  which  are  official,  and  most  of  which  are  older 
than  homoeopathy  in  medicine ;  and  avoid  pocket-cases,  drachm-vials 
and  triturations,  as  badges  of  charlatanism.  It  is  high  time  that  we 
asserted  our  independence  in  all  these  matters,  and  made  use  freely  of 
those  means  which  are  recommended  by  our  individual  judgments  as  pro¬ 
motive  of  the  best  results  to  our  patients  and  to  ourselves.  With  a  small 
stock  of  reliable  fluid  extracts,  such  as  are  manufactured  by  Parke,  Davis 
&  Co.,  of  Detroit,  or  Dr.  Edward  R.  Squibb,  of  Brooklyn, — an  equally 
moderate  supply  of  gelatin- coated  pills  and  compressed  tablets  from  the 
best  houses,  such  as  McKesson  &  Robbins,  Schieffelin  &  Co.,  Warner  & 
Co.,  Wyeth  &  Co.,  physicians  could  check-mate  the  unscrupulous  prac¬ 
tices  of  many  druggists  to  a  great  extent,  save  their  patients  many  dollars, 
and  retain  many  a  dollar  for  their  own  pockets,  which  under  the  present 
system  goes  to  their  enemies.  The  homoeopaths  understand  the  money 
part  of  the  argument  well.  When  their  patients’  medicine  is  exhausted, 
the  doctor  must  be  seen  for  a  fresh  supply,  meaning  of  course  another 
consultation  about  symptoms,  a  change  perhaps  from  Mercurius  Dulcis 
to  Mercurius  Vivus,  and  another  fee.  The  expense  is  nothing,  sugar 
of  milk  being  cheap,  and  there  is  no  prescription  in  the  patient’s  pocket- 
book,  to  be  renewed  scores  of  times  (paying  toll  however  every  time 
to  the  druggist),  and  finally  to  be  copied  by  aunts,  mothers  and  friends, 
as  a  sovereign  remedy  for  a  cough,  or  a  really  wonderful  receipt  in  a 
case  of  croup. 

Filling  a  Prescription  means  a  combination  of  operations  which 
requires  great  care,  undivided  attention,  and  a  special  practical  appren¬ 
ticeship  at  the  dispensing  desk.  In  the  following  discussion  of  extempo- 


446 


PRESCRIPTIONS. 


raneous  preparations  such  hints  are  incorporated  as  are  particularly 
applicable  to  the  compounding  of  each  article  under  consideration  ;  and 
they  may  be  prefaced  by  a  few  general  suggestions  which  will  serve  to 
point  out  the  most  approved  method  of  dealing  with  this  important  part  of 
the  druggist’s  work. 

The  prescription  should  first  be  slowly  read  over  in  a  critical  spirit,  but 
no  word  or  action  of  unfavorable  criticism  should  reach  the  ears  or  eyes  of 
the  messenger.  To  shrug  the  shoulders  while  scanning  the  items,  to  laugh 
or  even  smile  at  the  phraseology,  to  question  the  person  offering  it  as  to 
whom  it  is  for,  or  what  complaint  it  is  given  for,  are  instances  of  such 
flagrant  treason  to  the  prescriber  as  would  justify  his  kicking  the  offender 
with  a  copper-toed  boot.  The  compounder  has  no  business  whatever  with 
the  propriety  of  the  recipe  for  its  purpose.  It  might  have  been  given  as 
a  placebo  for  reasons  eminently  wise  and  judicious ;  or  if  not  so  consti¬ 
tuted  it  has  at  least  been  ordered  by  one  who  is  in  possession  of  facts  which 
the  druggist  knows  nothing  about,  even  if  by  education  and  experience 
he  were  competent  to  judge  in  the  matter,  which  he  seldom  is.  His  criti¬ 
cism  should  be  directed  only  to  the  dosage  and  the  pharmaceutical  compati¬ 
bility  of  the  ingredients.  Even  in  the  latter  case  he  must  remember  that 
incompatibles  are  often  prescribed  with  the  view  of  forming  another  agent 
from  the  chemical  reaction  produced.  If  he  thinks  that  there  is  any  mis¬ 
take,  and  the  drugs  ordered  are  in  any  degree  poisonous,  it  is  his  duty  to 
make  an  excuse  for  delay  to  the  messenger  and  at  once  communicate  with 
the  physician.  This  course,  in  these  days  of  telephones,  is  nearly  always 
practicable. 

After  reading  the  prescription,  it  is  well  to  number  it  and  write  the 
label.  This  gives  time  for  the  label  to  dry,  and  avoids  the  use  of  blotting 
paper,  which  often  mars  the  writing  and  renders  the  directions  all  but 
illegible. 

A  clearly  defined  method  should  next  be  decided  on  by  which  to 
compound  the  prescription.  Directions  for  such  plans  of  procedure  will 
be  found  in  the  succeeding  pages  under  the  titles  of  the  various  prepa¬ 
rations.  Next,  the  ingredients  should  be  carefully  weighed  or  measured 
out,  each  one  being  checked  off  so  as  to  avoid  the  danger  of  its  being 
duplicated.  In  many  cases  the  excipient  is  not  specified,  its  choice 
being  left  to  the  druggist ;  but  in  all  such  a  note  should  be  made  on 
the  prescription  to  show  the  article  used,  in  order  that  in  the  event  of 
a  renewal  there  may  be  no  difference  perceptible.  No  alteration  or  addi¬ 
tion  should  ever  be  made  which  would  in  any  degree  affect  the  medicinal 
action  of  the  prescription,  or  interfere  with  the  obvious  intention  of  the 
prescriber. 

The  labelling  of  the  package  and  the  numbering  and  filing  of  the  pre¬ 
scription  are  matters  of  mechanical  detail  which  are  best  learned  at  the 


PRESCRIPTIONS. 


/ 


447 


counter.  Various  devices  for  simplifying  these  operations  are  in  vogue 
and  may  be  seen  in  any  well-appointed  drug-store.  Poisonous  articles 
sold  by  the  druggists  should  always  be  labelled  “  Poison,”  and  the  trans¬ 
action  entered  in  a  book  usually  required  by  law  to  be  kept  for  that  pur¬ 
pose  ;  but  in  the  case  of  prescriptions  the  word  “Poison”  should  not 
appear  on  the  package  or  label  unless  so  directed  by  the  prescriber. 


Stock  Solutions  of  the  salts  most  frequently  prescribed  are  kept  in 
many  establishments  for  convenience  in  dispensing.  Those  most  gener¬ 
ally  used  are  the  following  : — 

Alum, —  ^ijss  in  a  quart  of  distilled  water.  Of  this  solution  each  fluidounce  represents 
3  ss  of  the  salt. 

Potassium  Bicay'bonate, —  ^j  in  f^iv  of  distilled  water;  of  which  3  ss  contains  3J  of 
the  salt. 

Potassium  Chlorate, —  I  in  24  of  distilled  water,  will  not  crystallize  as  the  temperature 
changes. 

Potassiu?7i  Bromide , — I  in  3  of  distilled  water,  makes  a  very  convenient  solution  for 
dispensing  purposes. 

Chloral  Hydrate, —  I  in  I  of  distilled  water:  of  which  each|minim  contains  a  grain  of 
chloral. 

Morphine  Sulphate, — gr.  xvj  in  5  j  of  distilled  water,  with  a  grain  of  Salicylic  Acid  or 
3  drops  of  Carbolic  Acid  to  prevent  change.  Of  this  solution,  known  as  Magendie’s,  each 
minim  contains  gr.  A-  of  the  salt,  and  rtpx  contain  gr.  i.  A  safer  solution  is  the  Liquor 
Morphiae  Sulphatis  of  the  U.  S.  P.,  1870,  which  had  one  grain  of  the  salt  in  each  fluid- 
ounce. 

Carbolic  Acid, —  p)]  in  f^iv  of  glycerin,  makes  a  convenient  solution  which  will  mix 
with  water  in  all  proportions.  npivss  represent  gr.  j  of  the  acid. 

Tannic  Acid, —  ^j  in  f^iv  of  glycerin,  dissolved  by  the  aid  of  a  gentle  heat.  rtpivss 
represent  gr.  j  of  the  acid. 


The  following  rules  for  the  pharmaceutical  student  are  quoted  from  the 
Chemist'1 2 3 4 5 6 7 8 9 10 11 12  s  and  Druggist' s  Diary  for  1885.  They  are  well  worth  remem¬ 
bering. 

1.  Read  through  a  prescription,  rapidly  and  in  a  manner  suggesting  no  suspicion  or 
doubt. 

2.  Write  directions  invariably  before  dispensing.  Avoid  thus  the  use  of  blotting- 
paper;  a  good  dispenser  uses  almost  none. 

3.  If  a  mixture  contains  readily  soluble  ingredients,  never  use  a  mortar. 

4.  Avoid  effecting  solution  by  heat,  for  fear  of  recrystallization. 

5.  With  syrups  and  also  ingredients  not  water,  arrange  in  dispensing  to  rinse  out  the 
measure  and  leave  it  clean ;  a  skilled  dispenser  shows  very  little  traces  of  his  work. 

6.  Carefully  clean  and  put  away  weights  and  scales  after  each  operation. 

7.  Hold  the  scales  firmly  by  the  left  hand,  never  lift  them  high  above  the  counter,  and 
judge  of  the  weight  as  much  by  the  indicator  as  by  the  position  of  the  scale. 

8.  Select  glass  pans  for  scales,  preferably  of  heavy  make,  and  discard  flimsy  brass 
material,  which  corrodes  speedily  and  becomes  inaccurate. 

9.  Learn  to  judge  of  the  quantity  to  be  weighed  with  tolerable  accuracy;  train  the  eye 
as  well  as  the  hand. 

10.  If  in  doubt,  always  begin  with  that  about  which  you  have  no  doubt. 

11.  Be  rapid  in  manipulation.  Finish  wrapping,  tying,  or  sealing  quickly.  Slow  dis¬ 
pensing  is  bad  dispensing,  and  arises  either  from  deficient  practice  or  want  of  knowledge. 

12.  Never,  when  in  a  shadow  of  doubt,  hesitate  to  ask  advice  from  a  fear  of  compro¬ 
mising  your  own  dignity. 


443 


INCOMPATIBILITY. 


INCOMPATIBILITY. 

Incompatibility  may  be  Chemical,  Pharmaceutical  or  Therapeutical, 
according  to  the  prescribed  combination  results  in  chemical  decomposi¬ 
tion,  physical  disassociation  or  antagonistic  action.  In  the  first  case  the 
incompatibility  may  be  unintentional  or  intentional  on  the  part  of  the 
prescriber,  for  in  many  cases  the  result  of  the  chemical  action  affords  the 
substance  desired. 


Instances  of  intentional  incompatibility  are  the  mixtures  of  Calomel  and  Corrosive  Sub¬ 
limate  with  Limewater,  producing  the  Black  and  Yellow  Oxides  of  Mercury  respectively, 
and  commonly  known  as  “Black  Wash  ”  and  “Yellow  Wash.”  Such  combination 
should  not  be  filtered  (as  a  novice  might  suppose),  but  should  be  dispensed  with  a 
“  Shake-label,”  that  the  precipitate  may  be  uniformly  distributed  before  using. 


Chemical  Incompatibility  generally  results  from  neglect  on  the  part 
of  the  prescriber  of  the  most  common  chemical  reactions,  such  as — 

1.  Acids  tend  to  combine  with  bases  and  to  form  salts. 

2.  Weak  acids  or  bases  are  displaced  from  their  combinations  by 
stronger  ones,  so  that  salts  in  solution  when  brought  together  generally 
exchange  their  radicles,  especially  if  by  doing  so  an  insoluble  compound 
can  be  formed. 

3.  A  salt  in  solution  is  easily  decomposed  by  a  strong  alkali  if  the  salt 
is  one  having  a  weak  or  volatile  base. 

4.  A  substance  in  solution  may  be  decomposed  by  another  without  pre¬ 
cipitation,  the  product  being  soluble  in  the  solution. 

5.  Alkaloidal  salts  are  precipitated  from  their  solutions  by  the  addition 
of  fixed  alkalies,  their  salts  or  salts  which  produce  insoluble  compounds. 
Oxides  of  the  fixed  alkalies  decompose  salts  of  the  metals  proper,  and 
those  of  the  alkaloids,  precipitating  their  bases  ;  but  the  base  may  be 
soluble  in  an  excess  of  the  alkali. 

6.  Tannic  or  Gallic  Acids  and  vegetable  substances  containing  them 
precipitate  albumen,  alkaloids  and  most  of  the  metallic  oxides,  and  form 
inky  solutions  when  brought  into  contact  with  the  persalts  of  Iron. 
Tannic  Acid  precipitates  gelatin. 

7.  Glucosides  are  incompatible  with  free  acids  or  Emulsin. 

Examples  of  the  neglect  of  these  principles  are  seen  in  the  prescribing  of  Quinine  Sul¬ 
phate  in  mixture  with  Potassium  Acetate,  resulting  in  a  voluminous  precipitate  of  Quinine 
Acetate  which  could  not  be  poured  from  the  bottle; — Vinegars  or  Syrups  containing 
Acetic  Acid  (Syr.  Allii,  Syr.  Scillm)  added  to  a  solution  of  alkaline  carbonates,  causing 
decomposition  of  the  latter  with  evolution  of  C02 ; — the  addition  of  Liquor  Potassae  to  a 
solution  of  Ammonia-alum,  setting  free  gaseous  ammonia; — the  mixing  of  Strychnine 
Sulphate  and  Potassium  Bromide  in  solution,  causing  the  decomposition  of  the  alkaloid 
sulphate  and  precipitation  of  Strychnine; — preparations  of  Cinchona  with  salts  of  Iron, 
forming  an  inky  tannate  of  iron ;  Elixir  of  Chloral  with  alkalies,  causing  the  elimination 
of  Chloroform  and  its  subsequent  evaporation,  etc.,  etc. 

The  following  table  shows  the  most  important  instances  of  solutions 


INCOMPATIBILITY.  ,  449 

which  mutually  precipitate  each  other,  the  letter  P  meaning  “  forms  a 
precipitate  with  — 


Table  of  some  Mutually  Pre¬ 
cipitant  Solutions. 

Alkaloidal  Solutions 

(generally). 

1 

Metallic  Solutions 
(generally). 

Lead  Solutions. 

Silver  Solutions. 

Calcic  Solutions. 

Magnesic  Solutions. 

Albuminous  Solutions. 

Gelatinous  Solutions. 

Solutions  of  Alkalies, . 

P 

P 

P 

P 

P 

P 

Tannic  Acid, . 

P 

P 

P 

P 

,  # 

#  # 

P 

P 

Carbonic  Acid  and  Sol.  of  Carbonates,  .  . 

P 

P 

P 

P 

P 

P 

Sulphuric  Acid  and  Sol.  of  Sulphates,  .  .  . 

.  . 

.  . 

P 

P 

P 

.  . 

Phosph.  Acid  and  Sol.  of  Phosphates,  .  . 

P 

P 

P 

P 

P 

P 

Boric  Acid  and  Sol.  of  Borates,  . 

P 

P 

P 

P 

Hydrochloric  Acid  and  Sol.  of  Chlorides,  . 

.  . 

.  , 

P 

P 

Hydrobromic  Acid  and  Sol.  of  Bromides,  . 

.  . 

.  . 

P 

P 

Hydriodic  Acid  and  Sol.  of  Iodides,  .  .  . 

P 

.  . 

P 

P 

Solutions  of  Sulphides, . 

P 

P 

P 

Arsenical  Solutions, . 

P 

P 

P 

Albumen, . 

P 

P 

P 

The  following  more  or  less  insoluble  salts  will  be  formed  whenever  the 
materials  of  which  they  are  composed  are  brought  together  in  solutions : 
the  Hydrates,  Carbonates,  Phosphates,  Borates,  Arseniates  and  Tan  nates 
of  most  earthy  and  heavy  metals  and  alkaloids,  and  the  metallic  Sulphides; 
the  Sulphates  of  Calcium,  and  of  Lead,  and  the  subsalts  of  Mercury;  the 
Chlorides,  Iodides,  and  Bromides  of  Bismuth,  Silver,  Lead,  and  subsalts 
of  Mercury;  the  Iodides  of  Quinine,  Morphine  and  most  alkaloids. 

Instances  are — Limewater  or  Aromatic  Spirit  of  Ammonia  with  Tincture  of  Chloride 
of  Iron,  or  solutions  of  Mercury  salts,  or  neutral  solutions  of  Quinine  or  Morphine  salts. 

Ammonium,  Potassium  and  Sodium  carbonates  or  bi-carbonates  with  Limewater. 

Solutions  of  Magnesium  Sulphate,  Alum,  Zinc  Acetate  or  Sulphate  with  solutions  of 
salts  of  Iron,  Manganese,  Bismuth,  Antimony,  Lead,  and  of  most  alkaloids. 

Ammonium  or  Sodium  Phosphates  with  solutions  of  Iron  salts,  with  Limewater,  solu¬ 
tion  of  Magnesium  Sulphate,  of  Alum,  etc. 

Liquor  Potassii  Arsenitis  with  Limewater,  with  solutions  of  basic  salts  of  Iron,  and  of 
neutral  salts  of  Quinine  and  Morphine,  etc. 

Solutions,  Decoctions,  Tinctures  and  Extracts  containing  Tannic  Acid  with  solutions  of 
salts  of  Iron,  Mercury,  Antimony,  Lead  (as  also  with  solutions  containing  albuminous 
substances  and  Gelatin). 

Limewater  with  solutions  of  Quinine  and  Morphine  Sulphates. 

Solutions  of  Lead  Acetate  with  Zinc  Sulphate  or  Alum. 

Sodium  Chloride  with  Silver  Nitrate. 

Morphine  Hydrochlorate  with  Lead  Acetate. 

Alkaline  Iodides  or  Bromides  with  Bismuth  Carbonate  or  Sub-nitrate,  with  Lead  Ace¬ 
tate,  with  Sub  chloride  of  Mercury,  or  with  neutral  solutions  of  Quinine,  Morphine  and 
Strychnine  salts. 


Explosive  Compounds  result  from  the  admixture  of  powerful  oxid¬ 
izing  agents  with  substances  which  are  readily  oxidizable.  The  most 
important  members  of  these  two  classes  are  as  follows  : — 

29 


450 


INCOMPATIBILITY. 


Oxidizers. 

Nitric  Acid.  Chromic  Acid. 
Free  Hydrochloric  Acid. 
Nitro-hydrochloric  Acid. 
Potassium  Chlorate. 
Potassium  Permanganate. 


Oxidizable  or  Combustible. 

Glycerin,  Sugar,  Alcohols. 
Oils  and  Ethers. 

Sulphur  and  Sulphides. 

Dry  Organic  Substances. 
Phosphorus. 


Explosions  have  resulted  from  mixing  Fluid  Extract  of  Uva  Ursi  with  certain  samples 
of  Spirit  of  Nitre,  Chromic  Acid,with  Glycerin,  Permanganate  of  Potassium  with  Glycerin, 
Nitric  Acid  with  Glycerin,  Nitrate  of  Silver  with  Creasote,  Oxide  of  Silver  in  pill  with 
Extract  of  Gentian,  Potassium  Chlorate  with  Glycerin  and  Tincture  of  the  Chloride  of 
Iron.  Chloride  of  Lime  triturated  with  Sulphur  in  a  mortar  has  exploded,  so  also  has 
Calcium  or  Sodium  Hypophosphite  when  triturated  alone.  Tincture  of  Iodine  with  Am¬ 
monia  forms  the  Iodide  of  Nitrogen,  which  is  highly  explosive,  especially  if  triturated  in 
the  presence  of  water.  Catechu  and  Potassium  Chlorate  in  a  dentifrice  have  exploded  in 
the  mouth  from  the  friction  produced  by  a  dry  tooth-brush. 


Poisonous  Compounds  may  be  formed  by  the  admixture  of  many 
substances  in  solution,  such  as — 

Potassium  Chlorate  with  Potassium  Iodide ,  in  solution  together  do  not 
react  at  ordinary  temperatures,  but  in  the  system  they  evolve  a  poisonous 
agent,  probably  the  Iodate  of  Potassium. 

Potassium  Chlorate  with  Syrup  of  Iodide  of  Iron ,  liberates  Iodine  from 
the  Iodide  in  the  warm  stomach,  causing  severe  gastric  irritation,  perhaps 
gastritis  of  dangerous  degree. 

Dilute  Hydrocyanic  Acid  or  Potassium  Cyanide ,  with  Calomel ,  forms 
the  Bichloride  and  Bicyanide  of  Mercury,  both  virulent  poisons ; — with 
metallic  hydrates,  carbonates,  sub-nitrates  or  sub-chlorides,  cyanides  of 
the  metals  are  formed  which  are  even  more  poisonous  than  the  acid  itself 
in  its  usual  diluted  form. 


Pharmaceutical  Incompatibility  differs  from  chemical  incompati¬ 
bility  in  the  absence  of  chemical  action,  and  is  generally  produced  by 
adding  one  substance  to  another  which,  through  differences  in  solubility, 
causes  a  precipitation  of  solid  matter  or  a  separation  of  part  of  the  liquid. 
The  constituents  separated  may  be  active  and  hence  important,  or  inert 
and  therefore  unimportant. 

Instances  of  this  are — the  addition  of  an  acid  to  a  Quinine  and  Liquorice  mixture,  result¬ 
ing  in  precipitation  of  the  Glycyrrhizin  (relied  onto  cover  the  taste  of  the  Quinine)  by  the 
acid; — or  the  use  of  Quinine,  Tincture  of  Ferric  Chloride  and  Liquorice  together; — or 
the  prescribing  of  solutions  of  Chloral  and  Potassium  Bromide  with  an  alcoholic  prepara¬ 
tion,  the  Chloral  separating  to  the  top  as  an  alcoholate,  and  therefore  dangerously  in 
excess  for  the  first  few  doses; — or  the  neglect  to  prescribe  Acacia  or  some  other  emulsifier 
in  mixtures  of  an  alcoholic  fluid  extract  of  a  resinous  body  with  an  aqueous  preparation, 
which  would  result  in  the  separation  of  the  resin  to  the  surface  and  an  overdose  with  the 
first  teaspoonful. 

When  the  fluid  extracts  are  diluted  with  liquids  differing  in  composition 
from  those  used  in  the  fluid  extracts,  the  gum,  albumen,  resin  and  mucil¬ 
age  are  often  separated.  In  such  a  case  as  Fluid  Extract  of  Cannabis 


INCOMPATIBILITY. 


451 


Indica  the  active  resin  would  be  thrown  out  of  solution,  and  floating  on 
top  might  cause  serious  symptoms ;  but  in  many  other  instances  the  pre¬ 
cipitate  would  be  inert  and  filtration  would  be  in  order.  Water  is  the 
solvent  for  albuminous,  gelatinous,  gummy,  and  saccharine  bodies  and  for 
a  large  number  of  inorganic  salts  ;  while  Alcohol  is  the  solvent  for  vola¬ 
tile  oil  and  resins,  gum-resins,  resinoids,  balsams,  and  all  drugs  contain¬ 
ing  these  as  their  active  principles.  The  solvent  power  of  either  Alcohol 
or  Water  for  their  particular  substances  decreases  in  proportion  to  the 
amount  of  the  other  added. 

Instances  of  Pharmaceutical  Incompatibility. 

Resinous  tinctures  or  Fluid  Extracts  with  aqueous  solutions. 

Tincture  of  Guaiac  with  spirit  of  nitric  ether. 

Compound  Infusion  of  Gentian  with  infusion  of  wild  cherry. 

Compound  Infusion  of  Cinchona  with  compound  infusion  of  gentian. 

Essential  oils  with  aqueous  liquids  in  quantities  exceeding  I  drop  to  ^j. 

Fixed  oils  and  Copaiba  with  aqueous  liquids  (except  excipients). 

Tinctures  made  with  Alcohol  with  those  made  with  diluted  alcohol. 

Alcoholic  tinctures  and  fluid  extracts  with  aqueous  preparations. 

Spirit  of  Nitric  Ether  with  strong  mucilages. 

Infusions  generally  with  metallic  salts. 


Therapeutical  Incompatibility  arises  when  two  agents  are  admin¬ 
istered  together  which  oppose  each  other  in  their  action  on  the  human 
system, — as  for  instance  Belladonna  in  any  form  with  Physostigma.  But 
in  many  cases  physiological  antagonists  are  designedly  prescribed  together, 
one  as  a  guard  against  the  action  of  the  other,  as  in  the  hypodermic  ad¬ 
ministration  of  Morphine  guarded  by  Atropine.  The  antagonists  to  each 
of  the  active  medicinal  agents  may  be  found  in  the  section  on  Materia 
Medica  under  their  various  titles;  but  they  may  be  well  summarized  as 
to  the  most  important  ones  in  the  following  list. 

Physiological  Antagonists. 

Aconitine , — Atropine,  Digitalin,  Strychnine. 

Alcohol , — Strychnine. 

Ammonium  Chloride , — Chloral- hydrate. 

Atropine , — *Aconitine,  *Bromal-hydrate,  Chloral-hydrate,  Hydrocyanic  Acid,  Jaborandi, 
Muscarine,  *Morphine,  Physostigmine,  Phytolacca,  Pilocarpine,  Quinine.  [Those 
marked  *  will  not  prevent  death  from  a  lethal  dose  of  Atropine,  though  the  latter  will 
prevent  death  from  a  lethal  dose  of  either  of  them.] 

Barium , — Sodium  Sulphate,  Potassium  salts. 

Bromal-hydrate , — Atropine. 

Brucine , — Chloral- hydrate. 

Calabarine , — Chloral-hydrate. 

Carbolic  Acid, — Chloral-hydrate. 

Chloral-hydrate , —  Ammonium  Chloride,  Atropine,  Brucine,  Calabarine,  Carbolic  Acid, 
Codeine,  Physostigma,  Picrotoxine,  Strychnine,  Thebaine. 

Chloroform , — Amyl  Nitrite. 

Cocaine , — Morphine. 

Codeine , — Chloral  hydrate. 

Digitalin , — Aconitine,  Muscarine,  Saponin. 

Gelsemium, — Opium,  Atropine. 


452 


INCOMPATIBILITY. 


Morphine , — Atropine,  Caffeine,  Chloroform,  Cocaine,  Daturine,  Hyoscyamine,  Nicotine, 
Physostigma. 

Muscarine , — Atropine. 

Opium , — Atropine,  Gelsemium,  Veratrum  Viride. 

Physostigma , — Atropine,  Chloral,  Morphine. 

Saponin , — Digitalin. 

Strychnine , — Alcohol,  Chloral,  Hydrocyanic  Acid,  Nicotine,  Nitrite  of  Amyl. 

Thebaine , — Chloral-hydrate. 


The  Dangers  of  Incompatibility  may  in  a  great  measure  be 
avoided  by  the  use  of  the  utmost  simplicity  in  prescribing.  The  subject 
can  only  be  glanced  at  within  these  pages,  but  the  following  simple  rules 
may  help  the  burdened  memory  of  the  student  and  the  practitioner. 

(1) .  Never  use  more  than  one  remedy  at  a  time,  if  one  will  serve  the 
purpose. 

(2) .  Never  use  Strong  Mineral  Acids  with  other  agents,  unless  you 
know  exactly  what  reaction  will  ensue.  They  decompose  salts  of  the 
weaker  acids,  and  form  ethers  when  combined  with  alcohol.  Never  com¬ 
bine  free  acids  with  hydrates  or  carbonates. 

(3) .  Select  the  simplest  solvent,  diluent  or  excipient  you  know  of,  re¬ 
membering  that  the  solvent  power  of  alcohol  and  of  water  for  their 
respective  substances  decreases  in  proportion  to  the  quantity  of  the  other 
added. 

(4) .  Generally  do  not  combine  two  or  more  soluble  salts ;  for  such 
salts  in  solution,  when  brought  together,  usually  exchange  their  radicles, 
thereby  forming  an  insoluble  compound. 

The  following  more  or  less  insoluble  salts  will  be  formed  whenever  the  materials  of 
which  they  are  composed  are  brought  together  in  solutions :  the  Hydrates,  Carbonates, 
Phosphates,  Borates,  Arseniates  and  Tannates  of  most  earthy  and  heavy  metals  and  alka¬ 
loids,  and  the  metallic  Sulphides  ;  the  Sulphates  of  Calcium,  of  Lead,  and  the  subsalts  of 
Mercury;  the  Chlorides,  Iodides,  and  Bromides  of  Bismuth,  Silver,  Lead,  and  Mercury; 
the  Iodides  of  Quinine,  Morphine  and  most  alkaloids. 

(5  ).  Never  order  a  drug  in  combination  with  any  of  its  Tests  or  Anti¬ 
dotes. 

(6) .  Never  prescribe  a  Glucoside ,  (as  Santonin,  Colocynthin,  etc.),  in 
combination  with  free  acids  or  with  a  substance  containing  Eitiulsin ,  as 
these  agents  will  decompose  it. 

(7) .  Aconite  should  be  ordered  in  water  alone,  Mercuric  Chloride  by 
itself  in  water  or  in  simple  syrup.  The  latter  drug  is  incompatible  with 
almost  everything,  even  the  Compound  Syrup  of  Sarsaparilla  being  said 
to  decompose  it. 

(8) .  Iodide  of  Potassium  decomposes  most  of  the  metallic  salts,  and  is 
one  of  the  drugs  which  are  best  administered  alone. 

(9) .  The  following  named  substances  are  incompatible  with  so  many 
others  that  it  is  best  to  always  prescribe  them  alone ;  they  are  best  given 
in  simple  solution  : — 


EXTEMPORANEOUS  PREPARATIONS. 


453 


Dilute  Hydrocyanic  Acid. 

Dilute  Nitro-hydrochloric  Acid. 
Sulphuric  Acid. 

Mercuric  Chloride  (Corr.  Sub.). 

Iodine  and  Iodides. 

Syrup  of  the  Iodide  of  Iron. 

Potassium  Permanganate. 

Potassium  Acetate. 

Potassium  Bromide 
Tartar  Emetic. 

Tincture  of  Guaiac. 

Tannic  and 


Morphine  Acetate. 

Morphine  Hydrochlorate. 
Quinine  Sulphate. 

Liquor  Calcis. 

Liquor  Potassae. 

Liquor  Potassii  Arsenitis. 
Liquor  Ferri  Nitratis. 

Tinct.  Ferri  Chloridi. 

Zinc  Acetate. 

Citrate  of  Iron  and  Quinine. 
Free  Chlorine  in  Solution. 
Gallic  Acids. 


(io).  Silver  Nitrate  and  the  Acetate  and  Sub-acetate  of  Lead,  though 
incompatible  with  almost  everything,  may  be  combined  with  Opium ,  the 
latter  forming  with  Opium  a  compound,  which,  though  insoluble,  is  thera¬ 
peutically  active  as  an  astringent  and  anodyne  lotion.  Silver  Nitrate  with 
Creasote  forms  an  explosive  compound. 

(n).  Tannic  and  Gallic  Acids,  and  substances  containing  them  (as 
the  Astringent  Bitters),  precipitate  albumen,  alkaloids  and  most  soluble 
metallic  salts.  They  may  be  prescribed  with  the  proto-salts  of  Iron,  but 
not  with  its  per-salts.  Calumba  is  the  best  vegetable  tonic  to  use  with 
ferric  salts,  as  it  contains  neither  tannic  nor  gallic  acids.  Tannic  Acid 
precipitates  gelatin. 

(12) .  Iodine  and  the  soluble  Iodides  are  incompatible  with  the  alkaloids 
and  substances  containing  them,  also  with  most  metallic  salts. 

(13) .  Alkalies  neutralize  free  acids,  and  precipitate  the  alkaloids  and 
the  soluble  non-alkaline  metallic  salts.  Oxides  of  the  Alkalies  decompose 
salts  of  the  metals  proper,  and  salts  of  the  alkaloids,  precipitating  their 
bases ;  but  the  base  may  be  soluble  in  an  excess  of  the  alkali. 

(14) .  Resinous  Tinctures  or  Fluid  Extracts,  (<?.  g. ,  Tinct.  Cannabis 
Indicae)  when  combined  with  aqueous  solutions,  should  always  have  Aca¬ 
cia  or  some  other  emulsifying  agent  added,  to  prevent  the  separation  of 
the  resin,  which  otherwise  will  be  deposited  on  the  sides  of  the  bottle  or 
will  float  on  top  of  the  mixture. 

(15) .  Tincture  of  Digitalis  should  not  be  mixed  with  aqueous  or  syrupy 
solutions,  for  in  such  cases  a  decomposition  of  the  active  principles  may 
occur,  forming  new  and  poisonous  ones. 


LIQUID  EXTEMPORANEOUS  PREPARATIONS. 

Mixtures  (Misturce), — in  official  pharmacy  are  aqueous  preparations 
containing  some  insoluble  ingredients  held  in  suspension  by  an  appropriate 
vehicle.  In  extemporaneous  pharmacy,  however,  the  term  Mixture  is 
applied  to  every  fluid  compound  intended  for  internal  use,  except  a  few 
which  bear  distinctive  titles,  such  as  Emulsions,  Draughts,  Enemas,  Elixirs 
and  Drinks.  The  simplest  form  of  mixture  in  this  extended  sense  is  that 


454 


EXTEMPORANEOUS  PREPARATIONS. 


in  which  two  or  more  liquids  are  mixed  together ;  but  a  great  variety  of 
substances  may  be  prescribed  in  this  form,  chief  among  which  are  most  of 
the  soluble  salts,  light  insoluble  powders,  salts  which  may  be  diffused  by 
agitation,  extracts,  gum-resins,  and  the  fixed  essential  oils.  They  are 
generally  ordered  in  2,  3,  4,  6,  8,  10  and  12-ounce  vials. 

The  substances  suitable  to  the  mixture-form,  properly  so  called,  are 
those  which,  though  more  or  less  insoluble  in  water,  will  mix  with  it  by 
agitation,  trituration,  etc.  Those  most  frequently  ordered  are  as  follows  : — 


Diffusion  by  Agitation  ; — 

Calcii  Phosphas  Praecip. 
Cinchonae  Pulvis. 

Ipecacuanhae  Pulvis. 

Magnesia. 

Quininae  Sulphas. 

Sulphur  Praecipitatum. 

Suspendible  by  Viscid  Excipients  : — 

Essential  Oils. 

Oleum  Amygdalae. 

Oleum  MorrUuae. 

Oleum  Olivas. 

Oleum  Ricini. 

Copaiba. 

Ferri  Carbonas  Saccharatus. 


Miscible  only  by  Trituration  :■ 

Ammoniacum. 

Asafoetida. 

Confectio  Rosae. 
Confectio  Sennas. 
Extractum  Aconiti. 

Ext.  Beiladonnae. 

Ext.  Conii. 

Ext.  Hyoscyami. 

Ext.  Slramonii. 

Ext.  Glycyrrhizae. 

Ext.  Krameriae. 

Ext.  Taraxaci. 

Guaiacum. 

Scammonium. 

Myrrha. 


Best  suspended  by  the  aid  of  a  fixed  oil  or  yolk  of  egg  : — 

Ext.  Cannabis  Indicas.  Oleum  Terebinthinae. 

Camphora.  Chloroformum. 


Solutions  intended  for  internal  administration  are  classed  as  Mixtures  in 
extemporaneous  pharmacy,  for  the  reason  stated  above.  The  following 
list  of  acids  and  salts  comprises  most  of  the  solids  which  are  best  adapted 
for  use  in  liquid  form,  by  reason  of  their  solubility  in  water. 


Acidum  Citricum. 

Acidum  Tannicum. 

Acidum  Tartaricum. 

Alumen. 

Ammonii  Chloridum. 
Antimonii  et  Potassii  Tartras. 
Barii  Chloridum. 

Calcii  Chloridum. 

Calcii  Hypophosphis. 

Ferri  Pyrophosphas. 

Ferri  Sulphas. 

Ferri  et  Ammonii  Citras. 
Ferri  et  Potassii  Tartras. 

Ferri  et  Quininae  Citras. 
Magnesii  Sulphas. 

Mangani  Sulphas. 

Potassii  Acetas. 

Potassii  Bicarbonas. 


Potassii  Carbonas. 
Potassii  Citras. 

Potassii  Chloras. 

Potassii  Hypophosphis. 
Potassii  Tartras. 

Potassii  et  Sodii  Tartras. 
Potassii  Bromidum. 
Potassii  Iodidum. 

Morph  inae  Acetas. 
Morphinae  Hydrochloras. 
Morphinae  Sulphas. 

Sodii  Bicarbonas. 

Sodii  Boras. 

Sodii  Carbonas. 

Sodii  Chloridum. 

Sodii  Hypophosphis. 
Sodii  Phosphas. 

Sodii  Sulphas. 


A  few  require  the  use  of  viscid  substances  as  vehicles  or  correctives. 
They  are  as  follows  :  — 


EXTEMPORANEOUS  PREPARATIONS. 


455 


Ammonii  Carbonas.  Potassa. 

Plumbi  Acetas.  Potassii  Cyanidum. 

Hydrargyri  Chloridum  Corrosivutn. 

Certain  salts  are  best  ordered  by  prescribing  such  agents  as  will  when 
in  solution  together  react  upon  each  other  and  produce  the  desired  salt. 
Instances  of  this  may  be  found  in  the  pharmacopoeial  processes  for  most  of 
the  official  Liquores  ;  the  salts  so  produced  being  the  following :  — 


Ammonii  Acetas. 
Magnesii  Citras. 
Potassii  Citras. 
Ferri  Citras. 

Ferri  Acetas. 

Ferri  Chloridum. 
Hydrargyri  Nitras. 


Ferri  Nitras. 
Ferri  Phosphas. 
Potassii  Arsenis. 
Potassii  Hydras. 
Sodii  Hydras. 
Soda  Chlorata. 
Zinci  Chloridum. 
Arsenii  et  Hydrargyri  Iodidum. 


Certain  other  substances  require  the  addition  of  other  agents  in  order 
to  form  eligible  solutions.  Such  are  the  following  : — 


Quinince  Sulphas, — requires  acidulated  water  for  its  solution,  the  acid  used  being  gen¬ 
erally  Sulphuric  diluted,  or  the  Aromatic  Sulphuric.  This  method  of  prescribing  this 
salt  develops  its  bitter  taste  to  the  utmost,  and  is  often  avoided  by  ordering  the  drug  to  be 
suspended  in  a  viscid  liquid,  such  as  Pulv.  Acaciae  in  Syrup  of  Ginger.  In  such  a  case 
an  officious  dispenser  anxious  to  show  his  smartness  may  add  some  dilute  Sulphuric  Acid 
to  dissolve  the  Quinine  and  thus  defeat  the  object  of  the  prescriber. 

Sulphate  of  Quinine  may  be  prescribed  with  Aromatic  Spirit  of  Ammonia,  Spirit  of 
Nitrous  Ether,  Tinctures  or  other  alcoholic  preparations  together  with  Glycerin  or  Syrup 
and  Water.  In  such  cases  the  salt  should  be  first  dissolved  in  the  alcoholic  portion  of  the 
prescription ;  then  the  glycerin  or  syrup,  and  finally  the  aqueous  portions  should  be  added 
gradually.  It  may  also  be  ordered  with  dilute  Sulphuric  Acid  and  some  vegetable  infusion 
containing  Tannin,  in  which  case  a  precipitate  of  Tannate  of  Quinine  will  be  produced. 
This  of  course  should  not  be  filtered,  but  should  be  dispensed  with  a  “  Shake-label.” 

[For  the  use  of  “  Veloutine  ”  as  a  vehicle  for  the  use  of  Quinine  Salts,  see  ante ,  pages 
182,  207.] 

Chinoidin ,  Cinchonine  Sulphate  and  Quinidine  Sulphate , — also  require  the  addition  of 
dilute  mineral  acid  for  their  solution  in  aqueous  mixtures. 

Iodine, — requires  the  addition  of  Iodide  of  Potassium  for  its  solution  in  a  convenient 
quantity  of  water,  as  in  the  case  of  the  official  Liquor  Iodi  Compositus. 

Red  Iodide  of  Mercury, — requires  the  addition  of  Iodide  of  Potassium  or  Mercuric 
Chloride  for  its  aqueous  solution. 

Potassii  Bitartras ,  Cream  of  Tartar, — requires  the  addition  of  Borax  or  Boric  Acid 
for  its  solution  in  water. 

Benzoic  Acid, — requires  the  addition  of  Borax  to  aid  its  solubility  in  water,  an  equal 
part  of  the  latter  making  it  5  times  more  soluble  than  when  alone. 

Lime , — is  more  soluble  in  sweetened  water  than  in  plain  water,  the  sugar  aiding  its 
solution. 


Excipients  are  substances  which  give  form  and  consistence  to  prescrip¬ 
tions,  and  serve  as  vehicles  for  the  exhibition  of  the  other  ingredients. 
Some  of  the  excipients  are  diluents ,  or  agents  which  effect  the  dilution 
or  division  of  the  active  ingredients ;  while  others  act  in  the  double  capa¬ 
city  of  diluents  and  flavoring  agents.  The  excipients  most  generally  used 
in  mixtures  may  be  tabulated  as  follows,  viz.  :  — 

Diluents.  True  Excipients. 

Water  (Aqua).  Acacia  (Pulv). 

Medicated  Waters  (Aquae).  Tragacanth  (Pulv). 


456 


EXTEMPORANEOUS  PREPARATIONS. 


Diluents. 


True  Excipients. 


Syrups. 

Mel  Rosae. 
Elixir  Aurantii. 


Sugars. 
Confections. 
Some  Extracts. 


Yolk  of  Egg  (Vitellus). 


Flavoring  Agents. 


Oleum  Cari. 

Ol.  Caryophylli. 

01.  Cinnamomi. 

01.  Gaultherise. 

01.  Sassafras. 

01.  Amygdalae  Amarse. 
Tinctura  Tolutana. 

Tinct.  Zingiberis. 

Tinct.  Cinnamomi. 

Tinct.  Cardamomi. 

Tinct.  Cardamomi  Comp. 


Tinct.  Gentianse  Comp. 
Tinct.  Aurantii  Dulcis. 
Tinct.  Vanillae. 

Spiritus  Anisi. 

Spiritus  Limonis. 

Spiritus  Myristicse. 
Spiritus  Menthae  Piperitae. 
Spiritus  Menthae  Viridis. 
Spiritus  Lavandulae. 
Syrupus  Limonis. 

Syrupus  Tolutanus. 


Syrupus  Zingiberis. 


Compounding  the  Mixture  is  a  matter  of  no  slight  importance,  and  one 
which  is  best  learned  at  the  dispensing  counter,  though  a  few  directions 
may  not  be  out  of  place.  In  the  case  of  the  simplest  form  of  mixture, 
where  two  or  more  fluid  preparations  are  prescribed  together,  the  only 
operations  required  are  the  measuring  of  the  several  ingredients  and  pour¬ 
ing  them  into  the  designed  vial.  In  doing  this  the  compounder  should 
pursue  a  regular  and  definite  order  of  procedure.  Taking  in  his  left  hand 
a  graduate  of  sufficient  capacity  to  hold  the  whole  quantity  prescribed,  he 
should  walk  along  the  shelves,  and  with  the  right  hand  pour  from  the 
stock-bottles  the  requisite  quantity  of  each  ingredient  in  the  order  in 
which  they  are  entered  on  the  prescription.  A  skillful  clerk  will  hold 
the  graduate  between  the  thumb  and  first  finger,  the  prescription  between 
the  second  and  third  fingers,  and  the  stopper  of  the  stock-bottle  between 
the  little  finger  and  the  hand,  leaving  his  right  hand  free  for  the  manipu¬ 
lation  of  the  bottles  containing  the  ingredients. 

When  an  actively  poisonous  agent  is  ordered  it  should  always  be  the 
last  thing  put  into  the  mixture.  Attention  to  this  rule  will  prevent  the 
danger  of  the  toxic  substance  being  put  in  twice. 

The  order  in  which  the  ingredients  are  put  together  is  not  of  so  much 
importance  in  compounding  a  simple  mixture  as  in  the  case  of  an  emulsion, 
and  the  order  of  the  prescription  can  usually  be  followed,  with  the  excep¬ 
tion  noted  in  the  preceding  paragraph.  Still,  when  several  alcoholic 
preparations,  syrups  and  waters  are  ordered  together,  it  is  good  practice  to 
first  mix  the  alcoholic  fluids,  then  to  add  the  syrups  and  finally  the  water, 
so  as  to  avoid  the  precipitation  of  resinous  principles  which  would  occur 
if  the  alcoholic  solutions  were  added  to  the  water.  Distilled  water  should 
always  be  used,  in  order  to  insure  uniformity  in  taste  and  appearance, 
and  also  as  a  matter  of  purity  and  cleanliness.  All  mixtures  should  be 
well  shaken  before  being  labelled. 


EXTEMPORANEOUS  PREPARATIONS. 


457 


Solids  which  are  comparatively  insoluble  or  only  slowly  soluble  require 
to  be  rubbed  up  in  a  mortar  with  one  or  more  of  the  fluid  ingredients. 
Glass  mortars  are  much  employed  for  this  purpose,  and  many  compounders 
mix  all  the  ingredients  in  such  a  mortar  before  transferring  them  to  their 
vial.  Vegetable  powders  (as  Rhubarb,  Ipecac.,  etc.),  or  finely  pulverized 
inorganic  substances,  are  often  ordered  in  intimate  mixture  with  water, 
thickened  with  mucilage  or  syrup.  In  such  cases  the  mixture  should  be 
made  in  a  porcelain  or  wedgewood  mortar,  enough  mucilage  or  syrup 
being  added  at  first  to  make  a  thick  paste,  and  after  this  is  rubbed  smooth 
the  water  may  be  gradually  added  during  the  continued  process  of  mixing. 
This  process  will  answer  for  all  inorganic  substances  in  powder,  except 
Magnesia,  which  is  best  mixed  by  being  thrown  on  the  surface  of  the 
water,  and  after  it  has  sunk  to  the  bottom  as  a  uniform  sediment  the  other 
ingredients  may  be  added,  and  the  whole  well  shaken.  Froth  upon  the 
surface  of  the  liquid,  which  often  arises  after  agitation,  and  may  prevent 
the  corking  of  the  bottle,  will  quickly  subside  on  the  addition  of  a  few 
drops  of  alcohol. 

The  following  are  samples  of  prescriptions  for  medicines  to  be  admin¬ 
istered  in  mixture  form  :  — 


Bismuth  Alixture  for  Children. 

R.  Bismuthi  Subcarbonatis,  .  3  ij. 

Syrupi  Acaciae, 

Aquae  Cinnamomi,  aa^ij. 

Misce.  Signa, — A  teaspoonful  every 
hour  in  choleraic  diarrhoea. 


Quinine  Mixture  for  Children. 

R.  Quininae  Sulphatis  (pulv.),  g  ss. 
Pulveris  Acaciae,  .  .  .  .  it  ss. 

S\  rupi  Zingiberis,  ...  5  iv. 

Fiat  mistura.  Signa. — A  teaspoonful 
thrice  daily. 


Emulsions  (Emulsiones), — are  mixtures  containing  an  oil  or  a  resin¬ 
ous  substance  in  a  state  of  minute  subdivision,  and  suspended  in  water  by 
the  aid  of  some  viscid  excipient,  as  gum,  soap,  alkali,  or  yolk  of  egg. 

Natural  Emulsions  comprise  two  classes  of  substances, — (1)  those 
emulsions  which  exist  ready  formed  in  nature,  as  milk,  yolk  of  egg,  the 
milky  juices  of  plants,  etc.  ;  and  (2)  the  mixtures  formed  by  rubbing  up 
gum-resins  (as  Ammoniacum,  Myrrh,  Asafetida)  with  water.  Each  of 
the  latter  substances  contains,  together  with  its  resin,  enough  gum  to  make 
a  perfect  emulsion  when  triturated  with  water.  The  manufactured  emul¬ 
sions  are  simply  imitations  of  the  natural  ones,  sufficient  gum  being  added 
in  case  of  a  resinous  substance  to  cause  its  suspension  in  the  aqueous 
diluent. 

Emulsification  consists  in  the  division  of  the  oily  or  resinous  substance 
into  very  minute  globules,  and  surrounding  each  globule  with  a  thin  envel¬ 
ope  of  the  excipient.  If  properly  done  the  globules  will  remain  mechan¬ 
ically  suspended  in  the  water,  without  any  tendency  towards  recombination. 
Milk  is  the  best  illustration  of  a  natural  emulsion,  its  butter  existing  in 
the  aqueous  portion  as  very  minute  globules,  each  surrounded  by  a  thin 


458 


EXTEMPORANEOUS  PREPARATIONS. 


film  of  casein.  Yolk  of  Egg  is  a  dense  emulsion,  consisting  of  oil  sus¬ 
pended  in  water  by  means  of  albumen. 

The  Excipients  which  may  be  used  for  emulsification  are  the  follow¬ 
ing,  arranged  in  the  order  of  their  most  frequent  employment,  viz.  :  — 

Mucilage  of  Acacia, — used  for  oils  and  resins.  Powdered  Acacia  is  even  better,  being 
made  into  a  mucilage  by  the  process  of  emulsification ;  such  a  mucilage  having  the  advan¬ 
tage  of  being  perfectly  fresh  when  incorporated  with  the  other  ingredients.  To  give 
uniformly  good  results  the  following  proportions  in  parts  by  weight  should  be  used,  viz. : — 

Gum  Acacia. 

I  part  of  Fixed  Oils  or  Copaiba  requires, . y2 

I  “  “  Balsam  of  Peru  “  . 2 

I  “  “  Oil  of  Turpentine,  “  . I 

Mucilage  of  Tragacanth ,  —may  also  be  used  for  oils  and  resins,  but  it  has  not  proved 
so  satisfactory  as  the  preceding.  The  same  may  be  said  of  powdered  Tragacanth. 

Vitellus,  Yolk  of  Egg. — is  an  excellent  agent  for  emulsifying  oils,  but  mixtures  made 
with  it  must  be  used  within  a  few  days,  as  they  will  not  keep  long.  One  yolk  will  emul- 
sionize  an  ounce  of  fixed  oil,  and  is  about  equal  to  half  an  ounce  of  Acacia.  It  is  best 
suited  to  emulsions  of  cod-liver  oil  intended  for  immediate  administration.  The  official 
Mistura  Chloroformi  is  an  emulsion  made  with  yolk  of  egg.  Glyceritum  Vitelli  or  Gly- 
conin  is  an  official  preparation  consisting  of  glycerin  and  yolk  of  egg.  (See  ante,  page 
400).  One  ounce  of  it  will  emulsify  three  ounces  of  fixed  oil. 

Liquor  Potassce, — may  be  used  for  oils,  the  resulting  compound  being  however  a  soap 
rather  than  an  emulsion.  Copaiba  is  usually  emulsified  by  using  both  a  gum  and  an  alkali ; 
a  similar  process  being  employed  for  many  of  the  fixed  oils. 

Tincture  of  Senega, — wdl  emulsify  fats  and  oils  very  efficiently,  and  even  in  very  small 
quantities,  npx  emulsifying  an  ounce  of  fixed  oil. 

Tincture  of  Quillaia  (Soap-bark), — is  a  good  emulsifier  for  oils,  and  is  much  used  in 
Europe  for  this  purpose. 

Milk, — is  used  to  emulsify  Scammony  in  the  Mistura  Scammonii,  which  is  official  in 
the  British  Pharmacopoeia. 

Syrups,  Confections  and  Extracts, — may  be  used  in  making  emulsions,  but  are  rarely 
so  employed. 

Soap, — is  occasionally  used  for  emulsifying  Oil  of  Turpentine. 

The  Method  of  preparing  an  emulsion  which  experience  has  shown  to 
be  the  best,  is  as  follows: — Add  the  oil,  resin,  etc.,  to  a  proper  quantity 
of  the  excipient,  and  mix  both  thoroughly  in  a  wedgewood  mortar.  Then 
add  enough  water  to  equal  one-half  the  weight  of  the  previous  mixture, 
and  triturate  the  whole  rapidly  and  unceasingly  until  the  emulsion  is  homo¬ 
geneous  and  of  a  whitish  color.  Next,  add  the  remainder  of  the  water 
slowly,  with  continual  stirring  ;  finally  incorporating  the  other  ingredients, 
if  any. 

Emulsions  are  sometimes  flavored  and  at  the  same  time  colored,  with 
such  a  preparation  as  the  Compound  Tincture  of  Cardamom  ;  but  they 
present  a  better  appearance  when  perfectly  white.  Alcoholic  preparations 
should  not  be  added  in  large  quantity  to  emulsions  made  with  Acacia  or 
Yolk  of  Egg,  as  alcohol  will  precipitate  the  emulsifying  agent.  Volatile 
Oils  require  admixture  with  a  fixed  oil  before  being  made  into  an  emul¬ 
sion.  Soluble  salts  should  never  be  prescribed  with  emulsions  of  oils. 
Acids  are  incompatible  with  mixtures  which  have  been  emulsified  by  an 
alkali.  Mucilage  used  for  emulsions  should  always  be  freshly  prepared. 


Water. 


EXTEMPORANEOUS  PREPARATIONS.  459 

The  following  examples  of  prescriptions  for  emulsions  will  represent 
those  generally  met  with  : — 


Cod-Liver  Oil  Emulsion. 


&.  Olei  Morrhuae, . £  ij. 

Vini  Albi, . 5  iss. 

Ac.  Phos.  Dil., . ^iij. 

Syrupi, . 3  v. 

Vitellum, . j. 


Aq.  Amygd.  Amar.  ad.,  .  .  3  viij. 
Misce,  et  fiat  emulsio. 

Sig. — Tablespoonful  doses. 


Alkaline  Emulsion  of  Copaiba. 


R .  Copaibae, 

Liq.  Potassae, . aa  3  ij. 

Misce,  et  adde — 

Pulv.  Acaciae, 

Pulv.  Sacchari . aa  %  i j . 


Aq.  Menth.  Viridis,  ad,  .  .  .  ^iv. 
Misce,  et  fiat  etnulsio. 

Sig. — Tablespoonful  doses. 


Elixirs  (Elixiria), — are  mixtures  containing  alcohol,  water  and  sugar, 
with  certain  medicinally  active  ingredients,  and  supposed  to  be  so  prepared 
as  to  be  particularly  palatable,  which  is  seldom  true.  There  is  one  official 
elixir,  Elixir  Aurantii  (see  ante,  page  122),  which  may  be  used  as  a  basis 
for  the  extemporaneous  prescribing  of  these  preparations.  The  manufac¬ 
turers  have  put  on  the  market  a  great  variety  of  elixirs,  and  most  drug¬ 
gists  keep  a  stock  of  them  on  hand  prepared  in  the  shop  ;  but  they  may 
be  ordered  by  prescription  just  as  any  other  mixture  would  be.  The  sub¬ 
stances  generally  used  in  this  form  are  as  follows  : — 


Arsenic. 

Bismuth. 

Bromide  of  Ammonium. 
Bromide  of  Lithium. 
Bromide  of  Potassium. 
Calisaya  Bark. 

Chloral  Hydrate. 

Coca. 

Gentian. 


Guarana. 

Iron,  Tincture  of  the  Chloride. 
Iron,  Phosphate. 

Iron,  Pyrophosphate. 

Liquorice. 

Pepsin. 

Quinine. 

Strychnine. 

Taraxacum. 

Valerianate  of  Ammonium. 


Many  of  these  agents  are  combined  with  each  other,  as  in  the  Elixir  of  Bismuth  and 
Strychnine;  Elixir  of  Calisaya,  Iron  and  Strychnine;  Elixir  of  Gentian  with  Tincture  of 
Chloride  of  Iron  ;  Elixir  of  Iron,  Quinine  and  Strychnine,  etc.,  etc. 


A  Draught  (Haustus), — is  an  extemporaneous  mixture  consisting  of 
a  single  dose,  and  usually  ordered  in  a  vial  containing  from  one  to  two 
fluidounces. 

Effervescing  Draught  is  one  of  the  best  known.  It  is  prepared  by  neutralizing  a  watery 
solution  of  Potassium  Bicarbonate  with  Lemon-juice  or  Citric  Acid,  and  may  be  drank 
during  effervescence.  When  the  CO,2  has  escaped  it  is  a  solution  of  Potassium  Citrate  in 
water,  and  corresponds  to  the  official  Mistura  Potassii  Citratis,  or  Neutral  Mixture.  (See 
ante ,  page  323.) 

Black  Draught  is  another  well-known  preparation  of  this  class.  It  is  official  as  In- 
fusum  Sennae  Compositum.  (See  ante,  page  364.) 


A  Drink  (Potus), — is  a  solution  or  a  mixture  intended  to  be  used  ad 
libitum ,  and  generally  consists  of  a  Potassium  or  Sodium  salt ;  or  a  min¬ 
eral  acid,  in  dilute  solution,  sweetened  and  flavored. 


460 


EXTEMPORANEOUS  PREPARATIONS. 


The  “  Imperial  Drink  ”  is  made  after  the  following  formula  :  R  .  Potassii  Bitartratis, 
£  ij ;  Olei  Limonis,  rtpv ;  Aquae  Bullientis,  q.  s.  ad  3  xx.  M.  Fiat  potus.  Sig. — Use 
as  a  drink. 


A  Gargle  (Gargarysma), —  is  a  mixture  or  solution  for  application  to 
the  pharynx  or  the  mouth  (mouth-wash).  It  should  never  contain  any 
active  drug,  which  would  produce  dangerous  symptoms  if  swallowed  ; 
nor  any  agent  which  would  injure  the  teeth  or  the  mucous  membrane. 
Gargles  are  ordered  and  compounded  in  the  same  manner  as  mixtures. 
They  usually  contain  astringent  or  disinfecting  salts  (Alum,  Borax,  Sul¬ 
phate  of  Zinc,  Chlorate  of  Potassium),  with  a  vegetable  astringent,  and 
often  Honey.  The  following  formulae  will  illustrate  prescriptions  of  this 
class. 


R.  Tr.  Guaiaci  Ammoniatce, 

Tr.  Cinchonae  Comp.,  aa  .  ^ ij. 
Mellis  Despumat.,  .  .  .  .  %  vj. 
Bene  simul  agita,  et  adde — 

Potassii  Chloratis,  .  .  .  .  gr.  lxxx. 

Aquae,  q.  s .ad . 5 iv. 

Fiat  gargarysma.  Sig. — Gargle. 


R.  Aluminis, . £ij. 

Granati  Corticis, . ^  iv. 

Petal.  Rosae  Ruhr.,  .  .  .  .7,]. 
Mellis  Despumat.,  .  .  .  .5  j. 

Aquae  Bullientis, . ^  vj. 

M.  Sig. — Gargle. 


( Goddard .) 


A  Lotion  (Lotio)  or  Wash, — is  a  solution  or  mixture  of  medicinal 
agents,  intended  for  external  application ;  and  usually  consists  of  some 
soluble,  astringent  salt,  dissolved  in  water,  with  perhaps  some  glycerin  or 
alcohol.  A  Fomentation  (Fotus)  is  a  similar  preparation  used  hot.  A 
Collyrium  is  an  eye-wash,  and  generally  contains  a  soluble  astringent  salt 
dissolved  in  rose-water  or  distilled  water,  in  the  proportion  of  gr.  j-iv  to 
the  5.  The  only  official  preparation  suitable  for  a  lotion  is  the  Liquor 
Plumbi  Subacetatis  Dilutus,  or  Lead-water.  A  well-known  anodyne,  re¬ 
frigerant  and  astringent  lotion  is  that  represented  by  the  first  two  of  the 
following  prescriptions. 


Lead-water  and  Laudanum. 

R.  Liq.  Plumbi  Subacetatis,  .  .  ^j. 

Tinct.  Opii, . ,^j. 

Aquae,  q.  s.  ad . 3  viij . 

M.  Fiat  lotio.  Sig. — Lotion. 

Gross. 


Collyrium. 

R.  Sodii  Boratis, . gr.  x. 

Aquae  Camphorae,  .  .  .  .  g  ij. 
Mucil.  Cydonii, 

Aquae  Destil., . aa  ^ss. 

M.  Fiat  collyrium.  Sig. — Eye-water; 
a  few  drops  to  be  put  into  the  eye  three  or 
four  times  daily. 


Lead  and  Opium  Wash. 

R  .  Liq.  Plumbi  Subacetatis, 

Tinct.  Opii, . aa  £  j. 

Aquae,  q.  s  .ad . 5  viij. 

M.  Fiat  lotio.  Sig. — Lotion. 

Sturgis. 


Collyriutfi  of  Four  Sulphates. 

R.  Zinci  Sulphatis, 

Ferri  Sulphatis, 

Cupri  Sulphatis, 

Aluminis,  . aa  gr.  j. 

Aquae  Destillatae,  .  .  .  .  3  j. 

M.  Fiat  collyrium.  Sig. — For  use  with 
brush  to  palpebral  conjunctivae,  and  to  be 
washed  off  with  clean  water. 


Liniments  (Linimenta), — are  mixtures  intended  for  external  applica- 


EXTEMPORANEOUS  PREPARATIONS. 


461 


tion  to  the  skin  with  friction.  The  official  liniments  are  solutions  of 
various  substances  in  oily  liquids  or  in  alcoholic  liquids  containing  fatty 
oils,  and  are  enumerated  on  page  427.  Extemporaneous  liniments  may 
correspond  to  the  official  ones  or  they  may  be  simple  mixtures  of  fluids 
without  either  fat  or  soap.  A  prescription  for  each  kind  is  appended. 
The  official  Linimentum  Saponis  (Soap  Liniment)  is  a  good  basis  for 
extemporaneous  preparations  of  this  class. 

Compound  Chloroform  Liniment. 

fit.  Extracti  Belladon.  FI.,  .  .  5  ss. 

Extracti  Aconiti  FI., 

Chloroformi  Venalis,  .  .  aagij. 

Spiritus  Camphorse,  .  .  .  ,^j. 

Alcoholis  Diluti,  ad  .  .  .  g  vii 
M.  Fiat  linimentum. 

Sig. — Poison.  To  be  rubbed  on 
painful  part. 


Anodyne  Liniment. 

R.  Tinct.  Aconiti, . £ij. 

Tinct.  Opii, . 5  iv. 

Tinct.  arnicse, . ;jj. 

Chloroformi, . gij. 

Linim.  Saponis,  ad  .  .  .  5  iv. 

M.  Fiat  linimentum. 

Sig. — Poison.  Liniment. 

An  Embrocation  is  a  similar  preparation,  but  of  thinner  consistence. 
The  term  is  almost  obsolete. 


Stokes'  Liniment. 


5ss. 

3J- 

j- 

S'T 


Army  Medical  WagoJt  Liniment. 

fit .  Liq.  Ammonite, 

01.  Terebinthinae, 

01.  Olivae, 

aa,  partes  aequales. 

M.  Fiat  linimentum. 

Sig. — Liniment. 


T 

the 


bt.  Olei  Terebinth.,  . 
Acidi  Acetici, 

Olei  Limonis, 
Vitellum,  .  .  . 
Aquae  Rosae,  .  . 
M.  Fiat  linimentum. 
Sig. — Liniment. 


Injections  (Injectiones), — are  liquid  preparations  intended  for  intro¬ 
duction  into  the  cavities  of  the  body  by  means  of  a  syringe.  When 
thrown  into  the  rectum  they  are  termed  Enemas  (Enemata),  or  Clysters , 
and  are  usually  prepared  at  the  bedside.  Enemata  may  be  demulcent, 
laxative,  nutritive,  stimulant,  or  vermifuge  in  character ;  and  always  have 
warm  or  tepid  water  as  their  diluent,  with  which  are  incorporated  such 
medicaments  as  may  be  desired.  They  may  consist  simply  of  water  to 
act  as  a  wash  for  the  cleansing  of  the  bowel.  Injections  are  termed  vagi¬ 
nal ,  urethral ,  vesical ,  nasal ,  hypodermic ,  etc.,  according  to  the  locality  in 
which  they  are  employed.  A  special  form  of  syringe  is  employed  in  each 
case,  the  discussion  of  which  belongs  rather  to  the  domain  of  surgery 
than  that  of  medicine.  Those  used  for  the  nasal  cavities  are  often 
arranged  with  small  holes  or  an  atomizing  attachment,  so  as  to  deliver 
the  injection  in  the  form  of  a  fine  spray.  A  Collunarium  is  a  nasal 
douche  or  wash.  In  the  Appendix  will  be  found  a  list  of  formulae  for 
hypodermic  injections  ;  a  few  prescriptions  for  other  forms  are  appended 
below. 


462 


EXTEMPORANEOUS  PREPARATIONS. 


Enema  for  Stricture  of  the  Rectum. 


R.  Bismuth!  Subcarb.,  .  .  .  .  Jjj. 
Extracti  Opii  Aquosi,  .  .  gr.  ij. 
Glycerini,  Aquae,  .  .  .  aa^ij. 


M.  Fiat  enema.  Sig. — Two  table- 

spoonsful  to  be  injected  thrice  weekly. 


Demulcent  Enema. 

R  .  Tincturae  Opii, . npxx. 

Decocti  Amyli,  ....  ^iv-vj. 
M.  Hat  enema. 


Vermifuge  Enema. 


R.  Extr.  Quassiae  FI.,  .  .  .  .  ^jss. 
Aquae,  . 5  ijss. 


M.  Sig. — A  tablespoonful  with  an  equal 
quantity  of  warm  water,  as  an  enema,  to  be 
retained  as  long  as  possible. 


Nasal  Injection  [Dobells). 


R .  Ac.  Carbolici,  . £jss. 

Sodii  Bicarb., 

Sodii  Boratis, . aa^iv. 

Glycerini, . 3  xivss. 

Aquae,  q.  s  .ad . 5  viij. 


M.  Sig. — A  tablespoonful  diluted  with 
an  equal  quantity  of  tepid  water  to  be  used 
thrice  daily  with  a  nasal  sprayer. 


Injection  for  Gonorrhoea. 

(Injection  Brou.) 

R  .  Zinci  Sulphatis, . gr.  viij. 

Plumbi  Acetatis,  .  .  .  .  gr.  xv. 

Tincturae  Opii, . 3  ij. 

Tinct.  Catechu, . ^j. 

Aquae  Rosae,  q.  s  .ad  .  .3  vj. 

M.  Fiat  injectio.  Sig.—  Use  with  a 
urethral  syringe. 


Injection  for  Chronic  Urethritis. 

R.  Hydrarg.  Chi.  Corrosivi,  .  gr.  lf. 

Zinci  Chloridi, . gr.  ss. 

Aquae  Destillatae,  ...  .3  viij. 

M.  Sig. — A  teaspoonful  to  be  injected 
well  down  into  the  urethra  thrice  daily, 
through  a  gum-catheter. 


Vaginal  Injections  for  Leucorrhcea. 


R.  Aluminis, . ^j. 

Zinci  Sulphatis, . gss. 


Sodii  Boratis, . gr.  iv. 

M.  Sig. — Dissolve  in  half-a-pint  of 
warm  water,  and  use  with  a  vaginal  sy¬ 
ringe. 


R.  Acidi  Tannici, . %j. 

Glycerini, . 3  iv. 


M.  Sig. — One-half  with  an  equal  quan¬ 
tity  of  water  to  be  injected  twice  daily. 


Baths  (Balnea),  are  often  medicated,  and  then  become  medicinal 
preparations.  The  ingredients  only  are  ordered  in  a  prescription,  as  per 
the  following  examples,  each  of  which  is  intended  for  a  bath  of  25  to  30 


gallons :  — 

Balneum.  Acidi  Nitrohydrochlorici. 

R .  Acidi  Nitrici, 

Acidi  Hydrochlorici,  .  .  aa^j. 

M.  Sig. — Use  with  30  gallons  of  hot 
water,  as  a  bath. 


Balneum  Sulphuris  Composition. 

R.  Sulphuris  Prsecip.,  .  .  .  .  ^ij. 
Sodii  Hyposulphitis,  .  .  .  gj. 
Acidi  Sulphurici  Dil.,  .  .  3  ss. 

Aquse,  . Oj. 

M.  Sig. — For  a  30-gallon  bath. 


SOLID  EXTEMPORANEOUS  PREPARATIONS. 

Pills  (Pilulae), — are  described  on  page  430,  where  also  the  official 
pills  are  enumerated.  They  constitute  a  form  of  medicine  very  much  used 
in  extemporaneous  pharmacy,  and  one  with  the  preparation  of  which  the 
compounder  should  be  perfectly  familiar,  for  it  will  constitute  fully  one- 
third  of  his  work  at  the  dispensing  counter.  Pills  should  not  exceed  5 
grains  in  weight,  unless  the  ingredients  are  very  heavy,  as  Bismuth,  Calo¬ 
mel,  Hydrargyrum  cum  Creta,  etc.,  of  which  6,  8,  or  10  grains  may  be 
made  into  a  pill  which  may  be  readily  swallowed. 


EXTEMPORANEOUS  PREPARATIONS. 


463 


A  Bolus  is  a  similar  mass,  but  larger  than  a  pill,  while  the  names 
Granule  and  Parvule  are  given  to  masses  smaller  than  the  average  pill. 

The  Process  of  Pill-making  is  briefly  as  follows :  The  ingredients 
ordered  in  the  prescription  are  separately  weighed  out  in  the  order  of  their 
bulk,  commencing  with  that  one  of  which  the  smallest  quantity  is  to  be 
used.  If  any  require  pulverization  they  should  first  be  placed  in  the  mor¬ 
tar,  and  reduced  to  powder  ;  then  the  other  dry  ingredients,  next  the  soft 
extracts  and  the  excipient  selected,  and  the  whole  is  worked  up  into  a 
mass,  the  Pill-mass ,  by  the  aid  of  the  mortar  and  pestle.  The  perfect 
pill-mass  should  be  uniform  throughout,  should  not  show  any  particles  of 
any  one  ingredient,  should  have  such  a  consistence  that  the  pills  made 
from  it  will  retain  their  shape,  should  not  be  too  hard,  nor  too  dry,  nor 
should  it  stick  to  the  fingers.  The  mortar  should  be  large  and  shallow, 
of  unpolished  wedgewood  ware ;  having  a  thick,  smooth  and  well-formed 
bottom,  and  a  pestle  which  fits  it.  The  operation  of  working  up  the  mass 
is  one  of  kneading  it  between  the  end  of  the  pestle  and  the  side  of  the 
mortar,  and  if  proper  ingredients  and  excipient  are  used,  and  if  the  work 
is  well  done,  the  mass  will  eventually  loosen  itself  from  both  mortar  and 
pestle.  If  it  does  not  do  so  it  should  be  removed  with  a  spatula  when  suf¬ 
ficiently  worked,  and  may  then  be  kneaded  fora  few  minutes  between  the 
fingers.  It  should  then  be  placed  upon  the  tile  or  slab  previously  dusted 
with  a  little  Lycopodium  or  Starch  in  fine  powder,  and  rolled  into  a  long 
cylinder  by  the  aid  of  a  broad-bladed  spatula,  until  the  mass  is  of  a  length 
corresponding  to  the  divisions  on  the  tile-scale  which  represent  the  number 
of  pills  to  be  made.  The  mass  should  then  be  placed  along  the  scale,  and 
a  cut  made  through  it  with  the  spatula  at  each  division  of  the  scale,  the 
pieces  being  at  once  rounded  separately  into  pills  by  the  thumb  and  two 
fingers  of  each  hand.  A  pill-machine  is  often  employed,  consisting  of 
two  metal  plates  having  semicylindrical  grooves  on  one  side,  and  set  into 
wooden  boards,  the  whole  forming  a  convenient  apparatus  for  rolling  the 
mass  and  then  cutting  it  into  the  required  number  of  pills  by  one  move¬ 
ment.  The  pills  are  then  left  to  dry  upon  the  slab  while  the  label  is  being 
written,  after  which  they  are  placed  in  a  pill-box,  or  in  a  wide-mouthed 
bottle  if  they  contain  volatile  ingredients,  and  surrounded  by  a  consperga- 
live  powder  (Lycopodium,  powdered  Chalk,  dusted  Talc),  to  prevent  their 
adhering  together  or  losing  their  shape. 

Excipients  used  in  pill-making  are  seldom  mentioned  in  the  prescrip¬ 
tion,  but  are  usually  left  to  the  choice  of  the  compounder.  Some  sub¬ 
stances  need  no  excipient,  but  may  be  madeat  once  into  pills;  such  being 
the  softer  Extracts  and  some  Gum-resins,  the  former  if  too  hard  only 
needing  a  little  water,  and  the  latter  a  few  drops  of  spirit  to  soften  them 
to  the  required  degree  of  plasticity.  Every  druggist  has  his  favorite  pill- 
excipient,  many  using  a  paste  made  of  powdered  Tragacanth  1,  Glycerin 


46+ 


EXTEMPORANEOUS  PREPARATIONS. 


3^4  and  Water  i  part,  while  others  use  Extract  of  Malt,  or  a  mixture  of 
Syrup  and  powdered  Acacia,  for  general  use.  Powdered  Tragacanth  to 
give  tenacity,  Glycerin  to  keep  the  mass  soft,  and  Water  to  develop  the 
adhesive  qualities  of  many  ingredients,  will  answer  for  fully  nine-tenths 
of  all  the  cases  which  occur  in  practice.  These  three  excipients  should 
stand  on  the  dispensing  counter  ready  for  use,  and  all  ready-made  pastes 
or  mixtures  should  be  discarded,  as  being  slovenly,  dirty  and  liable  to 
change.  The  excipients  described  below  are  those  in  general  use,  and  are 
arranged  in  the  order  of  their  comparative  importance,  viz.  :  — 

Liquid  Excipients. 

Glycerin , — -is  a  very  valuable  excipient,  as  it  continually  attracts  moisture  from  the 
atmosphere,  and  pills  made  from  it  do  not  get  hard.  It  should  be  used  always  for  Qui¬ 
nine  pills.  Glyceriles  of  Starch  or  Tragacanth  are  generally  useful  excipients.  The 
former  is  official,  the  latter  is  made  in  the  proportion  of  g  ss  to  the  . 

Glucose , — is  a  good  excipient,  being  colorless,  adhesive,  and  not  readily  volatilized  at 
ordinary  temperatures.  Since  its  introduction  by  Mr.  Lascheid  for  this  purpose  it  has 
steadily  grown  in  favor. 

Honey , — may  be  used  for  dark-colored  substances.  It  should  be  evaporated  to  one-half 
its  bulk,  and  then  if  mixed  with  a  little  Tragacanth,  it  makes  an  excellent  excipient  for 
insoluble  powders. 

Extract  of  Malt, — is  a  pretty  fair  excipient,  but  has  the  disadvantage  of  its  dark  color. 

Syrup , — is  a  fair  excipient  for  powders,  but  it  should  not  be  used  for  metallic  salts,  espe¬ 
cially  Calomel,  which  it  reduces  in  a  short  time.  Syrup  of  Acacia  is  good  where  there 
is  little  room  left  for  the  excipient,  but  if  kept  too  long,  pdls  made  with  it  become  very  hard 
and  insoluble. 

Mucilage  of  Acacia, — is  very  adhesive,  but  not  a  good  excipient  for  the  same  reason 
as  given  for  the  syrup. 

Water, — is  only  used  alone  as  an  excipient  when  the  ingredients  possess  sufficient  adhe¬ 
siveness  to  be  developed  by  the  water.  Such  are  the  following  powders  :  Aloes,  Rhubarb, 
Kino,  Tannic  Acid,  Opium,  Squill,  Asafetida, — also  Citrate  of  Iron,  Sulphate  of  Ber- 
berine,  etc. 

Alcohol, — is  used  to  soften  Camphor,  Compound  Extract  of  Colocynth,  Guaiac,  resinous 
extracts,  gums,  etc. 

Solid  Excipients. 

Tragacanth, — is  an  excellent  excipient,  especially  for  substances  which  are  too  soft, 
giving  them  body  and  elasticity. 

Acacia, — is  added  to  give  more  adhesiveness  than  can  be  obtained  from  viscid  liquids 
alone.  Pills  made  with  it  are  generally  very  hard.  It  is  used  for  Nitrate  of  Silver,  which 
may  explode  if  mixed  with  vegetable  extracts  or  glucose. 

Soap, — is  the  best  for  resinous  and  fatty  substances,  increasing  the  solubility  of  the  former. 
It  is  more  employed  in  the  official  pills  than  any  other  excipient,  but  should  not  be  used 
for  substances  which  are  decomposed  by  an  alkali,  nor  for  Tartar  Emetic. 

Bread-crumb  (Mica  Panis), — is  an  excellent  excipient  for  Croton  Oil,  or  other  powerful 
liquid  substances,  as  Volatile  Oils. 

Confection  of  Rose, — is  too  bulky  for  general  use,  but  is  a  good  excipient  for  very  active 
agents,  like  Strychnine,  which  are  used  in  small  quantity. 

Althcea, — is  good  for  absorbing  and  adhesive  purposes,  but  is  too  bulky  for  general  use. 

Petrolatum,  Cacao  Butter  and  Resin  Cerate, — are  used  for  oxidizable  substances,  as 
Potassium  Permanganate. 

Kaolin, — is  well  adapted  for  Nitrate  of  Silver,  and  other  substances  which  are  easily 
decomposed. 

Liquorice , — is  an  old  excipient,  but  not  much  employed  now.  In  powder  it  may  be 
used  for  oils. 


Conspergatives, — are  absorbent  powders  which  are  dusted  upon  the 


EXTEMPORANEOUS  PREPARATIONS. 


465 


finished  pills  and  put  around  them  in  the  box  or  vial  in  which  they  are 
dispensed,  to  keep  them  from  sticking  together  and  losing  their  shape. 
Powdered  Liquorice  was  formerly  much  used  for  this  purpose,  but  the  best 
conspergatives  are  Lycopodium ,  Talc ,  Altlicea,  and  Rice  Flour ,  the  latter 
especially  for  white  pills. 

Substances  Suitable  for  the  pilular  form  of  medicine  are  the  follow¬ 
ing:— 

Those  acting  in  small  doses.  Heavy,  insoluble  substances. 

Those  intended  to  act  slowly.  Fetid  substances. 

Those  to  act  on  the  lower  bowel.  Vegetable  extracts. 

Gum-resins,  Balsams,  Turpentine. 

When  the  basis  is  an  unadhesive  substance,  one  of  the  other  ingredients 
should  be  an  extract  or  a  vegetable  powder,  which  will  form  a  mass  by 
moisture  alone.  Attention  to  this  rule  in  prescribing  pills  will  often  pre¬ 
vent  the  increase  of  their  size  by  inert  excipients. 

Difficult  substances  to  combine,  except  by  peculiar  treatment,  are 
met  with  frequently.  The  following  notes  will  cover  most  of  these  cases :  — 

Aloes, — is  best  treated  on  a  heated  slab  with  alcohol  in  very  small  quantity.  Soap  is 
the  excipient  in  the  official  Pilulae  Aloes. 

Butyl  Chloral  Hydrate, — should  be  treated  with  a  little  Confection  of  Rose  and  thick 
mucilage. 

Calcium  Sulphide, — should  be  well  triturated  with  an  equal  quantity  of  Sugar  of  Milk, 
and  then  worked  up  with  a  little  powdered  Liquorice-root  and  Tragacanth  Mucilage. 

Camphor, — should  be  powdered  with  a  little  alcohol,  and  may  be  worked  into  a  pill- 
mass  with  Glycerite  of  Tragacanth  after  the  evaporation  of  the  alcohol. 

Carbolic  Acid, — requires  nearly  an  equal  part  of  wheaten  flour  or  bread-crumb,  with  a 
very  minute  quantity  of  Glycerite  of  Tragacanth.  Creasote  may  be  made  into  a  mass  by 
the  addition  of  powdered  Liquorice  with  a  very  little  bees’  wax.  If  made  into  a  pill  with 
Oxide  of  Silver  it  will  explode  unless  the  silver  salt  be  first  diluted  by  trituration  with 
Liquorice,  Gentian  or  some  other  inert  powder. 

Citrate  of  Iron  and  Quinine, — is  very  deliquescent  with  most  excipients.  Canada  Bal¬ 
sam  is  the  best  for  it. 

Copaiba, — may  be  made  into  pill- mass  by  the  addition  of  a  little  Carbonate  of  Magne¬ 
sium  or  Wax. 

Croton  Oil , — is  best  worked  up  with  bread-crumb,  though  powdered  Liquorice  and 
mucilage  may  be  used. 

Ferrum  Iodide, — in  pill  form  requires  special  manipulation  and  protection  to  remain 
unoxidized.  The  official  Pil.  Ferri  Iodidi  is  prepared  with  Iodine  and  Reduced  Iron,  has 
Liquorice,  Sugar  and  Acacia  as  excipients,  and  is  protected  by  a  coating  of  Balsam  of 
Tolu  (see  ante,  page  216).  In  other  formulae,  Acacia,  Althaea,  Cocoa-butter,  Elm-bark 
and  Liquorice  are  used  as  excipients. 

Ferri  Sulphas, — is  used  in  Blaud’s  Pill  and  in  the  official  Pil.  Ferri  Compositae,  with 
Carbonate  of  Potassium,  to  form  by  mutual  decomposition  Ferrous  Carbonate,  which 
quickly  passes  into  the  ferric  salt  by  exposure.  Myrrh  in  powder  and  Syrup  are  the  ex¬ 
cipients  used  for  the  official  pill. 

Gallic  Acid , — makes  a  good  pill  with  a  very  small  quantity  of  Glycerin.  Tannic  Acid 
requires  about  one-fifth  its  weight  of  Glycerin  and  one-tenth  of  Mucilage. 

Phosphorus, — presents  the  problem  of  combining  it  in  pill  without  letting  it  oxidize. 
This  is  believed  to  be  accomplished  by  the  pharmacopoeial  directions  for  the  Pil.  Phos- 
phori,  according  to  which  the  Phosphorus  is  dissolved  in  Chloroform  in  a  test-tube,  then 
quickly  worked  into  a  mass  with  Althaea,  Acacia,  Glycerin  and  Water,  and  finally  the 
pills  are  coated  by  shaking  with  an  Ethereal  solution  of  Balsam  of  Tolu.  Carbon  Bisul¬ 
phide  is  a  better  solvent,  but  when  it  is  used  the  pill-mass  retains  its  disgusting  odor. 

30 


466 


EXTEMPORANEOUS  PREPARATIONS. 


Potassium  Acetate , — requires  Canada  Balsam  to  secure  its  stability  in  pill  form.  Potas¬ 
sium  Iodide  is  best  manipulated  by  rubbing  into  a  smooth  paste  with  a  very  little  water, 
then  adding  a  small  quantity  of  Liquorice  powder.  Potassium  Permanganate  should  be 
worked  up  with  kaolin  and  a  very  little  water.  Resin  Cerate,  Soft  and  Hard  Paraffin 
and  Cacao-butter  are  also  used  as  its  excipients. 

Quinine , — requires  very  clean  hands  and  tools,  and  a  colorless  excipient,  as  Glycerin 
or  Glucose,  to  make  a  nice-looking  pill.  If  one  part  of  Tartaric  Acid  is  added  to  four  of 
the  Quinine  salt  the  mass  will  be  less  likely  to  crumble  and  will  be  of  less  bulk.  Sul¬ 
phate  of  Quinine  may  be  made  into  small  and  soluble  pills  by  simply  triturating  it  with 
Aromatic  Sulphuric  Acid  rtpiij  to  each  5  grains  of  the  salt.  The  moulding  into  pills 
should  be  done  at  the  moment  when  the  mass  has  begun  to  dry.  A  drop  of  syrup  or 
honey,  added  at  this  time,  will  prevent  the  too  rapid  hardening  of  the  mass. 

Rhubarb, — in  powder  makes  a  good  mass  with  one-fifth  of  its  weight  of  Glycerin;  but 
Soap  is  the  excipient  ordered  for  the  official  Pilulse  Rhei. 


Substances  Unsuited  to  the  pilular  form  are:  — 

Those  requiring  large  doses,  and  those  which  are  volatile. 

Emetics,  and  other  agents  administered  for  immediate  effect. 

Essential  Oils  in  quantity  exceeding  half  a  drop  to  each  pill. 

Oils  and  other  bodies  which  require  much  solid  matter  to  make  a  mass; 

except  those  having  a  very  small  dose,  as  Croton  Oil. 

Deliquescent  Salts,  unless  intended  to  be  used  immediately. 

Efflorescent  Salts,  unless  deprived  of  their  water  of  crystallization. 


Deliquescent  Salts. 

Ammonii  Iodidum. 

■ - Nitras. 

- Valerianas. 

Auri  Chloridum. 

Calcii  Chloridum. 

Chinoline  Salts,  except  the  Tartrate,  which 
is  stable. 

Lithii  Citras. 

-  Bromidum. 

- Salicylas. 

Magnesii  Citras. 

Potassa. 

- cum  Calce. 

Potassii  Acetas. 

-  Carbonas. 

- Citras. 

- Cyanidum. 

-  Hypophosphis. 

- Sulphis. 

- Tartras. 

Sodii  Hypophosphis. 

-  Iodidum. 

Zinci  Bromidum. 

- Chloridum. 

-  Iodidum. 


Efflorescent  Salts. 

Alumen  (slightly). 

Ammonii  Carbonas. 

-  Phosphas. 

Ant.  et  Potass.  Tartras  (slightly) . 
Cupri  Acetas. 

-  Sulphas. 

Magnesii  Sulphas  (slightly). 
Potassii  et  Sodii  Tartras  (slightly). 

-  Ferrocyanidum  (slightly). 

Quininse  Bisulphas. 

- Sulphas  (after  a  time). 

Soda. 

Sodii  Acetas. 

- -  Arsenias  (slightly). 

- Benzoas. 

-  Boras  (slightly). 

-  Carbonas. 

-  Hyposulphis. 

-  Phosphas. 

-  Santoninas  (slightly). 

- Sulphas. 

- Sulphis. 

Strychninae  Sulphas. 

Zinci  Acetas. 

- Sulphas. 


Coated  Pills  are  manufactured  upon  a  large  scale  by  the  large  drug 
houses,  extensive  machinery  being  employed  for  the  purpose.  The  coat¬ 
ing  material  used  is  either  Sugar  or  Gelatin.  The  U.  S.  Pharmacopoeia 
directs  that  two  of  the  official  pills  shall  be  coated  by  being  shaken  with 
a  solution  of  Balsam  of  Tolu  in  Ether,  viz. — Pil.  Ferri  Iodidi  and  Pil. 


EXTEMPORANEOUS  PREPARATIONS. 


467 


Phosphori.  In  extemporaneous  pharmacy  it  is  rarely  practicable  to  coat 
pills  with  anything  except  gold  or  silver  leaf,  and  this  is  sometimes  directed 
by  the  prescribes  the  word  “  Deaurenter — let  them  be  gilded”  being 
used  in  the  subscription.  To  do  this  neatly  the  pills  should  have  no  trace 
of  powder  on  them,  but  should  be  first  coated  with  a  trifle  of  fresh  mucilage 
by  rolling  between  the  mucilage-moistened  fingers,  each  pill  being  then 
dropped  directly  on  to  a  sheet  of  gold  or  silver  leaf,  until  a  dozen  or  more 
are  so  deposited.  The  leaf  and  its  pills  are  then  allowed  to  slide  into  a 
globular  boxwood  shaker,  or  the  leaf  may  be  first  placed  in  the  shaker  and 
the  pills  dropped  on  it  there.  A  cautious  circular  movement  being  given 
to  the  shaker  the  pills  are  caused  to  travel  around  its  walls,  and  when  the 
cover  is  removed  they  will  be  found  to  have  each  received  an  even  coat¬ 
ing  of  the  metal  used.  Gold  leaf  should  always  be  employed  for  pills  of 
Blue  Mass  or  Asafetida,  as  silver  is  amalgamated  with  the  former  and 
turned  black  by  the  latter. 

Albumen  may  be  used  for  coating  small  numbers  of  pills,  which  should  be  of  very  firm 
consistence  before  the  coating  is  applied.  Each  pill  is  rolled  between  two  fingers  with  a 
little  white  of  egg,  and  then  revolved  in  a  warm  pan.  Another  method  of  finishing  them 
is,  after  coating  with  albumen,  to  rotate  them  in  a  tray  with  powdered  French  chalk  until 
their  surfaces  become  smooth  and  shiny.  When  carefully  done  this  process  gives  a  very 
nice  finish. 


Compressed  Pills,  as  now  largely  manufactured  by  several  reliable 
firms,  consist  of  various  medicinal  powders  pressed  into  pill  or  tablet  shape 
by  machinery.  They  are  extremely  convenient  preparations  for  the  phy¬ 
sician’s  use,  as  quite  a  variety  can  be  carried  in  a  pocket-case,  and  as  slight 
pressure  is  sufficient  to  reduce  them  to  powder,  they  can  be  dispensed  with 
facility  and  accuracy  of  dosage.  Messrs.  John  Wyeth  &  Brother,  of  Phila¬ 
delphia,  manufacture  a  very  extensive  line  of  these  pills,  including  nearly, 
all  those  put  up  in  the  sugar-coated  or  gelatin-coated  form  by  other  houses. 
The  trade-list  of  this  firm  should  be  in  the  hands  of  every  physician  who 
keeps  a  small  stock  of  medicines  in  his  office,  or  who  carries  a  pocket-case 
of  drugs.  The  following  list  includes  the  most  important  of  these  prepa¬ 
rations,  the  figures  representing  the  number  of  grains  in  a  pill  in  each 
case. 

Acid,  Arsenious,  fa,  fa,  3V’  2V 

- Benzoic,  5. 

- Gallic,  5. 

- Salicylic,  2 y2,  5. 

- Salicylic,  2^,  and  Morphine  fa. 

- Tannic,  2,  5. 

Aconitina,  fa. 

Aloes,  2.  Aloes  et  Ferri  (U.  S.  P.). 

Aloes  2,  et  Myrrh  1. 

Aloes  et  Rhei  et  Gentian 
Aloin,  yf.  ]/2. 

Ammonium  Bromide,  5,  10. 

Ammonium  Chloride,  3,  5,  10. 


Atropine,  fa. 

Bismuth  Subcarb.,  5. 

- Subnitrate,  5,  10. 

Borax,  5. 

Caffeine  Citrate,  I. 

Calcium  Sulphide,  y1^,  X?  X>  1. 

Calomel,  X>  X>  G  2>  3>  5- 
Calomel  2,  Opium  1. 

Camphor  Monobromated,  2,  3,  5. 
Cathartic  Comp.  (U.  S.  P.)  and  Imp’ved. 
Cerium  Oxalate,  2. 

Cinchona  Alkaloids  (Mixed). 

Cinchonine  Sulphate,  2,  3,  4,  5. 


468 


EXTEMPORANEOUS  PREPARATIONS. 


Cinchonidine  Sulphate,  2,  3,  4,  5. 
Codeine,  y. 

Digitaline,  f0. 

Extract  of  Cannabis  Indica,  y. 

Extract  of  Ignatia  Amara,  y,  ]/2. 
Extract  of  Nux  Vomica,  y,  y. 
Ferrum  (Quevenne’s),  I,  2. 

Ferrum  Arseniate,  y,  y. 

-  Proto-carb.,  3,  5. 

- Lactate,  1. 

- Pyrophosphate,  2. 

- and  Quinine  Citrate,  2,  3,  5. 

Hydrargyrum,  I,  3,  5. 

Chlor.  Corros.,  4*0  >  2V  tV* 

-  Iod.  Rub.,  3L,  tl 

-  Proto-Iodide,  TXo,  Ve,  K* 

Ipecac,  et  Opii,  2,  3,  5. 

Morphine  Sulphate,  yL-,  y,  l/e,  y,  y. 
Opium  Deodorized,  1. 

Opium  y,  and  Lead  Acetate  I  y. 


Pepsin  Sacch.,  2,  5. 

Podophyllin,  y,  y ,  1^,  1,  2. 
Potassium  Bromide,  5,  10. 

-  Chlorate,  5. 

-  Iodide,  5. 

-  Nitrate,  5. 

— - Permanganate,  X/Zi  1,  2. 

Quinine  Bisulphate,  I,  2,  3,  4,  5. 

-  Salicylate,  2. 

- -  Sulphate,  I,  2,  3,  4,  5. 

Quinquinine,  2,  3. 

Rhubarb  3.  Rhei  Co.  (U.  S.  P.). 
Rhei  2,  et  Magnesiae,  2. 

Salicin,  2^,  5. 

Santonin,  1. 

Santonin  1,  et  Calomel  1. 

Sodium  Bicarbonate,  5. 

-  Salicylate,  3,  5. 

Strychnine,  T^,  up  to 
Zinc  Phosphide,  yE  up  to 


The  following  prescriptions  represent  the  composition  of  a  few  unoffi¬ 
cial  pills  in  general  use.  A  complete  pill  formulary  is  easily  obtained, 
being  published  annually  by  each  of  the  principal  manufacturers. 


Pills  of  Iron. 

be  .  Ferri  Reducti, . gr.  1. 

Mannae, . gr.  xv 

Glucosi,  q.  s. 

Fiat  massa,  et  div.  in  pil.  xxv. 

Sig. — One  after  each  meal. 


Emtnenagogue  Pill  (  Otto ). 

pc .  Ferri  Sulph.  Exsic.,  .  .  .  gr.  xlviij. 

Pulv.  Aloes, . gr.  xij. 

Terebinthinae, . gr.  xxxij. 

01.  Terebinth., . rrpx. 

Fiat  massa,  et  div.  in  pil.  xxx. 

Sig. — Two,  three  times  a  day. 


Hooper' s  Female  Pills. 

bt.  Pulv.  Aloes  Socot.,  .  .  .  gr.  xlviij. 
Ferri  Sulph.  Exsic.,  .  .  .  gr.  xxiv. 
Ext.  Hellebori  Nig., 

Pulv.  Myrrhae, 

Saponis, . aa  gr.  xij. 

Pulv.  Canellae  Alb., 

Pulv.  Zingiberis,  .  .  .  aa  gr.  vj. 
Aquae  vel  Syrupi,  q.  s. 

Fiat  massa,  et  div.  in  pil.,  quisque  pondo 
gr.  ijss. 

Sig. — One  to  three  at  a  dose. 


Anaphrodisiac  and  Sedative. 


B  .  Camphorae . gr.  xxx. 

Lupulini,  .  .  .  .  .  .  .  .  gr.  xx. 


Fiat  massa,  et  div.  in  pil.  xx. 
Sig. — One  thrice  daily. 


Astringent  Pill. 

1£  .  Plumbi  Acetatis . gr.  xvj„ 

Pulv.  Camphorae, . gr.  xij. 

Pulv.  Opii, . .  .  .  gr.  iij. 

Bismuthi  Subcarb.,  .  .  .  .  gr.  xij. 
Ext.  Gentiance,  q.  s. 

Fiat  mass,  et  div.  in  pil.  xij. 

Sig. — One  thrice  daily. 


Astringent  Pill. 

be .  Argenti  Nitratis, . gr.  xx. 

Pulv.  Cretae  (Gallicae),  .  .  gr.  lxxx. 
Petrolati,  q.  s. 

Fiat  massa,  et  div.  in  pil.  xl. 


Cholagogue  Pills  (Squibb). 

be .  Resinae  Podophylli,  .  .  .  .  gr.  vj. 
Ext.  Belladon.  Alcohol,  .  .  gr.  iij. 
Pulv.  Capsici, 

Pulv.  Sacch.  Lactis,  .  .  aa  gr.  xxiv. 

Pulv.  Acaciae, . gr.  vj. 

Glycerini  Syrupi,  q.  s. 

Fiat  massa,  et  div.  in  pil.  xxiv. 

Sig. — One  or  two  as  required. 


Aperient  Pills. 

R .  Pulv.  Aloes  Socot.,  .  .  .  gr.  xxiv. 

Pulv.  Rhei . gr.  xlviij. 

Hydrarg.  Chlor.  Mitis,  .  .  gr.  iv. 
Ant.  et  Potas.  Tart.,  .  .  .  gr.  ij. 
Fiat  massa,  et  div.  in  pil.  xxiv. 

Sig. — One  or  two  as  needed. 


EXTEMPORANEOUS  PREPARATIONS. 


469 


Tonic  Pill  for  Women. 

B*  Strychninae  Sulph., 

Ac.  Arseniosi,  .  .  .  .  aa  gr.  j. 
Ext.  Belladonnas,  .  .  .  .  gr.  v. 

Quininae  Sulph., . gr.  xxxv. 

Massae  Ferri  Carb.,  .  .  .  gr.  xc. 
Fiat  massa,  et  div.  in  pil.  xxxv. 

Sig. — One  three  times  daily. 


Anti-bilious  Pills. 

B  .  Pulv.  Scammonii, 

Pulv.  Aloes  Socot., 

Pulv.  Gambogiae, 

Hydrarg.  Chlor.  Mitis, 

Potass.  Bitart.,  .  .  ,  .  aa  gr.  xx. 
Ext.  Taraxaci,  q.  s. 

Fiat  massa,  et  div.  in  pil.  xx. 


Gelatin  Capsules  are  to  be  obtained  from  the  drug  stores,  of  various 
sizes  from  o  to  10.  They  are  a  convenient  means  of  administering  oils  or 
nauseous  solids,  and  when  filled  may  be  swallowed  as  easily  as  a  large  pill. 
By  some  of  the  manufacturers  Soluble  Elastic  Capsules  are  prepared,  each 
containing  an  ordinary  dose  of  such  medicines  as  Castor  Oil,  Cod-liver 
Oil,  etc.  The  largest  of  these  capsules  makes  a  bolus  which  may  be  swab 
lowed  with  a  little  effort,  as  it  is  quite  compressible  and  changes  its  shape 
to  suit  the  calibre  of  the  passage.  The  ordinary  capsules  are  easily  filled 
by  the  aid  of  a  paper  funnel,  and  the  end  of  a  pen-holder  as  a  packer  ; 
but  simple  devices  (< capsule-fillers )  may  be  obtained  for  the  purpose  of 
facilitating  the  operation. 

B  .  Pulv.  Opii, . gr.  x. 

Pulv.  Camphorae,  .  .  .  .  gr.  xx. 

Sacch.  Alb.,  q.  s. 

Trit.,  et  fiant  capsulae  x. 

Sig. — One  at  bedtime  for  chordee  ;  re¬ 
peat  in  two  hours  if  necessary. 


B  .  Copaibae, . 3  iss. 

Oleo-resinae  Cubebae,  ...  3  ss. 

M.,  et  fiant  capsulae  xij. 

Sig. — Two  capsules  three  times  daily, 
soon  after  meals,  for  gonorrhoea. 


Troches  (Trochisci), — also  named  Tablets,  Pastilles,  Lozenges,  etc., 
and  Compressed  Pills,  are  not  readily  compounded  at  the  dispensing 
counter,  but  may  be  obtained  in  all  first-class  shops,  being  prepared  in 
great  variety  by  the  manufacturers.  Besides  the  official  Troches  (see 
ante ,  page  431),  those  named  in  the  following  list  are  generally  for  sale  : — 


Troches  ( 

Alum,  gr.  ij. 

Alum  gr.  1^4,  Catechu  gr.  ij. 

Ammonium  Chloride  gr.  ij,  and  Cubebs 

gr- j- 

Ammon.  Chlor.  gr.  ij,  Liquorice  gr.  viij. 
Benzoic  Acid,  gr.  y2. 

Borax,  gr.  iij. 

Bismuth,  gr.  ij,  and  Charcoal,  gr.  v. 
Bronchial, — 01. -res.  Cubebs,  gr.  4,  Tolu, 
gr.  L  01.  Sassafras,  gr.  j1^,  and  Ext.  of 
Liquorice,  gr.  vij. 

Brown  Mixture. 

Carbolic  Acid,  gr.  j. 


Lozenges .) 

Ginger  and  Sodium  Bicarb. 

Guaiac.,  gr.  ij. 

Kino,  gr.  ij. 

Lettuce,  gr.  j. 

Lime-juice. 

Logwood,  gr.  ij. 

Magnesia,  gr.  iij. 

Pellitory,  gr.  j. 

Pepsin,  gr.  iij.  Charcoal,  gr.  iij,  Magnesia, 
gr.  ij,  and  Ginger,  gr.  j. 

Potassium  Bitartrate,  gr.  iij. 

Potassium  Citrate,  gr.  iij. 

Santonin,  gr.  y,  and  Calomel,  gr.  l/2. 


470 


EXTEMPORANEOUS  PREPARATIONS. 


Compressed  Tablets . 

Ammonium  Chloride,  gr.  iij. 

Charcoal,  gr.  x. 

Cocaine  Hydrochlorate. 

Dover’s  Powder. 

Mercury,  Yellow  Oxide,  gr.  ^1^. 

Pepsin  and  Pancreatin. 

Potassium  Bicarb.,  gr.  v. 

Potassium  Chlorate,  aa  gr.  v. 

Potas.  Chlorate  and  Borax,  gr.  2j4- 
Potas.  Chi.  and  Ammon.  Chloride. 
Spencer’s  Chloramine  Pastilles. 

Sodium  Bicarb.,  gr.  iv,  Ammon.  Carb.,  gr. 
01.  Menth.  Pip.,  gtt. 


Compressed  Tablets. 

Sodium  Salicylate,  gr.  iij. 

Antiseptic.  Hydrarg.  Chlor.  Corr.,gr.  vijss. 
Fehhng’s  Test  for  grape-sugar  in  the  urine. 

Hypodermic  Tablets. 

Morphine  Sulphate,  gr.  to  ]/z. 

Morph.  Sulph.  and  Atropine  Sulph. 
Atropine  Sulphate,  gr.  40V 
Strychnine  Sulphate,  gr. 

Apomorphine  Muriate,  gr.  ^ ,  TE. 
Pilocarpine  Muriate,  gr.  /i- 
(And  several  others.) 


Confections  (Confectiones),  and  Electuaries  (Electuaria), — are 
very  seldom  prescribed,  and  therefore  can  have  but  little  place  in  extem¬ 
poraneous  pharmacy.  They  are  medicinal  powders,  etc.,  beaten  up  with 
sugar,  honey  or  molasses,  to  the  consistence  of  a  thick  paste,  and  are 
administered  with  a  spoon  like  preserved  fruits.  The  two  official  con¬ 
fections  are  described  on  page  431,  and  a  few  old  formulae  for  similar 
preparations  are  given  below  as  pharmaceutical  curios.  .  The  first  is  a 
meritorious  prescription. 


Electuary  for  Piles. 

R .  Potassii  Bitartratis, 

Potassii  Nitratis, 

Pulv.  Jalapae, . aa  5  ss. 

Confectio  Sennae,  .  .  .  ^j. 

Syrupi  Zingiberis,  q.  s. 

M.  Fiat  electuarium. 

Sig. — A  piece  the  size  of  a  marble  to  be 
taken  thrice  daily. 


The  Chelsea  Pensioner. 

R  .  Sulphuris  Loti, . 3  ij. 

Potassii  Bitart., . J j. 

Pulv.  Rhei, . %  ij. 

Guaiaci  Resinje, . ^j. 

Mellis  Despum., . tbj. 

Myristicam  Pulv.,  .  .  .  .  j. 

M.  Fiat  electuarium. 

Sig. — A  dessertspoonful  twice  daily,  as 
a  laxative  in  chronic  rheumatism. 


Confectio  Damocratis. 

[An  ingredient  of  Warburg’s  Tincture.] 

This  preparation  was  official  in  the  London  Pharmacopoeia  of  1745.  It  contained  I 
grain  of  Opium  in  ^ss,  and  consisted  of  45  ingredients,  as  follows,  viz.  :  Cinnamon,  14 
parts;  Myrrh,  11  parts; — White  Agaric,  Spikenard,  Ginger,  Spanish  Saffron,  Treacle, 
Mustard  Seed,  Frankincense  and  Chian  Turpentine,  of  each  10  parts; — Camel’s  Hay, 
Costus  Arabacus,  Zedoary,  Indian  leaf,  Mace,  French  Lavender,  Long  Pepper,  Seeds  of 
Harwort,  Juice  of  ripe  Cistus,  strained  Storax,  Opponex,  strained  Galbanum,  Balsam  of 
Gilead,  Oil  of  Nutmeg,  Russian  Castor,  of  each  8  parts; — Water  Germunder,  Balsam-tree 
Fruit,  Cubeb,  White  Pepper,  Seeds  of  Cretian  Carrot,  Poley  Mont,  strained  Bdellium,  of 
each  7  parts; — Gentian-root,  Celtic  Hard,  Leaves  of  Dittany  of  Crete,  Red  Rose,  Seeds 
of  Macedonium,  Parsley,  Sweet  Fennel  Seeds,  Seeds  of  Lesser  Cardamom,  Gum  Arabic, 
Opium,  of  each  5  parts; — Swreet  Flag,  Wild  Valerian,  Anise  seed,  Sagapenum,  of  each 
3  parts ;  Spigrul,  St.  John’s  Wort,  Juice  of  Acacia,  Catechu,  Dried  Bellies  of  Skunk,  of 
each  2 yz  parts; — the  roots  finely  powdered  and  the  whole  mixed  thoroughly  into  a  paste 
with  Clarified  Honey. 


Powders  (Pulveres), — as  prepared  extemporaneously  are  generally 
compound,  and  may  be  mixed  on  a  slab  with  a  spatula,  but  a  much  better 


EXTEMPORANEOUS  PREPARATIONS. 


471 


method  of  mixing  them  is  by  trituration  in  a  mortar.  The  latter  should 
always  be  employed  except  in  the  case  of  substances  which  may  explode 
if  so  treated,  as  Potassium  Chlorate  with  oxidizable  substances.  (See 
a?ite,  page  449.)  The  Diluent  best  employed  in  powders  is  Sugar  of  Milk,  * 
on  account  of  its  hardness,  its  density  and  its  comparative  insolubility. 

A  coloring  agent,  as  Carmine  in  minute  quantity,  is  a  useful  ingredient, 
enabling  the  eye  to  judge  of  the  degree  of  mixing  and  subdivision  ob¬ 
tained.  Powders  containing  soluble  salts,  extracts,  volatile  oils,  camphor, 
or  any  other  hygroscopic  or  volatile  substances,  should  be  dispensed  in 
waxed  paper.  For  ordinary  powders  the  plain  white  paper  of  the  drug 
stores  will  answer,  but  a  better  paper  for  small  powders  is  one  having  a 
high  surface  finish  and  made  very  thin,  as  the  white  glazed  French  demy. 
Powders  are  often  ordered  in  Wafers  (Cachets),  to  be  swallowed  without 
unfolding.  The  division  of  powders  into  the  number  of  papers  ( Char - 
tulce)  ordered,  and  folding  them  neatly,  requires  a  considerable  amount 
of  practice.  A  small  machine  is  used  over  which  the  ends  of  the  papers 
are  bent,  in  order  to  have  them  of  the  proper  size  for  the  box  in  which 
they  are  usually  dispensed.  If  they  are  to  be  put  into  an  envelope  less 
exactness  of  folding  is  required,  and  the  mechanical  contrivance  may  be 
dispensed  with. 

Substances  suitable  to  administration  in  the  form  of  powders  are  those 
which  are  insoluble,  those  which  would  be  chemically  incompatible  in  fluid 
form,  and  certain  pulverizable  extracts.  Those  which  are  unsuited  to  this 
form  are  such  as  have  a  very  nauseous  taste  or  odor,  substances  of  which 
the  dose  is  large,  those  which  are  deliquescent,  efflorescent  or  very  vola¬ 
tile,  and  those  which  liquefy  on  mixing.  A  list  of  deliquescent  and  efflo¬ 
rescent  salts  is  found  on  page  466,  while  the  following  named,  though 
dry  alone,  become  moist  when  triturated  together,  viz:  — 

Sodium  Sulphate  and  Potassium  Carbonate. 

Zinc  Sulphate  and  Lead  Acetate. 

Camphor  and  Chloral  Hydrate. 

Many  substances  cannot  be  powdered  without  the  intervention  of  another 
body  :  thus  Opium  requires  a  hard  substance  like  Sugar  of  Milk  or  Potas¬ 
sium  Sulphate,  Camphor  requires  a  minute  quantity  of  Alcohol,  Myrrh, 
needs  Sugar  or  Gum,  etc.  Substances,  as  the  alkaloids  and  their  salts, 
which  are  very  active  and  are  used  in  very  small  doses,  require  some 
inert  substance  to  give  them  bulk  enough  for  division  and  handling. 
Sugar  of  Milk  will  be  found  the  best  agent  for  this  purpose.  Prescrip¬ 
tions  may  order  the  ingredients  for  a  single  powder,  with  directions  to 
dispense  a  certain  number  of  the  same  composition  ;  or  they  may  give  the 
quantities  for  the  whole  number  of  powders  ordered,  with  instructions  to 
divide  into  a  certain  number.  The  dispenser  should  carefully  scan  the 
prescription  in  order  to  avoid  the  multiplication  of  quantities  where  divi- 


472 


EXTEMPORANEOUS  PREPARATIONS. 


sion  is  intended.  The  official  powders  are  enumerated  on  page  431  ;  and 
the  following  formulae  will  serve  to  illustrate  those  generally  prescribed  : — 


Astringent  Powder  for  Infants. 

R .  Plumbi  Acetatis, . gr.  ij. 

Pulveris  Opii, . gr.  ss. 

Camphorse, . gr.  j. 

Sacchari  Lactis, . gr.  iij. 

Trit.  et  div.  in  chartulas  xij. 

Sig. — One  every  2  or  3  hours  in  diar¬ 
rhoea  of  infants.  For  an  adult  the  above 
represents  one  dose. 


Gastric  Sedative. 

R.  Bismuthi  Subnitratis,  .  .  .  ^j. 
Pulveris  Rhei, 

Pulveris  Aromat . aa  3  ss. 

M.,  et  div.  in  chartulas  vj. 

Sig. — One  before  each  meal. 


Laxative  Powder. 

R .  Hydrarg.  Chlor.  Mitis,  .  .  gr.  x. 

Sacchari  Lactis, . gr.  xx. 

M.,  et  fiant  pulv.  x. 

Sig. — One  powder  twice  daily. 


Bismuth  and  Soda. 


R .  Bismuthi  Subnitratis, 

Sodii  Bicarb., . aagij. 

Pulv.  Zingiberis, . gr.  xl. 


M.,  et  div.  in  chartulas  xij. 

Sig. — One  after  each  meal. 

Corrective  in  dyspepsia,  acne  and  eczema. 


A  ntipruritic  Powder. 

R.  Pulveris  Camphorae,  .  .  .  gj. 


ZinciOxidi, . 3  iv. 

Pulv.  Amyli, . ^j. 


M.,  et  fiat  pul  vis. 

Sig.  — Use  locally  as  a  dusting  powder  to 
relieve  itching. 


Catarrh  Powder. 

R  .  Bismuthi  Subnitratis,  ...  3  iij. 

Pulv.  Acacise, . gij. 

Pulv.  Talc., . 3  ij. 

Morphines  Muriatis,  .  .  .  gr.  j. 

M.  Sig. — Use  by  insufflation. 


Compressed  Pills  are  really  powders  which  have  been  compressed  into 
pill  shape  by  machinery.  A  little  pressure  from  the  blade  of  a  spatula  will 
restore  them  to  powder  form.  (See  ante,  page  467.) 


Triturations  (Triturationes), — are  powders  containing  minute  doses 
of  very  active  agents  diluted  with  Sugar  of  Milk,  and  possessing  a  definite 
relation  between  the  active  ingredient  and  the  diluent,  namely,  1  in  10, 
according  to  the  general  formula  of  the  U.  S.  Pharmacopoeia,  which,  as 
well  as  the  one  official  trituration,  is  described  on  page  432.  Sugar  of 
Milk  is  employed  as  the  diluent  because  of  its  hardness  and  its  compara¬ 
tive  insolubility.  The  first  of  these  qualities  secures  the  fine  comminu¬ 
tion  of  the  active  ingredient  whereby  the  action  of  the  medicine  is 
increased  and  better  distributed.  Its  insolubility  makes  it  the  best 
diluent  for  powders  or  triturations  administered  from  a  spoon  or  glass 
with  fluid,  as  is  so  often  done,  for  unlike  cane  sugar  it  is  not  readily  dis¬ 
solved  and  does  not  leave  the  active  substance  behind  on  the  surface  of 
the  utensil.  Triturations  are  excellent  forms  for  the  administration  of 
powerful  alkaloids,  which  may  thus  be  divided  with  great  accuracy  into 
the  minute  quantities  required.  Mercury  and  its  salts  are  especially 
adapted  to  this  method  of  preparation,  being  more  uniformly  divided 
and  hence  more  active  than  when  administered  in  any  other  form. 
Triturations  of  mercury  with  sugar  were  commonly  used  in  England  a 


EXTEMPORANEOUS  PREPARATIONS. 


473 


hundred  years  ago,  and  triturations  of  many  substances  were  employed 
by  the  Arabian  physicians  of  the  13th  century.  But  the  subsequent 
adoption  of  these  preparations  by  the  homoeopathists  produced  such  a 
prejudice  against  them  in  the  ranks  of  the  regular  profession  that  until 
recently  any  one  using  them  stood  in  danger  of  being  stigmatized  as  a 
homoeopath.  Their  recent  recognition  by  the  U.  S.  Pharmacopoeia 
under  their  proper  title  does  away  with  any  such  implication,  though  it 
is  much  to  be  regretted  that  the  compilers  of  the  last  revision  of  the 
British  Pharmacopoeia  should  have  shown  their  fear  of  a  name  by  con¬ 
tinuing  the  title  “  Pul  vis  Elaterini  Compositus  ”  to  designate  a  prepara¬ 
tion  which  in  every  respect  is  a  trituration.  The  preparations  of  Pepsin 
daily  prescribed  by  physicians  all  over  the  country  are  really  sugar-of- 
milk  triturations  of  that  ferment,  and  not  pure  Pepsin  as  many  suppose. 
Prof.  H.  G.  Piffard,  Med.  Dept.  Univ.  of  the  City  of  New  York,  in  his 
treatise  on  the  Materia  Medica  and  Therapeutics  of  the  Skin  (N.  Y. , 
1881),  after  detailing  several  microscopical  examinations  of  pills  and 
triturations,  uses  the  following  language:  — 


“  It  is  to  be  expected,  .therefore,  that  the  protoiodide  trituration  will  prove,  ceteris 
paribus ,  more  active  than  the  pill,  and  such  we  have  found  it.  .  .  .  Iodides  of  Mercury 
....  Since  we  have  used  the  triturations,  however,  in  preference  to  the  ordinary  pills, 
patients  more  rarely  complain  of  disagreeable  sensations.  We  have  been  enabled  to 
materially  reduce  the  size  of  the  dose  in  order  to  obtain  the  desired  effect.  In  other 
words,  a  larger  proportion  of  the  drug  is  utilized  f<  r  specific  purposes,  while  but  a  small 

amount  remains  to  give  rise  to  local  irritation . I  have  nothing  to  add  to  this, 

except  that  I  continue  to  use  triturations  of  Mercury  and  other  substances  with  increasing 
satisfaction.  Beside  those  mentioned  I  employ  Calomel,  Cyanide  of  Mercury,  Black 
Oxide  of  Mercury  and  Corrosive  Sublimate  in  this  form.” 

The  following  examples  will  illustrate  the  mode  in  which  Triturations 
may  be  prescribed  :  — 


R .  ITydrarg.  Oxidi  Flavi,  .  .  .  gr.  ss. 

Sacchari  Lactis, . gr.  1. 

Trit.,  et  div.  in  chartulas  xxiv. 

Sig. — One  twice  daily. 


R.  Morphinae  Sulph.,  .  .  .  .  gr.  j. 

Sacchari  Lactis, . gr.  xyj. 

Trit.,  et  div.  in  chartulas,  viij. 

Sig. — One  every  six  hours. 


R  .  Hydrarg.  Chlor.  Mitis,  .  .  gr.  x. 
Sacchari  Lactis,  q.  s. 

Trit.,  et  div.  in  chartulas  x. 

Sig. — One  powder  daily. 


R .  Acidi  Arseniosi,  .  .  .  .  gr.  ss. 

Sacch.  Lactis, . gr.  xl. 

Trit.,  et  div.  in  chartulas  xx. 

Sig. — One  powder  thrice  daily. 


Suppositories  (Suppositoria), — are  small,  conical,  medicated  bodies 
intended  for  introduction  into  the  rectum,  uterus,  or  urethra  (bougies) 
occasionally  into  the  vagina.  No  official  suppositories  are  enumerated, 
but  a  general  formula  is  prescribed  by  the  pharmacopoeia  for  their  prepa¬ 
ration  (see  ante,  page  432).  The  basis  is  usually  Cacao-butter,  but  for 
those  intended  for  the  urethra  or  uterus  a  mixture  of  Gelatin  and  Glycerin 


474 


EXTEMPORANEOUS  PREPARATIONS. 


is  considered  the  best  excipient,  being  firmer  and  more  plastic  than 
cacao-butter,  and  more  easily  handled.  Hollow  cones  of  cacao  butter, 
or  some  composition  resembling  it,  are  kept  in  the  shops,  and  will  be 
used  by  the  average  druggist  in  filling  prescriptions  for  rectal  supposito¬ 
ries  unless  prohibited,  as  they  save  him  considerable  labor ;  the  active 
drug  being  simply  placed  in  the  centre  of  the  cone  which  is  then  sealed 
with  a  plug  fitting  in  its  base.  These  contrivances  are  by  no  means  so 
efficient  as  the  regular  suppository,  in  which  the  medicinal  agent  is 
thoroughly  incorporated  with  the  excipient,  for  the  former  smear  the 
rectum  with  a  quantity  of  melted  grease  before  the  active  portion  of  the 
preparation  is  permitted  to  come  in  contact  with  its  walls.  The  agents 
used  in  suppositories  are  chiefly  extracts  and  alkaloids  ;  some  few  powders, 
and  a  few  metallic  salts  are  occasionally  employed.  Those  for  the  adult 
rectum  should  contain  from  15  to  30  grains  of  the  excipient,  for  the 
vagina  a  drachm  of  cacao-butter  is  the  average  quantity.  Those  for  the 
uterus  and  urethra  are  made  of  cylindrical  instead  of  conical  form,  and 
about  the  diameter  of  a  No.  9  catheter. 

The  methods  of  compounding  suppositories  are  two,  viz.: — that  by 
the  use  of  moulds  (the  official  method),  and  that  by  hand.  The  former 
process  is  described  on  page  432,  but  many  prefer  the  hand  method, 
which  is  as  follows :  The  medicament  is  mixed  with  finely  shaved  Cacao- 
butter  by  the  aid  of  a  spatula  on  a  board  or  tile  lightly  dusted  with 
Lycopodium  or  Starch.  After  a  smooth  and  uniform  mixture  is  thus 
obtained,  the  mass  may  be  rolled  into  cylindrical  form,  cut  into  the 
required  sizes  and  with  the  spatula  given  the  required  shape.  When 
dispensed,  they  should  be  placed  in  a  powder-box,  between  layers  of 
cotton. 

Bougies  or  Pencils ,  as  urethral  and  uterine  suppositories  are  often 
termed,  may  be  prepared  by  melting  together  White  Gelatin  3,  Glycerin 
1,  and  Distilled  Water  1  part  by  weight,  then  adding  the  medicament, 
and  drawing  the  mass  into  a  glass  tube  previously  oiled  inside.  When 
cold  the  bougie  may  be  pushed  out  and  cut  into  suitable  lengths. 

The  Br.  Pharmacopoeia  describes  8  official  suppositories,  as  follows, 
viz.: — 


Suppositoria  Acidi  Carbolici  cum  Sapone , — Carbolic  Acid,  12  grains;  Curd  Soap,  in 
powder,  180  grains;  Glycerin  of  Starch,  40  grains;  to  make  12  suppositories,  each 
containing  I  grain  of  Carbolic  Acid. 

Suppositoria  Acidi  Tannici , — Tannic  Acid,  36  grains;  Oil  of  Theobroma,  144  grains; 
to  make  12  suppositories,  each  containing  3  grains  of  Tannic  Acid. 

Suppositoria  Acidi  Tannici  cum  Sapone, — Tannic  Acid,  36  grains  ;  Glycerin  of  Starch, 
30  grains;  Curd  Soap,  in  powder,  100  grains:  Starch  in  powder  q.  s.;  to  make  12  sup¬ 
positories,  each  containing  3  grains  of  Tannic  Acid. 

Suppositoria  Hydrargyri, — Mercurial  Ointment,  60  grains;  Oil  of  Theobroma,  120 
grains;  to  make  12  suppositories,  each  containing  5  grains  of  Mercurial  Ointment. 

Suppositoria  Iodoformi,  —  Iodoform,  36  grains;  Oil  of  Theobroma,  144  grains;  to 
make  12  suppositories,  each  containing  3  grains  of  Iodoform. 


EXTEMPORANEOUS  PREPARATIONS.  475 


Suppositoria  Morphines, — Morphine  Hydrochlorate,  6  grains;  Oil  of  Theobroma,  174 
grains;  to  make  12  suppositories,  each  containing  y2  grain  of  the  Morphine  salt. 

Suppositoria  Morphines  cum  Sapone, — Morphine  Hydrochlorate,  6  grains ;  Glycerin 
of  Starch,  30  grains;  Curd  Soap,  in  powder,  100  grains;  Starch,  q.  s.  to  make  12  sup¬ 
positories,  each  containing  y2  grain  of  the  Morphine  salt. 

Suppositoria  Plumbi  Coniposita, — Acetate  of  Lead,  36  grains;  Opium,  in  powder,  12 
grains;  Oil  of  Theobroma,  132  grains;  to  make  12  suppositories,  each  containing  3  grains 
of  Lead  Acetate  and  1  grain  of  Opium. 


Suppositories  and  Bougies  may  be  prescribed  in  the  manner  illustrated 
by  the  following  formulae  : — 


Anodyne  Suppository. 

R.  Ext.  Opii, . gr.  vj. 

Ext.  Belladonnae, . gr.  ss. 

Ext.  Hyoscyami, . gr.  ij. 

Olei  Theobromas,  q.  s. 

M.  Fiant  suppositoria  vj. 

Sig. — One  into  the  rectum  morning  and 
night. 


A  nthelrnintic. 

R.  Santonini, . gr.  xij. 

Olei  Theobromas, . ^j. 

M.  Fiant  suppositoria  vj. 

Sig. — One  into  the  rectum  as  directed. 


Quinine  Suppository. 

R .  Quininae  Sulphatis,  .  .  .  .  gr.  v. 

Olei  Theobromae, . gr.  x. 

Fiat  suppositorium  unum,  mitte  tales  sex 


Wade's  Bougies. 

R.  Iodoformi, . gj. 

Bismuthi  Subnitrat.,  .  .  .  .  ^j. 

Chloralis, . gr.  viij. 

Morphinas  Sulphat.,  .  .  .  .  gr.  iij. 

01.  Rosas, . rrpx. 

Gelatini,  et  Glycerini,  q.  s. 

M.  Fiant  bougia  xij. 

Sig. — One  into  urethra  thrice  daily. 


Bougie  for  Gleet. 

R.  Zinci  Sulphatis, . gr.  vj. 


Ac.  Carbolici, . Tip  iij. 

Pulv.  Hydrastis, . gr.  xij. 

Ext.  Belladonnae, . gr.  xij. 


Gelatini,  et  Glycerini,  q.  s. 

M.  Fiant  bougia  xij. 

Sig. — One  into  urethra  night  and  morn- 


Ointments  (Unguenta)  and  Cerates  (Cerata), — are  frequently  ordered 
on  extemporaneous  formulae,  though  the  34  official  preparations  of  these 
classes  (see  ante ,  pages  432,  433)  would  seem  to  give  the  physician  a 
sufficiently  wide  field  for  selection.  The  basis  used  is  usually  either  the 
official  Ceratum  or  Unguentum,  but  Petrolatum,  Lard,  Lead  Plaster  with 
a  fixed  oil,  etc.,  maybe  used.  Lard  is  probably  the  best  basis  for  all  oint¬ 
ments,  as  it  softens  the  skin  better  than  any  other  similar  substance.  Its 
disadvantage  is  that  it  soon  becomes  rancid,  so  that  preparations  made 
with  it  must  be  quickly  used.  Cerates  only  differ  from  ointments  in  their 
firmer  consistence,  melting  at  temperatures  above  104°  F.,  while  the  latter 
melt  below  the  ordinary  temperature  of  the  body.  Oleates  are  described 
fully  on  page  71. 

The  process  of  compounding  an  ointment  or  a  cerate  is  sufficiently  sim¬ 
ple,  being  generally  a  mere  matter  of  triturating  the  ingredients  together 
in  a  mortar,  or  of  their  incorporation  on  a  slab  by  means  of  a  spatula. 
Rarely  will  melting  be  required  in  the  compounding  of  extemporaneous 
ointments.  When  extracts,  powders  or  gritty  substances  are  ordered,  the 
ingredients  should  be  first  pulverized  into  a  fine  powder,  then  triturated 
with  a  small  quantity  of  the  basis  into  a  smooth,  impalpable  paste  ;  the 


4/6 


EXTEMPORANEOUS  PREPARATIONS. 


remainder  of  the  basis  being  added  gradually,  until  the  whole  is  thoroughly 
incorporated.  A  warm  mortar  may  be  required  for  hard  extracts.  Soluble 
salts  should  be  triturated  with  a  little  water  before  adding  the  excipient. 
Camphor  needs  a  little  alcohol  to  enable  it  to  be  pulverized ;  and  Iodine 
should  be  rubbed  to  a  fine  powder,  then  a  little  alcohol  added  and  finally 
the  excipient  by  degrees.  Iodide  of  sulphur  requires  persevering  work 
with  a  small  portion  of  olive  oil.  Borax  should  be  triturated  with  glycerin 
and  Red  Oxide  of  Mercury  with  distilled  water.  A  bone  or  horn  spatula 
should  be  used  for  all  ointments,  as  steel  or  iron  blades  will  injure  many 
substances,  particularly  alkaloids,  free  acids,  tannin  or  iodine,  and  several 
of  the  mercurial  salts.  Volatile  substances  should  be  added  last,  and 
quickly  worked  in,  so  that  their  evaporation  may  be  as  slight  as  possible. 

Ointments  are  dispensed  usually  in  amber-colored  glass  pots  with  wooden 
or  metallic  covers,  or  in  porcelain  jars  called  Gallipots.  In  hospital  and 
dispensary  practice  the  common  chip  pill-box  is  used,  but  soon  becomes 
excessively  dirty  and  disagreeable  to  handle. 


Ung.  Iodoformi  Compos. 


R.  Iodoformi,  .  .  * . £j. 

01  Anisi, . xx. 

Ol.  Rosae, 

01.  Ylang  ylang,  .  .  .  .  aa  TT\,  v. 

Ung.  Aquae  Rosae, . ^j. 

M.  Fiat  unguentum. 

Sig. — Ointment. 


Unguen  turn  A  nti-pruriticu in . 

R .  Camphorae, 

Chloralis  Hydrat., . aa^j. 

Tere  una  ad  liquorem,  dein 
adde  cum  tritu — 

Unguenti  Aquae  Rosae,  .  .  .  .  ^j 
M.  Fiat  unguentum. 

Sig. — Ointment. 


Plasters  (Emplastra), — are  rarely  prepared  extemporaneously,  the 
official  and  many  other  ones  being  produced  on  a  large  scale  by  the  manu¬ 
facturers,  and  kept  in  stock  by  all  druggists.  As  a  consequence  the  com¬ 
pounding  and  spreading  of  a  plaster  by  the  pharmaceutist  has  become  a 
lost  art.  The  official  plasters  are  enumerated  and  described  on  page  433, 
and  may  be  ordered  by  prescription  in  the  manner  illustrated  below. 
Blisters  may  be  produced  by  the  application  of  any  preparation  of  Can- 
tharides  sufficiently  strong  for  the  purpose.  Either  of  the  official  Cerates 
of  Cantharides  (see  page  151),  may  be  spread  on  Adhesive  Plaster  (Em- 
plastrum  Resinse),  making  a  blistering  plaster ;  or  Cantharidal  Collodion 
(see  page  15 1),  maybe  painted  over  the  surface.  Plasters  are  usually 
ordered  by  the  square  inch,  but  a  model  of  the  shape  and  size  may  be 
drawn  on  paper,  and  the  plaster  be  directed  to  conform  thereto,  as  in  the 
first  of  the  following  prescriptions.  Two  of  the  official  Papers  (Chartae) 
are  practically  plasters,  viz. — Charta  Cantharidis  and  Charta  Sinapis. 


Emplastrum  Vesicatorium. 

R  .  Cerati  Cantharidis.  q.  s. 

Extende  supra  Emplastrum  Resinae  hujus 
formae  et  magnitudinis. 

Sig. — Blistering  Plaster,  to  be  applied 
over  the  region  of  the  heart. 


Counter-irritant  and  Anodyne. 

R .  Chartce  Sinapis, 

Emplas.  Belladonna,  aa  3//  x  67/. 
Sig. — Apply  the  mustard  paper  first,  to 
be  followed  by  the  plaster  when  the  surlace 
has  been  well  reddened. 


GASEOUS  PREPARATIONS. 


477 


Poultices  (Cataplasmata), — are  usually  prepared  at  the  residence  of 
the  patient,  the  ingredients  only  being  ordered  from  the  druggist.  They 
are  generally  employed  as  a  means  of  applying  heat  and  moisture  to  a  cer¬ 
tain  portion  of  the  body,  but  are  sometimes  medicated  with  anodyne, 
counter-irritant  or  disinfectant  agents.  Poultices  are  not  official  in  the 
U.  S.  Pharmacopoeia,  but  are  in  the  British,  the  following  list  including 
all  so  recognized. 

Cataplasma  Carbonis , — Wood  Charcoal  i,  Crumb  of  bread  4,  Linseed  Meal  3,  Boiling 
Water  20  parts. 

Cataplasma  Conii , — Hemlock-juice  I,  evaporated  to  half  its  volume,  Linseed  Meal  4, 
Boiling  Water  10  parts. 

Cataplasma  Fermenti , — Beer  Yeast  3,  Wheaten  Flour  7,  Water  at  ioo0  F.,  3  parts. 

Cataplasma  Lini , — Linseed  Meal  2,  Boiling  Water  5  parts,  mixed  with  constant 
stirring. 

Cataplasma  Sinapis, — Mustard,  Linseed  Meal,  Boiling  Water  and  Water,  of  each  a 
sufficiency. 

Cataplasma  Soda  Chlorinata , — Solution  of  Chlorinated  Soda  1,  Linseed  Meal  2,  Boil¬ 
ing  Water  4  parts. 


Paints  (Pigmenta), — are  preparations  for  external  use,  which  cannot 
be  classed  with  the  preceding.  They  are  generally  prescribed  in  skin- 


diseases,  for  use  over  inflamed  joints, 
a  camel’ s-hair  brush. 

R  .  Tinct.  Iodi, . 3  j. 

/Etheris  Fort . ijiij. 

Tinct.  Aconiti, . 3ss. 

Ext.  Belladon.  FL,  .  .  .  .  3iv. 

Morph.  Sulph., . gr.  ij. 

Iodi, . 3jss. 

M.  et  fiat  pigmentum. 

Sig. — Paint  4  or  5  coats  freely  over  the 
inflamed  and  painful  parts. 


or  for  application  to  the  throat  with 


Pc.  Alcoholis,  Saponis  Viridis, 

Olei  Cadini, . aa^j. 

M.  et  fiat  pigmentum. 

Sig. — Paint  over  the  part. 


R.  Olei  Tiglii, . £j. 

yEtheris  Fort., . 3  ij. 

Tinct.  Iodi, . v)\. 


M.  Sig. — Paint  on  once  in  3  days. 


GASEOUS  PREPARATIONS. 

Vapors  (Vapores)  and  Inhalations  (Inhalationes), — are  medicines 
in  the  form  of  a  vapor,  a  gas  or  an  atomized  spray,  to  be  inhaled  by  the 
patient  for  their  local  action  on  the  respiratory  tract.  The  well-known 
steam-atomizer  is  the  agent  by  which  most  of  these  preparations  are 
administered,  though  many  substances  may  be  inhaled  from  the  surface  of 
hot-water,  from  a  sponge  in  a  bottle  surrounded  by  a  hot  cloth,  or  from  a 
heated  shovel.  They  are  prescribed  in  the  usual  manner,  as  follows: — 


Stimulant  Inhalation. 


R .  Olei  Cubebae . 3  ij. 

Magnesii  Carbon  at.,  .  .  .  3j. 
Aquae, . 3  iij. 


M.  Sig. — A  teaspoonful  in  a  pint  of 
water  at  150°  F.,  for  each  inhalation. 


Carbolized  Inhalation. 

R  .  Acidi  Carbolici, . rtpxlviij. 

Aquae,  q.  s . ad£  ij. 

M.  Sig. — Use  one-half  in  the  cup  of  a 
steam-atomizer  for  each  inhalation. 


473 


GASEOUS  PREPARATIONS. 


Oil  of  Pine. 

R .  01.  Pini  Sylvestris,  .  .  .  .  3  ij. 

Magnesii  Carb., . £j. 

Aquae, . §iij. 

M.  Sig. — A  teaspoonful  in  a  pint  of 
hot  water  for  each  inhalation. 


Tar  and  Turpentine. 

R  .  01.  Picis  Liquidoe, 

01.  Terebinth.,  .  .  .  .  aa^ij. 

M.  Sig. — Pour  slowly  in  a  hot  shovel 
in  the  sick-room,  keeping  the  vapor  confined 
therein. 


The  official  Charta  Potassii  Nitratis,  Nitre-paper  (see  ante,  page  323), 
is  a  preparation  intended  for  use  as  an  inhalation,  its  vapors  while  burning 
being  taken  into  the  lungs. 


PART  III. 


SPECIAL  THERAPEUTICS. 


Applied  Therapeutics  may  be  studied  either  with  the  various  thera¬ 
peutic  agents  as  the  objects  of  chief  consideration,  as  in  the  first  part  of 
this  work  ;  or  with  the  different  diseases  and  morbid  conditions  forming 
the  objects  of  study  in  respect  to  their  modification  and  treatment  by 
medicines.  In  the  following  pages  the  latter  method  is  followed,  the 
therapeutics  of  each  affection  being  exhibited  in  the  form  of  an  Analyti¬ 
cal  Index  to  the  recognized  text-books  of  the  day.  Every  indication  for 
the  use  of  a  drug,  or  statement  regarding  its  value,  is  followed  by  the 
initial  (in  parentheses)  of  its  author :  these  references  enabling  the  book 
to  be  used  as  an  index  to  the  authorities,  for  more  strict  differentiation 
between  indicated  remedies, — while  the  brief  analyses  given  include 
enough  to  make  each  section  a  complete  synopsis  of  the  most  advanced 
therapeutics  of  the  disease  forming  its  title. 

The  principal  authors  to  whom  references  are  made,  and  the  various 
initials  indicating  them,  are  comprised  in  the  following  list : 

References  and  Bibliography. 

(A.)  Aitkin. — The  Science  and  Practice  of  Medicine,  7th  edition,  revised. 

(Ag.)  Agnew. — The  Principles  and  Practice  of  Surgery,  Philadelphia,  1878. 

(B.)  Bartholozv. — Materia  Medica  and  Therapeutics,  6th  edition. 

(Br.)  Brunton. — Pharmacology,  Therapeutics  and  Materia  Medica,  3d  ed.,  1888. 

(C.)  Carter. — A  Practical  Treatise  on  Diseases  of  the  Eye,  edited  by  Green. 

(Cl.)  Clarke. — A  Manual  of  the  Practice  of  Surgery,  New  York,  1881. 

(D.)  Druitt. — A  Manual  of  Modern  Surgery,  12th  edition,  London,  1882. 

(E.)  Emmet. — Principles  and  Practice  of  Gynaecology,  3d  edition. 

(El.)  Ellis. — A  Practical  Manual  of  Diseases  of  Children,  3d  edition. 

(F.)  Fothergill. — The  Practitioner’s  Handbook  of  Treatment,  2d  edition. 

(G.)  Goodell. — Lessons  in  Gynaecology,  Philadelphia,  1882. 

(H.)  Hamilton . — Nervous  Diseases,  their  Description,  etc.,  2d  edition. 

(L.)  Leishman. — A  System  of  Midwifery,  3d  edition,  Philadelphia,  1884. 

(M.  &  P.)  Meigs  and  Pepper. — Diseases  of  Children,  7th  edition. 

(N.)  Niemeyer. — A  Text-book  of  Practical  Medicine,  9th  edition. 

(P.)  Phillips. — Materia  Medica  and  Therapeutics,  revised  edition,  1886. 

(Pf.)  Piffard. — Materia  Medica  and  Therapeutics  of  the  Skin,  N.  Y.,  1881. 

(R.)  Ringer. — A  Handbook  of  Therapeutics,  11th  edition,  New  York,  1886. 

(Ros.)  Rosenthal. — Diseases  of  the  Nervous  System,  New  York,  1884. 

479 


480 


ABDOMINAL  PLETHORA - ABORTION. 


(S.)  Sti/le. — Therapeutics  and  Materia  Medica,  4th  edition. 

(St.)  Sturgis. — The  Student's  Handbook  of  Venereal  Diseases,  18S3. 

(T.)  Tanner. — An  Index  of  Diseases  and  their  Treatment,  2d  edition. 

(Tr.)  Trousseau  and  Pidoux. — A  Treatise  on  Therapeutics,  9th  edition. 

(Tt.)  Tait. — Diseases  of  Women,  by  Lawson  Tait,  New  York,  1879. 

(W.)  Wood ,  H.  C. — Therapeutics,  Materia  Medica,  etc.,  6th  edition. 

(\Va.)  Waring. — Practical  Therapeutics,  4th  edition,  edited  by  Buxton. 

Besides  the  above  named,  occasional  references  are  made  to  other  works  by  the  same 
authors.  References  will  also  be  found,  with  names  in  full,  to  Anstie,  Brown-Sequard, 
Clymer,  Cohen,  Da  Costa,  Fordyce-Barker,  Gross,  Hammond,  Hilton,  Lister,  Mitchell, 
Nelaton,  Noyes,  Nussbaum,  Ricord,  Roosa,  Simpson,  Thomas,  and  others.  When  a 
statement  is  not  followed  by  any  reference  it  is  to  be  understood  as  coming  from  the 
writer  of  this  book. 


Abdominal  Plethora. 


Cathartics.  The  saline  and  hydragogue  cathartics  are  of  value  in  congestion 
of  the  portal  circulation  (B.).  Saline  Mineral  Waters,  especially  the  purgative 
saline  waters,  as  Vichy  and  Saratoga,  in  plethora  of  the  abdominal  viscera  (B.). 
Grape-cure  has  helped  many  cases,  particularly  those  of  hepatic  engorgement 
and  sluggish  portal  circulation  ;  is  best  used  after  a  preliminary  course  of  power¬ 
ful  mineral  waters  (P.).  Aliment  is  very  important.  A  dry  diet  is  particularly 
indicated  in  cases  of  dyspepsia  and  hepatic  enlargement  due  to  excessive  beer¬ 
drinking.  Avoid  much  bread,  also  salted  or  twice-cooked  meats,  rich  sauces, 
solid  vegetables  especially  cucumbers,  soups  and  fruits.  Biscuits,  fresh  meat, 
lemons,  fish,  fowl  and  game,  may  be  used.  [Compare  Hepatic  Congestion,. 
Obesity.] 

Prescriptions. 


R .  Potassii  Bicarbonatis, 

Sodii  Sulphatis, . aa  3  iv. 

Dissolve  in  pint  of  Water,  and  add 
Acidi  Tartarici  (cryst.),  .  ...  £ij. 

Cork  quickly  and  firmly,  yi d  to  be  taken 
thrice  daily. 


lit.  Resinte  Podophylli,  .  .  .  gr.  vj. 
Ext.  Colocynthidis  Co.,  .  .  gr.  xij 
Ext.  Belladonnae,  .  .  .  .  gr.  iij. 
Fiat  massa,  et  div.  in  pil.  no.  xij. 

Sig. — One  pill  every  night. 


Abortion. 

Opium,  cautiously  in  threatened  abortion,  is  often  very  valuable  (Wa.) ; — the 
tincture,  rrpxx-xxx  by  rectum  (Parvin) ; — Opium  to  check  uterine  action  and 
Ergot  to  restrain  hemorrhage  (B.).  Ergot,  small  tonic  doses  give  excellent 
results  in  threatened  abortion  (P.).  Tannin,  combined  with  Opium  and  Ipecac. 
(W.).  Cimicifuga,  to  prevent  miscarriage  when  uterus  is  irritable  and  prolapsed 
(R.).  Savine,  the  dried  powder  of  the  leaves,  gr.  xv-xx,  thrice  daily,  one  of  the 
most  powerful  remedies  against  the  hemorrhage  indicative  of  approaching 
abortion  (Wa.); — the  tincture  in  doses  of  5  to  10  drops,  every  yz  to  3  hours, 
useful  against  the  hemorrhage  (P.).  Viburnum  Prunifolium,  in  threatened  and 
habitual  abortion,  has  a  very  high  reputation.  Aurum  Chloride,  to  avert  the 
tendency  to  habitual  abortion  (B.).  Iron,  with  Potassium  Chlorate,  throughout 
the  pregnancy,  when  fatty  degeneration  the  cause  of  habitual  abortion  (McLane). 
Tamponade,  of  the  cervix  uteri,  with  cotton  or  sponge,  dipped  in  vinegar  or 
glycerin,  when  abortion  is  inevitable  and  it  is  desirable  to  hasten  it  and  restrain 
hemorrhage.  Empty  uterus  thoroughly  with  the  finger,  placenta-forceps  liable 
to  do  harm  (Barker).  Abortifacients  see  pages  48  and  230.  Quinine  and 
Ergotin,  of  each  gr.  ij  in  pill  every  3  hours,  the  routine  abortifacient  of  many 
irregular  practitioners.  Only  by  the  production  of  such  violent  irritation  of  the 
abdominal  and  pelvic  organs  as  generally  endangers  life,  can  the  pregnant 
uterus  be  stimulated  to  expel  its  contents  (P.).  The  abortifacient  effect  of  Savine 
and  other  drugs  cannot  be  obtained  unless  by  the  administration  of  a  quantity 
sufficient  to  endanger  life  (B.). 


ABSCESS - ACIDITY. 


481 


Prescriptions. 


R.  Ext.  Ergotae  Fluidi,  .  .  .  gv. 
Tinct.  Opii  Deodorat.,  .  .  ziij. 

Syrupi  Limonis, . 5j. 

M.  Sig. — A  teaspoonful  thrice  daily. 


R  .  Acidi  Tannici, . gr.  xv. 

Pulv.  Ipecacuanhas,  .  .  .  gr.  xij. 

Extracti  Opii, . gr.  iij. 

Ft.  pil.  xij.  Sig. — One  every  six  hours. 


Abscess. 

Poultices  to  check  or  to  assist  in  maturation,  may  be  smeared  with  Belladonna 
or  Opium  (R).  Belladonna,  as  plaster  to  subdue  (B) ;  painted  around  areola 
(\Va.)  ;  internally  often  successful  in  aborting  (R.).  Sulphide  of  Calcium,  half¬ 
grain  doses  frequently  repeated,  to  abort  abscess  or  to  hasten  formation  of  pus 
(B)  ;  gr.  -jE  every  hour  or  two,  gives  striking  results  in  healing  large  abscesses 
(R.).  Phosphate  of  Calcium,  in  large  abscesses  (R.).  Mercury  and  Morphine, 
the  Oleate  locally,  diminishes  induration  due  to  old  abscesses  and  prevents  the 
formation  of  new  ones  (R.).  Carbolic  Acid,  a  weak  solution  as  injection  after 
evacuation,  also  as  a  dressing  (Lister).  Silver  Nitrate,  a  strong  solution  in 
Nitrous  Ether  if  applied  early  to  adjacent  surface  will  check  inflammation  (B.). 
Blisters  or  Iodine,  as  counterirritants  around  or  adjacent  to  seat  of  disease  (R.). 
Potassium  Permanganate,  3j  to  the  pint  of  water,  to  correct  fetor  (B.).  Iodine, 
the  tincture  injected  after  opening  large  abscesses  (R.) ;  especially  in  scrofulous 
abscess  (Wa.).  Salicylic  or  Boracic  Acid,  as  dressings  (B.).  Sarsaparilla,  a 
very  useful  remedy  in  chronic  abscess  with  profuse  discharge  (P.).  Cod-liver 
Oil,  improves  and  lessens  discharge  from  scrofulous  abscesses  (Wa.).  Surgical. 
Opening  necessary  in  all  deep  abscesses,  or  when  on  face,  near  anus,  mammary, 
or  if  danger  of  its  opening  into  an  internal  cavity.  Open  with  grooved  director 
and  forceps  (Hilton).  Never  open  a  deep  abscess  with  a  plunge.  Drainage- 
tube  may  be  required,  also  irrigation  of  the  cavity  and  pressure  (Agnew). 
Weaning  of  child  necessary  in  chronic  mammary  abscess  (Gross).  Psoas  abscess 
may  result  from  strain  or  laceration  of  muscle,  as  by  heavy  lifting,  effort  to  re¬ 
cover  balance  when  skating,  etc.,  as  well  as  from  spinal  disease.  Symptoms 
often  obscure  and  simulating  those  of  chronic  malaria.  Early  opening  by 
lumbar  incision  necessary ;  then  tonics,  good  food,  and  daily  irrigation  of  the 
cavity  with  an  antiseptic  solution.  [Compare  Suppuration,  Carbuncle.] 


Prescriptions. 


R.  Syrupi  Ferri,  Quininae  et 

Strychninse  Phosphatum,  ^vj. 

Sig. — A  teaspoonful  in  water  thrice  daily. 
To  repair  waste  from  suppuration. 


R  .  Syrupi  Hypophosphitum,  .  ~  vj. 
Sig. — A  dessertspoonful  thrice  daily. 


R.  Quininae  Sulph., . £ j. 

Ferri  Pyrophosphatis,  .  .  3 j. 
Strychninae  Sulph.,  .  .  .  gr.  j. 
Ac.  Phosphor.  Dil.,  .  .  .  ^ij- 
Syrupi  Zingiberis,  .  .  .  .  ^ij. 
Aquae,  q.  s . ad  5  iv. 


M.  ft.  mistura.  Sig. — A  teaspoonful 
thrice  daily. 


Acidity. 

Acids,  Hydrochloric  or  Phosphoric  before  meals  ;  acid  wine,  a  genuine  Rhine 
wine  best ;  Sulphurous  Acid  npv-xxx  well  diluted  ;  for  acid  fermentation  of  starchy 
foods  (R.) ;  acids  after  meals  for  alkaline  pyrosis  (R.).  Tannic  Acid,  useful 
in  pill,  gr.  iv  with  TT\J  of  Glycerin  (B.).  Carbolic  Acid,  often  arrests  eructations 
(B.).  Alkalies,  after  meals  for  immediate  relief,  effects  only  temporary,  bicar¬ 
bonate  best  (R.) :  frequent  use  of  alkalies  enhances  the  mischief  (B.).  Nux 
Vomica,  gtt.  ij-iij  of  tincture  before  meals,  excellent  in  small  doses  (B.) ;  espe¬ 
cially  in  qcidity  of  pregnancy  (R.).  Pulsatilla,  gtt.  v  of  tincture  every  4  hours  in 
acid  dyspepsia  (P.).  Silver  Oxide,  extremely  useful  (B.).  Manganese  Oxide, 
gr.  x-xx  of  the  purified  black  oxide  relieves  (B.).  Kino,  a  favorite  remedy  (B.). 
Ipecacuanha,  in  acidity  of  pregnancy  (R.).  Mercury,  gr.  ss  of  gray  powder  ter 
in  die,  when  acidity  with  clayey  stools  (R.).  Bismuth,  gives  excellent  results, 
3i 


482 


ACNE. 


combined  with  Opium  or  Morphine,  sometimes  with  Magnesia  (R.).  Diet.  Use 
lemon-juice,  aerated  or  old  bread,  plain  biscuits.  Avoid  new  bread,  pastry  and 
vegetables. 

Prescriptions. 


R.  Bismuthi  Subnitrat.,  .  .  .  giij. 
Acidi  Carbolici,  ....  gr.  ij-v. 

Mucil.  Acaciae, . t^j. 

Aq.  Menth.  Pip.,  ....  3  iij. 

M.  Sig. — A  teaspoonful  3  or  4  times 
daily  for  adults. 


R  .  Sodii  Bicarb., . 3  ij. 

Spt.  Ammonite  Aromat.,  .  3  ij. 
Tinct.  Zingiberis,  .  .  .  .  p>]. 
Infus.  Gentianae  Co.  (U.  S. 

P.,  1870),  q.  s.  .  .  .ad  3  viij. 
M.  Sig. — A  tablespoonful  or  two. 


Acne. 


Alkalies,  internally  yield  the  best  results  in  a  number  of  cases  (Bulkley) ; 
alkaline  lotions  for  cases  with  seborrhoea  (B.).  Borax,  a  weak  solution  in  rose¬ 
water  (^j— 3 viij),  of  great  benefit  locally  in  acne  simplex  (Wa.)  Potassium 
Bromide,  in  moderate  doses  has  proved  curative  in  some  obstinate  cases  (R.). 
Sulphur,  internally  and  as  a  lotion.  In  severe  forms  an  ointment  of  the  iodide 
or  hypochlorite,  3ij  ad  5j  (R.).  Belladonna  locally,  is  of  some  service,  check¬ 
ing  the  abundant  secretion  from  the  sebaceous  follicles  (R  ).  Arsenic,  in  old 
cases,  especially  in  acne  indurata,  but  often  disappoints.  Given  with  bromides 
it  prevents  the  bromic  acne  (R.).  Phosphorus,  is  an  excellent  substitute  for 
arsenic  (B.) ;  the  compound  syrup  of  the  hypophosphites  in  acne  indurata  (R.). 
Mercury,  in  lotion  is  much  employed  (B.)  ;  a  weak  lotion  of  the  bichloride  to  the 
face  two  or  three  times  daily  (R.).  The  iodo-chloride  (gr.  v-xv  ad  5)  as  irritant 
application  (Fox) ;  or  ointments  containing  the  bichloride  or  biniodide  may  be 
employed  instead  of  the  green  soap  application  (Pf.)  Glycerin,  internally,  has 
been  used  with  success  (B.).  Berberis,  n\,v  of  a  fresh  tincture  thrice  daily  for 
the  acne  of  girls  at  puberty.  Bromide  of  Arsenic  is  adapted  to  the  majority  of 
cases  of  acne  vulgaris  (Pf.).  Calcium  Sulphide  is  indicated  in  cases  characterized 
by  a  tendency  to  pustulation  (Pf.)  Bismuth,  locally  as  a  cosmetic  (B.).  Mag¬ 
nesium  Sulphate,  as  a  purgative  daily  before  breakfast,  in  cases  of  acne  vulgaris 
depending  on  derangement  of  stomach  and  bowels  (Duhring) ;  the  salt,  finely  tri¬ 
turated,  is  an  excellent  dusting-powder  for  cases  of  acne  rosacea.  Water,  hot 
sponging  for  15  or  20  minutes  several  times  a  day,  followed  by  glycerite  of 
starch  to  allay  irritation  (R.) ;  the  local  use  of  very  hot  water  is  of  the  greatest 
benefit  in  all  inflammatory  forms  of  acne  (Bulkley).  Puncturing  each  papule 
with  a  lancet  point,  followed  by  very  hot  water,  and  ointments  of  sulphur  iodide, 
ammoniated  mercury,  etc.,  diluted  (Pf.).  Ergot  is  well  used  in  acne  rosacea 
and  other  forms  of  acne;  a  good  fluid  extract  with  glycerin  and  water,  giving 
5ss  internally  per  diem  (B.).  Diet  and  Hygiene,  require  careful  attention  (B.) ; 
powerful  tonics  are  often  required  (Bulkley).  Sapo  Viridis,  as  an  active  irritant 
in  subacute  cases,  applied  every  night  as  long  as  bearable,  then  emollients  until 
irritation  subsides,  when  the  green  soap  should  be  removed  (Pf.).  [Compare 
Seborrhoea.] 

Prescriptions. 


R.  Potassii  Acetatis, . oss-j* 

Tinct.  Nucis  Vomicae,  .  .  .  ^  ij. 
Ext.  Rumicis  Fluidi,  .  .  .  .  t^iv. 
Misce.  Sig. — A  teaspoonful,  largely  di¬ 
luted,  half  an  hour  before  meals. 


R.  Sulphuris, . ^j. 

Glycerini, . 3  j. 

Aquae  Rosae, . 5  vij 


M.  Sig. — Lotion. 


R.  Potassii  Acetatis, . %j. 

Spt.  Etheris  Nitrosi,  ....  5jss 

Ac.  Acetici  Dil., . %j. 

Ext.  Taraxaci  FI., . 3  ij. 


Misce.  Sig. — A  teaspoonful,  well  di¬ 
luted,  on  an  empty  stomach. 


R .  Hydrarg.  Chlor.  Corr.,  .  .  .  .  gr.  x. 
Alcoholis,  q.  s. 

Aquae  Destil., . 3  ij. 

M.  Fiat.  sol.  Sig. — A  teaspoonful  in 
pint  of  water  as  a  lotion,  twice  daily. 


483 


addison’s  disease — adynamia. 


R.  Magnesii  Sulphatis,  .  .  .  ^jss. 

Ferri  Sulphatis, . gr.xvj. 

Acidi  Sulphurici,  .  .  .  .  £ij. 

Aquae, .  q.  s.  ad  5  viij. 

M.  Sig. — A  tablespoonful  in  a  glass  of 
water  before  breakfast. 


R.  Potassii  Acetatis, . 3  iv-  g], 

Tinct.  Nucis  Vom.,  .  .  .  gij. 

Infusi  Quassiae,  vel 

Tinct.  Cinchonae  Co.,  .  ad  g  iv. 

M.  Sig. — Teaspoonful  in  water  after 
meals,  as  an  antacid  tonic. 


R.  Liq.  Potassae, . %j. 

Aquae  Rosae,  .  ...  ad  $  iv. 

M.  Sig. — Apply  with  a  soft  sponge 
twice  daily. 


R.  Bismuthi  Subnit., . gj. 

Ung.  Hydr.  Ammoniat.,  .  £ij. 


Ung.  Aq.  Rosae,  .  .  .  .  ad  gj. 
M.  et  fiat  unguentum. 


R .  Hydrarg.  Iodo-chlor.,  .  .  ,  gr.v-xv. 

_  Adipis, . gj. 

Fiat  unguentum.  An  irritating  applica¬ 
tion,  requiring  care. 


Addison’s  Disease. 


Arsenic,  with  cod-liver  oil,  gives  the  best  results  (Da  Costa).  Iron,  and  other 
tonics  are  useful,  especially  a  combination  of  the  chloride,  glycerin  and  chloro¬ 
form  (Greenhow).  Phosphorus,  has  seemed  to  exert  a  beneficial  influence 
(Wilks).  Treatment  must  be  symptomatic,  and  is  of  little  use,  the  disease 
being  always  fatal  (H.). 


Prescriptions. 


R.  Tinct.  Ferri  Chloridi,  .  .  .  gj. 


Spt.  Chloroformi, . 5  j. 

Glycerini, . g  vj. 


M.  Sig. —  A  dessertspoonful  in  water 
thrice  daily. 


R.  Quininae  Sulph., . 3  j. 

Ferri  Reducti, . £jss. 

Ac.  Arseniosi, 

Strych.  Sulph.,  ....  aa  gr.  iij. 


Confect.  Rosae,  q.  s. 
M.  et  div.  in  pilulas  lx. 


Adynamia. 

Cinchona  or  Quinine,  with  arsenic,  for  pale,  badly-fed  town-dwellers  (R.)  ; 
as  a  general  tonic  when  flesh  flabby,  skin  perspiring  (P.).  Arsenic,  for  swelled 
feet  of  old  or  weakly  persons,  and  breathlessness  from  weak  heart  (R.)  ;  tonic 
in  continued  doses  of  gr.  g1^  to  (Wa.).  Nux  Vomica,  in  adynamia  of  drunk¬ 
ards.  R.  Tinct.  Capsici  3vj  ;  Tinct.  Nucis  Vom.  gij  ;  gtt.  xx  in  water  every 
four  hours  (B.).  Lime  Salts,  the  phosphate,  when  from  prolonged  town-life  or 
overwork,  gr.  j,  with  grain  j  each  of  Phosphate  of  Iron  and  Carbonate  of  Lime, 
for  a  dose  (R.) ;  Hypophosphites,  of  Lime  or  Soda,  in  nervous  or  general  debility 
(R.)  Iron,  promotes  appetite  and  digestion  ;  gr.  j— iij  of  the  Sulphate,  or  the 
official  iron  and  aloes  pill,  or  with  manganese  (B.)  ;  anaemic  subjects  (R.). 
Hydrastine,  as  substitute  for  Quinine,  to  promote  appetite  and  digestion  and 
improve  assimilation  (B.).  Digitalis  or  Eucalyptus,  in  debility  with  weak  heart- 
action  (B.).  Bitters,  especially  Calumba  and  Gentian,  useful  for  a  short  time 
(B.).  Sanguinaria,  when  stomach  needs  stimulation  (P.).  Sarsaparilla,  broken- 
down,  syphilitic  constitutions  (P.).  Alcohol  is  of  great  value,  but  has  been 
abused  ;  hurtful  when  it  increases  temperature  and  pulse,  dryness  of  tongue, 
etc.  (B.) ;  a  wine  with  much  ether  in  debility  of  old  age,  especially  where  sleep¬ 
lessness,  indigestion  and  stomach  cramps  (R.).  Aliment,  sugar  and  saccharine 
fruits,  vegetables,  oil,  milk,  cod-liver  oil,  wine  of  good  body  and  strength  (B.). 
Porter  or  rum-and-milk  for  town-living  women  (R.)  Sea-bathing  is  useful  in 
chronic  illness,  with  much  debility  (R.).  Turkish  Baths,  when  debility  is 
caused  by  the  tropics,  but  caution  necessary,  When  town-dwellers  become 
stout  and  flabby,  are  easily  tired,  suffer  from  a  lack  of  energy  and  from  mental 
depression,  a  course  of  baths  is  beneficial  (R.).  [Compare  Anlemia,  Conva¬ 
lescence.] 


4§4 


AFT\pR-PAINS - AGALACTIA - ALBUMINURIA. 


Tonic  Prescriptions. 


R.  Quinine  Sulph., . gr.  xxx. 

Ac.  Sulph.  Dil.,  q.  s. 

Tinct.  Perri  Chlor.,  .  .  .  .  gij. 

Aquae, . ad  3  ij . 

M.  Sig. — A  teaspoonful  thrice  daily. 


R.  Tinct.  Ferri  Chlor.,  .  .  .  .  5  iv. 

Ac.  Phosphor.  Dil.,  .  .  .  .  3  vj. 

Sp.  Limonis, . ^  ij. 

Syrupi, . q.  s .ad  3 vj. 

M.  Sig. — A  dessertspoonful  in  water 
after  each  meal. 


R  .  Quininae  Sulph., . £j. 

Strychninae  Sulph.,  .  .  .  .  gr.  j. 

Tr.  Ferri  Chloridi,  .  .  .  .  3  v. 

Ac.  Phosph.  Dil., . 3  ij. 

Syr.  Limonis,-  .  .  .  .  ad  3  vj. 


M.  Sig. — A  teaspoonful  in  water  thrice 
daily,  in  nervous  debility. 


R  .  Ac.  Arseniosi, . gr.  j. 

Quininae  Sulph., . gr.  xl. 

Ferri  et  Pot.  Tart.,  .  .  .  .  gr.  lxxx. 
M.  Fiant  pil.  no.  xl. 

Sig. — One  after  each  meal. 


After-pains. 

Opium,  more  certain  in  action  than  any  other  remedy  (Wa.) ;  Morphine  and 
Atropine  (gr.  ^  and  gr.  combined  (B.),  hypodermically  (Wa.).  Belladonna, 
as  ointment,  much  used  in  France  (L.).  Camphor,  gr.  x  with  gr.  of  mor¬ 
phine,  an  effective  remedy  (B.) ;  3J  in  3yj  of  mucilage,  tablespoonful  doses 
every  hour  or  two  (Wa.).  Chloral,  will  stop  the  pains,  but  large  doses,  gr. 
xx-xl,  are  necessary  (R.).  Chloroform,  the  linimentum  chloroformi,  3j  with 
linim.  Saponis  gvj,  applied  on  flannel  to  the  abdomen  (Barker).  Quinine,  gr. 
v-x  night  and  morning,  with  the  above  chloroform  liniment  locally,  in  neuralgic 
after-pains  which  do  not  yield  to  opiates,  the  uterus  being  tender  on  pressure 
(Barker).  Gelsemium,  suspends  them,  large  doses  (rr^xx)  necessary  (B.).  Cimi- 
cffuga,  relieves  the  pains,  and  allays  general  nervous  excitement  (P.)  Ergot, 
is  better  than  cimicifuga  (R.).  Poultices,  warm,  over  the  hypogastrium,  with 
soothing  injections  into  the  vagina  (L.). 


Agalactia. 

Ricinis  Communis,  gr.  v  of  extract,  or  oj-ij  of  strong  decoction,  daily  in 
water  ;  also  the  leaves,  or  an  infusion,  locally  to  mammae  (T.).  Gossypium, 
an  emulsion  of  the  seeds  has  repute  in  India,  as  a  galactagogue.  A  wineglass 
of  the  decoction  every  20  or  30  minutes  (P.).  Pilocarpus,  remarkably  increases 
the  secretions  (B.).  Tea,  a  good  black  tea  promotes  the  milk-supply.  [Com¬ 
pare  Lactation.] 

Albuminuria. 

Aconite,  in  incipient,  high  body  temperature  (R.).  Lead,  diminishes  the 
albumen  (R.).  Turpentine,  gtt.  ss-j,  every  2  to  4  hours,  or  one  to  two  drop 
doses  night  and  morning,  of  great  value  in  chronic  albuminuria  without  marked 
symptoms  of  Bright’s  disease  (P.).  Gallic  Acid,  the  most  efficient  agent  in  the 
acute  form  to  restrain  loss  of  albumen  (B.  P.)  See  Aitken’s  formula  below. 
Cannabis  Indica  is  indicated  when  bloody  urine  (R.).  Chimaphila,  has  un¬ 
questioned  power  over  albuminuria  (P.).  Cantharis  rr\J  every  three  hours,  of 
the  tincture,  after  the  subsidence  of  acute  symptoms,  especially  when  bloody 
urine  (R.).  Fuchsine,  in  doses  of  gr.  j-iij,  completely  arrested  albuminuria  in 
many  cases  with  oedema  (Bouchut).  Alkalies,  the  citrates  and  acetates  as 
diuretics  (R.)  ;  the  Buffalo  Lithia  Water  of  Virginia,  is  highly  recommended. 
Nitro-glycerin,  vt\,  j  of  a  one  per  cent,  solution  to  dilate  the  peripheral  vessels, 
relieving  the  heart  and  lessening  the  renal  congestion  (B.).  Turkish  Baths, 
benefit  by  relieving  the  kidneys  of  work  (R.).  Milk-cure,  with  buttermilk, 
has  proved  very  efficient  in  many  cases  (B.).  Chalybeate  Waters,  especially 
those  having  purgative  qualities,  are  beneficial  (B.).  [Compare  Bright's 
Disease.] 


ALCOHOLISM. 


485 


Prescriptions. 


R.  Acidi  Gallici, . gj-ij. 

Ac.  Sulphurici  Dil.,  .  .  .  .  Z  ss. 

Tinct.  Lupuli, . .qj. 

Infusi  Lupuli, . ad  3  vj. 


M.  Sig. — Tablesp.  thrice  daily. 

[A  it  ken.) 


$ .  Mist.  Ferri  et  Ammonii  Acetatis 

(U.S.P0, . 5vi- 

Sig. — Teasp.  to  a  tablesp.  according  to 
age,  well  diluted,  thrice  daily. 

[Basham.) 


Alcoholism. 

Arsenic,  for  distressing  vomiting,  one  drop  of  liquor  arsenicalis  before  break¬ 
fast  (R.).  Capsicum,  in  dyspepsia  of  chronic  alcoholism,  and  to  induce  sleep  ; 
also  as  a  substitute  for  the  alcohol.  Gr.  x,  with  honey  (B.).  With  bromide  or 
arsenic  and  bitters  to  assist  in  overcoming  habit,  by  removing  the  distress  at 
pit  of  the  stomach.  The  tinct.  in  10-minim  doses  should  be  taken  shortly  before 
meals,  or  whenever  there  is  depression  or  craving  for  alcohol.  It  obviates  the 
morning  vomiting,  and  promotes  appetite  and  digestion  (R.)  Ammonia,  a  full 
dose  (3ss)  of  the  spirit  will  often  sober  a  drunkard  speedily  (R.)  ; — a  few  drops 
of  liquor  ammoniae,  diluted,  have  prompt  action  (S.) ; — Zj  of  the  aromatic  spirit 
with  capsicum,  see  formula  below.  Ammonium  Chloride,  of  high  value  (see 
ante ,  page  96).  Quinine,  especially  the  cinchona  rubra,  for  gastric  catarrh  of 
drunkards  (B.) ;  gr.  ij-vj  daily  to  raise  the  nervous  tone  (P.).  Nux  Vomica, 
for  after  stomachal  disorders  (B.) ;  in  tremor  of  chronic  alcoholism,  of  much 
value  (P.).  Strychnine  Nitrate,  hypodermically  ter  in  die  for  ten  days,  an 
absolute  cure  for  dipsomania  (Luton).  Bromides,  Zj  every  4-6  hours  in  the 
“horrors”  (B.).  Phosphorus,  in  chronic  alcoholism,  recommended  by  Anstie 
(R.).  Opium,  cautiously,  if  at  all  (B.) ; — Morphine  with  tonics  before  meals  for 
pain,  nausea,  and  want  of  appetite  (R.).  Cocaine,  has  been  pronounced  of  great 
benefit,  restoring  appetite,  inducing  sleep  and  promoting  digestion,  while  it 
soothes  the  brain  and  induces  a  feeling  of  contentment  and  calm  (R.).  Cimici- 
fuga,  is  said  to  be  useful  in  the  treatment  of  the  drunkard’s  stomach  (R.).  Chloral, 
is  very  successful,  gr.  xv-xx,  but  must  be  cautiously  used  with  old  worn-out 
drunkards  (B.)  Picrotoxin,  small  doses  for  the  tremor,  gr.  ^  repeated  (B.). 
Lupulin,  is  the  best  substitute  for  alcoholic  stimulants,  and  extremely  serviceable 
in  delirium  tremens  (B.).  Zinc  Oxide,  is  very  useful  in  chronic  alcoholism,  to 
diminish  the  craving,  to  relieve  the  gastric  catarrh  and  lessen  the  tremor  (B.). 
Acute  Alcoholic  Poisoning  requires  an  emetic  orthe  stomach-pump,  cold  douche 
to  the  head  and  breast,  warmth  to  the  feet  and  limbs.  Artificial  respiration  may 
be  required.  Milk,  mucilaginous  drinks,  and  black  coffee,  are  the  principal 
remedies.  A  milk  diet  often  creates  a  disgust  for  alcohol.  [Compare  Deli¬ 
rium  Tremens  and  Vomiting.] 


Prescr 

5c.  Tinct.  Capsici, . ^  ss. 

Potass.  Bromidi, . 3  ss. 

Vet  Liq.  Potass.  Arsenit.,  .  rr[l. 

Vet  Tinct.  Nucis  Vom.,  .  3  ij. 

Spt.  Ammonia;  Aromat.,  .  x.  iij. 

Syr.  Tolutani, . ad^  vj. 

M.  Fiat  mistura.  Sig.  —  A  dessert¬ 
spoonful  in  water  four  or  five  times  daily. 


BC 


Tinct.  Nucis  Vom.,  . 

•  •  z  j  • 

Tinct.  Gentianae  Co.,  . 

.  .  Z  iij- 

Spt.  Limonis,  .... 

•  •  "DT 

Spt.  Chloroformi,  .  . 

.  .  zj- 

Aquae, . q. 

s.  ad  x,  vj. 

M.  Sig. — One-sixth  to  be  taken  3  or  4 
times  daily,  for  insomnia. 


iptions. 

5c.  Zinci  Oxidi, . 3  j. 

Piperinae, . gr.  xx. 

M.  Fiant  pil.  no.  xx.  Sig. — One  pill 
thrice  daily. 

Be.  Ext.  Lupulini  FI.,  ....  5J. 

Ext.  Aromatici  FI.,  ] 

Tinct.  Capsici,  .  V  .  aa^vj. 

Mucil.  Acaciae,  .  j 

Aquae  Menth.  Viridis,  .  ad£  iv. 

Fiat  emulsio.  Sig. — A  teaspoonful  or 
two  as  required. 


3'b 

d>j- 


Be .  Tinct.  Gentianae  Co., 

Tinct.  Calumbae  Co., 

Tinct.  Nucis  Vom.,  .  .  .  rrLlxxx. 

M.  Sig. — A  dessertsp.  before  each  meal, 
for  lum-stomachs.  (Loomis,) 


486 


ALOPECIA - AMAUROSIS - AMENORRHCEA. 


Alopecia. 

Cantharides  tincture,  1  part  to  8  of  castor  oil,  well  rubbed  into  roots  of  hair, 
night  and  morning  (Wa.).  Arsenic,  rtpv  of  liq.  arsenic,  ter  die,  exercises  a  more 
or  less  powerful  influence  (Wa.).  Nitric  Acid,  with  olive  oil,  makes  a  service¬ 
able  liniment  (Wa.).  Pilocarpine,  has  a  decided  influence  on  the  growth  of  the 
hair  (B.).  Glycerin  in  combination  with  the  above  remedies  (Wa.).  Sulphur 
Iodide,  has  been  found  very  effectual,  used  internally  and  externally  (Wa.). 
Frequent  shaving  may  often  save  the  hair  in  alopecia  after  illness.  Use  clean 
brushes  with  long  bristles,  and  brush  against  the  natural  lay  of  the  hair.  [Com¬ 
pare  Tinea.] 

Prescriptions. 

R  .  Tinct.  Cantharidis,  ....  t^jss 


R. 


01.  Amygdalae  Expres., 
Aq.  Ammoniae,  . 

01.  Rosmarini,  . 
Alcoholis,  .  .  . 

Aquae  Destillat., 

Mellis  Despumat. , 


M.  Sig. — Lotion  for  the  hair. 


aa^j. 

.  5>i- 

•  o’J- 

•  St. 

ad 3  viij. 


(  Wilson.') 


R. 


Tinct.  Macis, . 3jss. 

Olei  Olivae,  . ad ^  ij. 

M.  Sig. — Lotion  for  baldness. 

( Hebra .) 


Tinct.  Capsici, . rr^xx. 

Glycerini, . j|ss. 

Spt.  Odorat., . adgvj. 

M.  Sig. — Hair  tonic.  (Gross.) 


R.  Pilocarpin.  Hydrochlorat.,  gr.  j. 
Aquae  Destillat.,  .  .  .  .  %j. 

M.  Sig. — Ten  to  thirty  drops  twice  daily, 
according  to  age,  to  improve  the  growth  of 
the  hair.  ( Bartholow .) 


Amaurosis  and  Amblyopia. 

Arnica,  has  long  been  a  popular  remedy  for  amaurosis  in  Germany.  Man- 
noir  employed  it  with  much  success  (P.,  Wa.).  Rue,  in  minim  doses  night  and 
morning, for  dimness  of  vision  from  functional  amaurotic  condition.  Elgajaki  says 
it  produces  dimness  of  vision,  and  in  smaller  doses  improves  the  eyesight  (P.). 
Strychnine,  may  cure,  in  functional  amaurosis  from  lead,  tobacco  and  alcohol 
(B.).  Gr.  ^0  hypodermically  (Nagel).  Hypodermically  in  tobacco  and  trau¬ 
matic  amaurosis,  and  in  progressive  nerve  atrophy  not  dependent  on  inter-cra¬ 
nial  disease  (R.).  Guaiac,  is  advised  for  cases  of  amaurosis  occurring  in  persons 
of  a  rheumatic  diathesis  (Wa.).  Santonin,  has  given  very  satisfactory  results 
in  amaurosis  (Wa.).  Veratrine,  as  lotion  brushed  over  eyelids,  brows  and 
temples  once  a  day,  is  often  useful,  but  should  not  be  permitted  to  touch  the 
conjunctiva,  or  great  pain  will  result.  See  formula  below  (Wa.).  Potassium 
Iodide,  in  amblyopia  from  lead-poisoning  (Wa.).  Seton,  a  small  seton  in  the 
temple  kept  open  for  along  period,  has  been  found  effectual  when  other  reme¬ 
dies  failed  (Wa.).  Amaurosis  and  Amblyopia  are  names  formerly  much  used 
to  denote  the  various  conditions  of  blindness,  before  ocular  diagnosis  became 
as  exact  as  it  now  is.  Amblyopia  is  still  used  to  designate  certain  impairments 
of  vision  not  accounted  for  by  any  organic  changes  visible  ( Roosa ). 


R  .  Veratrinae, . gr. 

Aitheris, . 3  ij 

Alcoholis, . 3  j. 


M.  Sig. — Use  with  a  brush  once 
over  eyelids,  eyebrows  and  temples. 


Prescriptions. 

R .  Strychninae  Sulphatis,  .  .  gr.  j. 

Alcoholis, . 3  j. 

Aquae  Destillatae,  .  .  .  ad$  iv. 

M.  Fiat  solutio.  Sig. — A  teaspoonful 
thrice  daily  before  meals,  when  not  used 
hypodermically. 


a  day 


Amenorrhcea. 

Aconite,  sudden  suppression  from  cold  or  wet  feet  (B.,  R.,  P.).  Pulsatilla,  in 
sudden  suppression,  also  aconite  (B.) ;  often  of  the  greatest  value  in  functional 


AMENORRHCEA. 


487 


form  (P.).  Iron,  when  from  anaemia,  the  most  frequent  cause.  Small  doses 
preferred.  Solution  of  acetate,  or  ferri  et  ammonii  citras  (gr.  ij),  or  ferri  et 
strychnine  citras  (gr.  j),  also  chalybeate  waters.  Caution. — Careful  diagnosis 
before  giving  iron  (B.).  Aloes,  when  dependent  on  anaemia  (B.) ;  at  the  pe¬ 
riods.  with  hot  pediluvia,  friction,  etc.  (R.,  P.).  Potassium  Permanganate,  gr.  j 
thrice  daily  increased  to  gr.  ij,  is  the  best  of  all  remedies  for  bringing  back  the 
menses,  having  specific  action  on  the  uterine  tissue  (R.)  ; — excellent  in  amen- 
orrhoea  from  cold  feet,  and  is  by  far  the  best  emmenagogue.  In  pill  it  may 
explode  ;  best  in  capsule  with  powdered  elm  or  liquorice  (Parvin).  Manganese 
Biniodide,  in  pill,  gr.  ij  thrice  daily,  is  a  very  efficient  emmenagogue.  Mercury. 
The  Biniodide  is  a  certain  and  safe  emmenagogue,  gr.  in  pill,  four  times 
daily.  Oxalic  Acid,  is  highly  praised,  gr.  in  mixture,  every  hour 

(Poulet).  Apiol,  when  from  functional  inactivity.  First  give  iron  for  the  blood; 
next  aloetic  purgatives,  then  apiol  (gr.  xv)  just  preceding  the  period  ;  or  a  daily 
dose  for  a  week,  or  several  days  before  (B.).  The  best  emmenagogue  next  to 
Potass.  Permang.  (Parvin).  Senega,  a  saturated  decoction  of  the  root,  to  extent 
of  a  pint  in  24  hours,  during  preceding  two  weeks,  advantageous  (P.).  Polygo¬ 
num,  has  given  excellent  results  when  used  in  £>ss  doses  four  times  daily  for  a 
week  (B.).  Cimicifuga,  has  been  recommended  (R.) ;  is  of  very  great  value 
(P.).  Arsenic,  combined  with  iron,  when  from  functional  inactivity  of  ovaries 
(B.)  Aurum  Salts  from  torpor  of  ovaries  (B.).  Ignatia,  in  suppression  of  hys¬ 
teria  (P.).  Cinnamon,  causes  a  flow  of  blood  to  the  womb  (Goodell).  Indigo, 
is  considered  very  efficient,  in  doses  of  from  3j  to  Z'w.  Larger  doses  produce 
nausea  and  vomiting.  Nux  Vomica,  small  doses  of  the  extract,  of  benefit  in 
some  obstinate  cases  (Wa.).  Silver  Nitrate,  in  substance  lightly  to  the  os  uteri, 
at  time  of  expected  discharge  (Wa.).  Colocynth,  in  chlorotic  amenorrhoea  (P.). 
Ergot,  has  cured  when  due  to  plethora  (B.) ;  when  anaemia  after  use  of  iron 
(R.) ;  in  chlorotic  (P.) ;  npj  every  yi  hour  for  5  or  6  hours  the  day  before  and 
that  of  the  expected  flow,  is  very  efficient  when  the  cessation  is  not  due  to 
anaemia  (A.  A.  Smith).  Senecio  Aureus,  seems  to  have  a  well-founded  reputa¬ 
tion.  Rue,  in  functional  inactivity.  01.  rutae,  n\j-v  (B.,  P.).  Sanguinaria, 
functional  amenorrhoea,  in  absence  of  plethora  (B.,  P.).  Savine,  general 
atony.  Extractum  sabinae,  fl.,  rrpv-x  (B.,  R.,  P.).  Serpentaria,  with  anaemia 
or  chlorosis  (B.),  Ammonium  Chloride,  for  headache  (R.).  Sitz-baths,  hot, 
for  six  days  before  period  ;  mustard  may  be  added  at  period.  Often  effectual 
in  sudden  suppression  (B.).  Spinal-ice-bag,  to  lower  dorsal  and  lumbar 
vertebrae ;  or  cold  sponging  useful  (R.).  Electricity,  in  atony  of  uterus  and 
ovaries  (B.).  [Compare  Anaemia,  Chlorosis.] 


Prescriptions. 


R.  Olei  Sabinae, . p)). 

Olei  Rutae, . "j. 


Tinct.  Polygon.  Hydropip.,  .  .  ^j. 

01.  Amygdalae  Expres., 

Mucil  Acaciae, 

Aquae  Menthae  Pip.,  .  .  .  ,  aa  3  ij. 
Fiat  mistura.  Sig. — A  teaspoonful  two 
or  three  times  daily.  ( Bartholow .) 


Tinct.  Ferri  Chloridi, 

.  3 

i  ij  - 

Tinct.  Cantharidis,  .  .  . 

rr 

*  O 

j- 

Tinct.  Guaiaci  Ammon.,  . 

•  5 

jss. 

Tinct.  Aloes, . 

ss. 

Syrupi, . q.  s 

ad  z 

vi- 

Fiat  mistura.  Sig. — A  tablespoonful 

thrice  daily,  in  simple  atonic  amenorrhoea. 

(//.  C.  Wood.  Dewees .) 


R.  Extr.  Aloes  Aquosi, . ^j. 

Ferri  Sulph.  Exsic., . £ij. 


o 


IV. 


Asafoetidae, 

Fiant  pilulae  100.  Sig. — One  pill  after 
each  meal,  gradually  increased  to  three. 

{Goodell.') 


R.  Quininae  Sulphat., . ^jss. 

Extr.  Nucis  Vom., . gr.  xij. 

Olei  Sabinae, . 3  ss. 

Aloes  Socotrin., . gr.  viij. 

Cantharidis . gr.  xxiv. 

Fiant  pilulae  xlviij.  Sig. — One  pill  thrice 
daily. 


488 


AN/E  MI  A. 


Anaemia. 

Nux  Vomica,  stimulates  blood-making  organs,  and  is  used  as  an  adjunct  to 
restorative  remedies  (B.).  Iron,  its  chief  value  is  to  improve  digestion  ;  also 
furnishes  haematin  to  the  blood.  The  most  astringent  preparation  is  the  best, 
and  should  be  used  after  meals.  Also  chalybeate  waters  (B.).  Some  stomachs, 
with  irritable  mucous  membrane,  require  bland  preparations.  A  pale,  flabby 
tongue  indicates  large  doses  of  the  perchloride  or  sulphate  (R.).  Arsenic,  as 
adjunct  to  iron,  and  where  iron  cannot  be  borne,  or  fails  (B.).  Quinine,  for 
badly-fed  town  dwellers  (R.).  Hypophosphites,  are  useful,  but  should  not  be 
given  with  iron,  cod-liver  oil,  or  stimulants  (R.).  Phosphate  of  Calcium,  in 
anaemia  of  growing  persons,  and  of  women  weakened  by  rapid  child-bearing 
or  excessive  menstruation  (R  ).  Lacto-phosphate  of  Calcium,  for  nursing 
mothers,  or  in  waste  from  suppuration  (B.).  Acids,  added  to  purgative  salts  as 
tonics  to  the  mucous  membrane  (R.).  Pepsin,  is  recommended  by  Hollmann 
(B.).  Manganese,  alone  not  of  much  use  ;  is  best  combined  with  iron  (B.).  Is 
not,  like  iron,  found  in  the  faeces,  nor  does  it  cause  constipation  (Wa.).  Gal¬ 
vanization,  as  aid  to  remedies  (B.).  Cold  Sponging,  needs  great  cautidn,  or 
may  lower  tone  by  minute  degrees  (R.).  Diet  and  Hygiene,  of  prime  import¬ 
ance.  Nourishing,  digestible  food,  in  as  large  quantities  as  can  be  assimilated 
— milk,  eggs,  animal  broths ;  afterwards,  fish,  poultry,  game,  mutton,  etc. 
Moderate  daily  out-of-door  exercise,  in  pure  air,  is  indispensable.  Bathing, 
especially  sea-bathing,  aids  restoration.  Wines,  often  useful.  Red  wines  are 
the  best. 


Tonic  Prescriptions. 


R.  Tinct.  Ferri  Chloridi,  .  .  .  .  3  iv. 

Ac.  Phosphorici  Dil.,  .  .  .  .  gvj. 

Spt.  Limonis, . ."ij. 

Syrupi, . q.  s.  ad  %  vj., 

Misce.  Sig. — A  dessertspoonful  in  water 
after  meals.  To  the  above  may  be  added 
g  ij  of  the  Liquor  Strychninae  Hydrochlo- 
ratis  of  the  B.  P.  (  Goodell. ) 


Hydrarg.  Chlor.  Corr.,  .  .  . 

gr-J-b 

Liq.  Acidi  Arseniosi,  .... 

si- 

Tinct.  Ferri  Chlor., . 

3 IV. 

Ac.  Hydrochlor.  Dil.,  .  .  . 

7\  iv. 

Syrupi, . 

Aquae, . q.  s .ad 

3VJ- 

Misce.  Sig. — A  dessertspoonful  in  a 
wineglassful  of  water  after  each  meal,  as 
an  alterative  tonic.  ( A .  H.  Smith.) 


R.  Tinct.  Nucis  Vom.,  ....  £pjss. 
Tinct.  Cinchonae,  .  .  .  .  ad  25  iv. 
M.  Sig. — A  teaspoonful  after  each 

meal. 


R.  Tinct.  Ferri  Chloridi,  ....  ^iij. 


Potassii  Chloratis, . sjj. 

Liq.  Strychninae  (B.  P.),  .  .  ,qj. 

Syr.  Simplicis, . 3  iv. 

Aquae  Cinnamomi,  ad  5  iv. 


Misce.  Sig. — One  or  two  teaspoonfuls 
after  each  meal. 


R  .  Quininae  Sulphatis, . gr.  xx. 

Ferri  Sulph.  Exsic., . gr.  xl. 

Strychninae  Sulph., . gr.  ss. 

Fiant  pilulae  xx.  Sig. — One  pill  thrice 
daily.  ( Bartholozv .) 


R.  Ferri  Sulph.  Exsiccat., 

Potass.  Carbonatis,  .  .  aa  .  .  gij. 
Syrupi,  q.  s. 

Fiant  pilulae  no.  xlviij.  Sig. — One  pill 
after  each  meal,  gradually  increased  to 


three.  ( Blatid .) 


R.  Acidi  Arseniosi, . gr.  j. 

Quininae  Sulphat., . gj. 

P’erri  et  Potass  Tart.,  .  .  .  .  3  ij. 


M.  Ft.  pil.  no.  xxx.  Sig. — One  pill 

after  each  meal. 


R.  Pil.  Ferri  Comp.  (U.S.),  .  .  .  xlviij. 
Sig. — One  to  three  after  meals. 


R.  Pil.  Ferri  Iodidi  (U.S.),  .  .  .  xlviij. 
Sig. — One  to  three  after  meals. 


R.  Massae  Ferri  Carbon  at.,  .  .  .  £j. 


Acidi  Arseniosi, . gr.  j. 

Quininae  Sulphatis, . gr.  xl. 


Fiat  massa,  et  div.  in  pilulas  xl. 
Sig. — One  or  two  thrice  daily. 


ANAESTHESIA - ANEURISM - ANGINA  PECTORIS. 


489 


Anaesthesia. 

Morphine,  subcutaneously  before  inhalation,  diminishes  the  danger,  and 
lessens  the  after-pain  if  an  operation  is  to  be  performed  (Nussbaum) ;  Morphine 
gr.  and  Atropine  gr.  y^,  hypodermically,  after  emergence  from  anaesthesia, 
will  relieve  the  nausea  and  vomiting.  A  preliminary  injection  of  Morphine 
lessens  the  stage  of  rigidity  and  spasm,  enables  a  smaller  quantity  of  the 
anaesthetic  to  be  used  with  full  effect,  prolongs  the  stage  of  insensibility, 
prevents  shock,  and  antagonizes  the  cardiac  and  respiratory  depression  (B.). 
Atropine,  is  decidedly  the  best  antagonist  to  the  respiratory  paralysis  of  Ether, 
and  should  be  given  hypodermically  (gr.  y1^)  as  soon  as  alarming  symptoms 
manifest  themselves  (Amidon).  The  writer  of  this  book  has  saved  at  least 
four  subjects  of  chloroform-narcosis  by  the  hypodermic  use  of  Atropine  after 
both  heart  and  respiration  had  apparently  failed.  Alcohol,  3 j  — i j  of  whiskey 
or  brandy,  before  inhalation,  to  sustain  the  heart  and  prolong  narcosis  (B.). 
[Compare  pages  80  and  171,  ante,  for  the  general  subject  of  Anaesthesia,  and 
page  25  for  a  list  of  Local  Anaesthetics.  See  also  the  article  Erythroxy- 
lon,  ante ,  page  209,  for  the  use  of  Cocaine  as  a  local  anaesthetic.] 


Aneurism. 


Potassium  Iodide,  in  large  doses^  (gr.  xv-^ss),  3  or  4  times  a  day,  gives  great 
relief,  and  has  cured  (B.) ;  combined  with  recumbent  position  and  restricted 
diet  (R.).  Veratrum  Viride,  aids  surgical  expedients  ;  also  in  large  internal 
aneurisms,  with  absolute  recumbence  and  a  little  Opium  to  relieve  pain, 
vomiting  to  be  avoided  (B.).  Ergot,  with  recumbent  position  ;  favors  coagula¬ 
tion  of  the  blood  in  sac  (B.) ;  Ergotin  (P.).  Gallic  Acid  and  Iron,  internally, 
have  cured  cases  of  aortic  aneurism  (Speer).  Chloroform,  inhalation,  great 
dyspnoea  (R.).  Plumbic  Acetate,  a  valuable  auxiliary  to  the  more  important 
items  of  rest,  diet  and  mechanical  appliances,  gr.  iij-v  ter  die  (Wa.) ;  its  use 
limited  to  the  sacculated  form  (S.).  Electrolysis,  galvano-puncture  in  deep 
aneurisms;  not  very  successful  (B.).  The  object  sought  is  the  coagulation  of 
blood  within  the  aneurismal  sac.  Cures  have  not  been  attained  by  this  treat¬ 
ment,  but  in  many  it  has  produced  great  amelioration  of  the  most  distressing 
symptoms  (Petit).  Aliment,  milk  regimen,  Jor  denutrition  (B.)  ;  a  low  diet, 
with  absolute  rest ;  Ergotin  and  Iodide  of  Potass,  for  deep  aneurisms  beyond 
reach  of  surgical  treatment  (B.).  Rest,  in  recumbent  posture,  and  light, 
unstimulating  diet,  are  primary  and  essential  elements  in  treatment  of  aneu¬ 
risms.  Surgical  Treatment  includes  ligation  of  the  vessels,  also  pressure  by  a 
tourniquet  or  bags  of  shot,  the  operator’s  fingers,  etc.,  applied  to  the  main 
artery  above  the  tumor,  and  the  introduction  of  fine  wire  into  the  sac  to  favor 
coagulation. 

Prescriptions. 


R.  Potassii  Iodidi, . ^ j. 

Tinct.  Veratri  Viridis,  .  .  ^jss. 

Tr.  Cinchonae  Co.,  .  .  .5]. 

Tr.  Cardamomi  Co.,  .  .  ^jss. 

Tr.  Gentianae  Co.,  .  .  .  3  ss. 

Syrupi  Simplicis, 

Alcoholis, . aa  ^  iv. 

Aquae, . q.  s.  ad  J  xvj. 

Misce.  Sig. —  3  ss  thrice  daily.  Each 
dose  has  gr.  xv  of  Pot.  Iod. 


li  .  Acidi  Gallici, . 3  j. 

Ext.  Ergotae, . gr.  xx. 

Digitalis,  . . gr.  xx. 

Fiat  massa,  et  div.  in  pil.  xx. 

Sig. — One  every  two  hours. 


R.  Plumbi  Acetatis, . gr.  xxxvj. 

Extracti  Opii, . gr.  iv. 

Confectionis  Rosae,  q.  s. 

Ft.  pil.  xij.  One  every  four  hours. 


Angina  Pectoris. 

Aconite,  believed  by  Gubler  to  be  appropriate,  and  by  Fleming  to  have  been 
curative  in  many  severe  cases  resisting  other  remedies  (P.).  In  cardiac  disease 
its  action  is  uncertain  (Br.).  Arsenic,  lessens  or  prevents  paroxysms,  if  used  in 
the  intervals  (B.,  R.,  Anstie).  Amyl  Nitrite,  as  inhalation,  affords  signal  relief 


490 


ANUS,  FISSURED - APHONIA. 


(R.,  B.) ;  unsafe  in  advanced  degeneration  of  cerebral  vessels  and  fatty 
degeneration  of  heart  (B.)  ;  gives  great  relief  during  paroxysms  (Br.).  Nitrite 
of  Sodium,  is  less  rapid  in  action  than  Nitrite  of  Amyl,  but  is  more  efficient  in 
preventing  return  of  symptoms  (Br.).  Laurocerasus,  as  anodyne  (P.).  Strych¬ 
nine,  in  the  milder  forms  ;  very  small  doses,  gr.  to  ^  (P.).  Glonoinum, 
doses  of  PVrjj(j  have  been  used  with  success  (Pf.,  R.).  Chamomile,  in  pseudo¬ 
spasms  of  hysterical  persons  (P.).  Ether,  aborts  a  mild  attack  (B.) ;  Sulphuric 
Ether,  in  nervous  form  ;  a  spoonful  immediately  on  commencement  of  attack 
will  greatly  mitigate  it  (Anstie).  Phosphorus,  often  serviceable  (R.).  Morphine, 
hypodermically,  especially  in  cardiac  dyspnoea ;  strengthens  the  heart  (R.). 
Turpentine,  applications,  hot,  over  chest,  to  mitigate  severity  of  the  paroxysms, 
especially  in  the  aged  (Wa.).  Quinine,  when  intermittent  (Wa.)  or  when  any 
malarial  taint  (Br.).  Brandy,  in  frequent  small  doses,  with  hot  bran  poultice 
over  heart,  and  warmth  to  extremities.  Cocaine,  in  doses  of  gr.  to  yz  thrice 
daily  for  two  days,  proved  curative  in  four  very  severe  cases  (Laskevitch). 

Anus,  Fissured. 

Hydrastis,  locally,  promotes  healing  (B.).  Rhatany,  as  injection,  night  and 
morning,  after  enema  in  the  morning  to  move  the  bowels  (Pf.,  Tr.).  Iodoform, 
improves  and  relieves  pain  (B.).  Iodo-tannin,  well  applied  effective  (B.). 
Belladonna,  locally,  of  great  service  for  painful  spasms  of  sphincter  (P.). 
Opium,  with  gall-ointment  for  fissures  of  anus ;  mild  purgatives  should  be 
simultaneously  employed  (R.).  Sulphur,  as  a  mild  purgative,  to  cause  soft 
motions  (R.).  Tannin,  3j-glycerin  ~ij ;  introduced  on  a  tent,  night  and  morning, 
with  great  advantage  (Wa.).  Collodion,  as  protective  covering  (P.)  Potassic 
Bromide,  with  5  parts  glycerin,  as  local  application  (R.).  Castor  Oil,  as  a  mild 
purgative  (R.)  ;  to  keep  motions  soft  (Br.).  Surgical  Means,  the  most  efficient ; 
forcible  dilatation  of  sphincter,  or  partial  division  in  severe  cases,  through  the 
mucous  membrane,  and  a  few  fibres  of  sphincter. 


Prescriptions. 


R.  Tinct.  Kramerice,  .  .  .  .  3  j. 


Ext.  Kramerite, . £ij. 

Aquae, . ad  ^\\\). 


M.  Sig. — One-fourth  as  injection,  night 
and  morning,  after  using  enema. 


R.  Sulphuris, . ^j. 

Pulveris  Aromat.,  .  .  .  .  spj. 

Confec.  Rosae,  . gij. 

Misce.  Sig. — One-third  to  be  taken  at 
bedtime  as  a  laxative. 


Aphonia. 

Ignatia,  in  hysterical  women  (P.).  Atropine,  in  hysterical  aphonia,  and  for 
fatigue  of  vocal  chords,  gr.  T^y  to  -gL,  morning  and  evening  (B.).  Nitric  Acid, 
rr^v-x  of  the  dilute  acid,  for  hoarseness  of  singers,  in  fatigue  of  vocal  cords, 
and  when  stomachal  (B.).  Benzoin,  the  tincture  by  inhalation  in  laryngeal 
catarrh  (Br.).  Oil  of  Rue,  as  inhalation  in  chronic  catarrh  (Br.).  Nitrate  of 
Uranium,  as  spray  in  very  chronic  catarrh  (Br.).  Alum,  gr.  x-^j  aq.,  as  spray, 
in  chronic  coughs  and  hoarseness  (R.).  Borax,  a  piece  the  size  of  a  pea 
allowed  to  dissolve  in  the  mouth  (R.).  Glycerin  of  Tannin,  locally  in  chronic 
inflammation  of  the  throat  (R.).  Sulphurous  Acid,  by  inhalation,  spray  or 
fumigation,  in  clergyman’s  aphonia  (R.).  Ipecacuanha,  wine,  as  spray,  when 
congestion  of  vocal  cords  (R.) ;  in  laryngeal  catarrh  (Br.).  Ammonium 
Chloride,  vapor  inhaled,  of  great  value  in  catarrhal  aphonia  (Wa.).  Turkish 
Bath,  at  commencement  of  a  feverish  cold  (R.) ;  in  acute  laryngeal  catarrh  (Br.). 
Galvanism,  localized,  the  best  means  for  hysterical  aphonia. 


Prescriptions. 


R.  Liq.  Ammonite, . 5). 

Aqu^> . .  •  •  A  j- 

M.  Sig. — A  teaspoonful  in  a  pint  of  hot 
water  for  each  inhalation. 


R.  Acidi  Nitrici  Dil.,  .  .  .  .  £ij. 
Tinct.  Calumbte,  .  .  .  .  £j. 

Aquce, . ad  5  iv. 

M.  Sig. — A  dessertsp.  in  a  winegl.  of 
water  thrice  daily. 


APHTHAE - APOPLEXY - APPETITE. 


49  1 


Aphthae. 


Potassium  Chlorate,  the  best  remedy.  Solution  of  gr.  x  to  the  5,  as  wash, 
alone  or  with  borax  (Br.),  and  gr.  x  to  xx  by  the  stomach  (B.).  Borax,  with 
honey,  or  as  glycerin  of  borax,  frequently  used  (R.)  ;  crystals  allowed  to  dissolve 
in  the  mouth  (W.).  Sulphurous  Acid,  as  solution,  strong  or  diluted,  locally  (R.). 
dilute  as  spray  (B.).  Mineral  Acids,  formerly  much  used  (B.).  Mercury,  Hydr. 
cum  creta  in  small  doses  to  remove  the  indigestion  on  which  aphthae  often 
depends  (B.),  borax  being  used  locally,  when  aphthae  exist  in  the  mouth  (Wa.). 
Copper  Sulphate,  a  weak  solution  painted  over  mucous  membrane  (R.).  Potas¬ 
sium  Iodide,  gr.  j-v-jf j  aquae,  locally  (B).  Salicylic  Acid,  one  part  (dissolved 
in  alcohol)  to  250  of  water  (R.).  Quinine,  gr.  j  every  2  or  3  hours,  in  infants 
(B.),  especially  when  consequent  on  diarrhoea  (Br.).  Coptis,  the  infusion  has 
repute  in  New  England  (B.).  Bismuth,  freely  to  parts  (B.)  ;  as  a  local  applica¬ 
tion  (Br.).  Glycerin,  will  sometimes  cure  (R.).  Rhubarb  the  compound 
powder  of  rhubarb,  to  remove  indigestion  (Br.)  ; — is  highly  useful  in  small 
doses  (Wa.). 


Prescriptions. 


R  .  Ac.  Sulphurosi, . 3  ij. 

Aquae, . ad^'i). 


M.  Sig. — Mouth-wash,  or  use  as  a  spray. 


R.  Pulv.  Rhei  Co.,  .  .  .  . 
Sacch.  Lactis,  q.  s. 
Triturat.  et  div.  in  pulv.  xij. 
thrice  daily. 


34 

Sig. — One 


Apoplexy. 


Aconite,  full  strong  pulse  ;  hot,  dry  skin,  plethoric  cases.  The  best  remedy 
(P.) ; — to  lower  blood-pressure  and  prevent  further  hemorrhage,  where  the  pulse 
is  strong  and  the  arterial  tension  high  (Br.).  Elaterium,  as  a  purgative  ;  a 
large  dose  (gr.  ij)  in  suppository  with  soap  ;  or  as  an  injection  into  large  bowel 
(P.).  Croton  Oil  as  purgative,  a  drop  may  be  put  on  the  back  of  the  tongue 
(Br.)  ; — or  lA  each  hour  (R.).  Colocynth,  as  a  derivative  purgative  (Br.) ; 
appears  to  act  well  (P).  Cold  Water,  often  harmful,  though  frequently  used. 
Injurious  when  face  pale,  surface  cool,  circulation  depressed  (B.).  Electricity. 
Very  mild  galvanic  currents  to  promote  absorption.  Caution  necessary,  espe¬ 
cially  if  much  headache  and  vertigo  (B.).  Diet  and  Hygiene,  of  great  import¬ 
ance  in  patients  subject  to  apoplexy.  Avoid  stimulating  food  and  drink 
(especially  beer),  overeating,  excitement,  haste,  exposure  to  hot  sun,  heated 
rooms,  etc.  At  no  subsequent  period  should  a  full  animal  diet  or  the  use  of 
undiluted  wines  be  indulged  in  (A.).  Diagnosis.  Should  be  carefully  differ¬ 
entiated  from  drunkenness,  with  which  it  is  often  confounded.  [Compare 
Cerebral  Congestion.] 


Prescriptions. 


R.  Tinct.  Aconiti, . TT^x. 

Aquae  Cinnamomi,  .  .  adf^  ij. 

M.  Sig. — A  teasp.  every  X  hour  for  2 
hours,  then  every  half-hour. 


R.  Ext.  Colocynthidis  Co.,  .  .  gr.  xx. 

Olei  Tiglii, . tryj. 

Fiat  massa,  et  div.  in  pil.  iv. 

Sig. — One  pill  as  required,  until  free 
purgation  ensues. 


Appetite. 

Ignatia,  will  correct  diseased  appetite  (P.) ;  especially  in  hysterical  subjects 
(Br.).  Anthemis,  will  stimulate  the  appetite.  Bitters,  to  stimulate  the  appe¬ 
tite  (R.).  Food  should  be  savory  and  well  cooked.  Habits  require  examining 
into,  when  lost  appetite  complained  of.  Fluorides  of  Sodium  or  Potassium  will 
produce  almost  total  anorexia,  and  may  be  employed  with  advantage  in  bulimia 
(Da  Costa).  [Compare  Dyspepsia.  | 


492 


ASCITES - ASTHENOPIA - ASTHMA. 


Prescriptions. 


R .  Gentians,  Quassias, 

Cinnamomi, . aa  gij. 

Sig. — Put  into  a  pint  of  boiling  water, 
and  when  cold,  strain ;  take  a  winegl. 
thrice  daily  as  an  appetizer. 


R .  Anthemidis, 

Quassiae, . aa  £j. 

Sig. — Put  in  a  pint  of  boiling  water,  and 
when  cold,  strain;  take  a  winegl.  thrice 
daily  before  meals  as  an  appetizer. 


Ascites. 

Digitalis  of  the  greatest  service,  except  where  aortic  regurgitation  and  car¬ 
diac  hypertrophy  (P.)  ;  fresh  infusion  best  (R.) ; — its  action  increased  by  com¬ 
bination  with  squill  and  pil.  hydrargyri  (Br.).  Arsenic,  when  from  feeble  heart, 
and  in  old  age  (B.).  Apocynum  Can.,  an  active  diuretic  (P.).  Copaiba,  excel¬ 
lent  in  hepatic  dropsy  (Br.).  Jaborandi,  has  given  good  results  (B.).  Stillingia, 
in  ascites  due  to  hepatic  changes  (B.).  Jalap,  the  compound  powder,  with 
podophyllum,  the  most  generally  approved  hydragogue  purgative  (B.).  Ela- 
terium,  to  produce  free  watery  evacuations.  Cautiously  in  debilitated  subjects. 
Contraindicated  when  gastro-intestinal  irritation  or  inflammation.  Is  depres¬ 
sant  (B.).  Milk-diet,  successful;  an  ancient  practice;  causes  profuse  alvine 
and  urinary  discharges  (B.)  ; — sometimes  very  useful  when  the  kidney  action 
is  inadequate  (Br.).  (Compare  Dropsy.] 


Prescriptions. 


R .  Resinae  Copaibae,  .  .  .  .  5  iij. 

Alcoholis, . %  v. 

Spt.  Chloroformi,  .  .  .  .  £j. 
Mucil.  Acaciae,  .  .  .  ,  .  3  ij. 

Aquae, . q.  s.  ad$x ij 

M.  Sig. — A  tablesp.  thrice  daily. 


R  .  Hydrarg.  Chlor.  Mitis, 

Pulv.  Digitalis, 

Pulv.  Scilloe, . aa  gr.  vj. 

Fiat  massa,  et  div.  in  pil.  vj. 

Sig. — One  pill  thrice  daily,  in  ascites 
from  hepatic  changes. 


Asthenopia. 

The  proper  glasses;  cold  douche;  rest  of  eyes.  Atropine,  systematically 
instilled,  to  prevent  strain,  and  control  spasm  of  the  accommodation  (C.). 
[Compare  Myopia.] 


Asthma. 

Aconite,  in  spasmodic  (P.) ;  often  averts  the  attack,  if  given  at  commence¬ 
ment  ;  useful  also  in  the  asthma  following  coryza  and  sneezing  in  children. 
(R.).  Ipecacuanha,  the  wine  as  spray  to  the  fauces,  sometimes  useful  in  severe 
bronchial  asthma,  but  not  of  much  service  in  genuine  asthma  (R.) ;  nauseating 
and  emetic  doses  in  spasmodic  form  (B.).  Lobelia,  gtt.  x  of  the  tincture  every 
hour  during  paroxysm  ;  rr^x  ter  die,  with  additional  doses  at  night,  in  bron¬ 
chitic  asthma  when  worse  at  night.  Cautiously  if  heart  disease  (R.).  Often 
gives  permanent  relief  (B.)  Arsenic,  as  cigarettes  as  well  as  by  internal  admin¬ 
istration  (B.).  One  drop  of  liquor  arsenicalis  ter  die,  in  attacks  from  bronchitis, 
local  irritation,  etc.,  allied  to  hay  fever  (R.).  Belladonna,  relieves  paroxysm 
when  expectoration  abundant,  skin  cool  and  moist  (B.).  Internally  in  large 
doses,  also  in  cigarettes  (Br.).  Atropine  hypodermically  is  more  efficient,  gr. 
-fo  at  bedtime  to  abort  morning  paroxysm  (B.).  Large  doses  required,  but  very 
satisfactory  (R.).  Was  much  valued  by  Dr.  Salter  and  M.  See  (P.).  Potassium 
Iodide,  when  from  acute  bronchial  catarrh,  gr.  xv-xx  each  2,  3,  or  4  hours  (B., 
R.).  The  best  medicament  to  suppress  the  asthmatic  attack,  in  bronchial  asthma, 
is  iodide  of  potassium  and  chloral  (Lazarus).  Is  the  specific  in  asthma,  if  any 
drug  can  be  so  called  ;  should  be  given  with  Lactucarium  (See).  Cocaine,  hypo¬ 
dermically,  is  used  with  the  best  results,  even  where  other  remedies  failed  to 
relieve  (Mosler).  The  leaves  of  the  coca-plant  make  the  best  cigarettes  for 
asthma  (Nachtigal).  Pilocarpine  Hydrochlorate,  gr.  l/e  in  water,  at  bedtime, 


ASTHMA. 


493 


promptly  and  effectively  relieves,  in  cases  of  bronchitic  asthma  with  hypertro¬ 
phic  rhinitis.  In  some  of  nine  years’  standing  it  gave  permanent  relief  appa¬ 
rently  (Wyss).  Nux  Vomica,  in  nervous  subjects  (B) ;  in  spasmodic  asthma, 
often  of  great  benefit  (P.).  Chloral,  may  arrest  paroxysm  (B.,  R.).  Chloroform, 
inhaled  from  warm  water.  Anaesthetics  relieve,  but  increasing  doses  required, 
leading  to  habit  (B.,  R.).  Ether,  full  dose,  may  avert  a  mild  attack  (B.).  Amyl 
Nitrite,  inhaled,  quickly  checks  spasmodic  asthma  (B.,  R.)  Antimony,  in  an 
affection  of  children  like  asthma.  Dissolve  a  grain  of  tartar-emetic  in  half  a 
pint  of  water,  and  give  a  teaspoonful  of  this  every  X  hour  for  the  first  hour, 
then  hourly.  If  vomiting  induced,  lessen  the  dose  (R.)  Coffee,  a  small  cup  of 
very  strong  coffee  often  useful  in  a  paroxysm  (R.).  Asthmatics  should  not  use 
it  as  a  beverage  (P.).  Stramonium,  twenty  grains  of  the  dried  leaves  or  ten  of 
the  powdered  root  may  be  smoked.  Datura  tatula  sometimes  better.  Stramo¬ 
nium  preparations  often  bad.  Asthmatics  advised  to  grow  the  drug  themselves 
(R.).  Grindelia,  gives  relief  in  spasmodic  form  (B.) ;  three  grains  of  extract 
thrice  daily,  to  prevent  attacks,  or  i^xx-xxx  of  liquid  extract  every  half-hour  or 
hourly  from  onset  of  paroxysm  (R.).  Ethyl  Iodide,  very  valuable  in  spasmodic 
form,  and  lessens  liability  to  subsequent  attacks.  rr\,v-xx  thrice  daily  by  inha¬ 
lation  (B.).  Cannabis  Indica,  has  been  useful  (R.).  Sulphurous  Acid,  by  inha¬ 
lation,  spray,  or  fumigation  (R.).  Morphine,  hypodermically,  quickly  cuts  short 
a  paroxysm  (B.)  ;  in  some  cases  morphine  will  induce  a  paroxysm  (R.).  Apo- 
morphine,  gr.  TX  hypodermically,  has  been  found  effective ;  or  gr.  every  3  or 
4  hours  in  camphor  water,  with  or  without  morphine  or  ipecacuanha.  Tobacco, 
smoking  sometimes  relieves  (R.,  P.).  Asafcetida,  has  been  recommended  (R.) ; 
palliative  only  (P.).  Colchicum,in  gouty  subjects  (R.).  Bromides,  relieve  but 
soon  lose  effect  (B.,  R.).  Eucalyptus,  smoked  with  stramonium,  belladonna, 
tobacco  (B.).  Quinine,  after  acute  symptoms  subside,  as  antipyretic  to  succeed¬ 
ing  fever  and  restorative  tonic  (B.).  Potassium  Nitrate,  the  inhalation  of  fumes 
of  burnt  nitre  paper  will  sometimes  avert  a  paroxysm.  Different  methods  of 
preparation  useful  for  different  cases  (R  ).  Oxygen,  when  no  heart  disease  (R.). 
Silver  Nitrate,  sometimes  injected  into  trachea  (R.).  Chamomile  Oil,  has  been 
found  very  serviceable  (P.).  Sanguinaria,  is  very  useful  in  humid  asthma,  and 
occasionally  so  in  the  spasmodic  form  (R.).  Galvanism,  of  pneumogastric 
often  relieves  ;  -)-  pole  beneath  mastoid  process  ;  —  pole  to  epigastrium.  Farad- 
ism  of  no  use  (B.).  Prophylaxis,  avoidance  of  exciting  causes,  especially  indi¬ 
gestible  food,  wet,  damp,  and  sudden  changes  of  temperature.  Attention  to 
the  stomach  will  do  most  for  many  asthmatic  patients.  An  important  point  is 
to  take  the  heaviest  meal  early  in  the  day,  and  very  solid  food  after  2  p.m. 
Shower-bath  and  out-of-door  exercise,  not,  however,  to  a  fatiguing  extent  (R.). 
In  special  cases  operative  treatment  of  the  nose  and  naso-pharynx  is  required 
(Lazarus). 


Prescriptions. 


Moisten  unsized  white  paper,  and  roll 
into  cigarettes,  each  containing  gr.  X  to 
gr.  j  of  the  salt.  Two  or  three  of  these 
to  be  inhaled  daily.  ( Bai'tholow .) 


Arsenical  Cigarettes. 

R  .  Sodii  Arseniatis,  .... 
Aquae  Destill atae,  .  .  . 


."ss-j. 

si- 


R .  Belladonnae  Fob,  .  .  . 
Stramonii  Fob, 

Hyoscyami, . 

Extracti  Opii,  .... 
Aquae  Lauro-cerasi,  q.  s. 


aa  Z  ss. 

.  .  gr.  iij 


3J- 


Dissolve  the  opium  'in  the  water,  and 
moisten  the  leaves  therewith.  When  dry, 
roll  into  tw'elve  cigarettes.  Smoke  two  to 


four  daily. 


(  Trousseau. ) 


R  .  Ext.  Grindeliae  Fluidi,  .  .  jf  ss. 


R .  Tinct.  Sanguinariae, 


Ext.  Lobeliae  Fh,  .  . 
Ext.  Belladonnae  Fh,  . 
Potassii  Iodidi,  .  .  . 
Glycerini, . 


Tinct.  Lobeliae, 
Ammonii  Iodidi,  .  . 
Syr.  Tolutani,  .  . 


.  aa  3j. 


M.  Sig. — A  teaspoonful  every  2,  3  or  4 


M.  Sig. — A  dessertspoonful  as  required.  hours,  in  humid  asthma. 


(B-> 


494 


ASTIGMATISM — ATHEROMA - ATROPHY - BALANITIS. 


R.  Chart.  Potass.  Nitratis,  .  .  .  j. 

Burn  in  a  close  room  and  inhale  the 
fumes. 


R .  Ammonii  Bromidi,  .  .  .  .  gr.  clx. 
Ammonii  Chloridi,  .  .  .  .  gr.  xc. 

Tinct.  Lobelia, . z  iij. 

Spt.  Etheris  Comp.,  .  .  .  ^j. 
Syrupi  Acaciee,  .  ...  ad  ^iv. 

M.  Sig. —  \  dessertspoonful  in  water, 
every  hour  or  two,  for  the  paroxysm. 

(. Pepper .) 


R.  Spt.  Etheris  Comp.,  .  .  .  .  gj. 
Tinct.  Belladonna?,  .  .  .  .  z)). 
M.  Sig. — A  teaspoonful  ter  in  die. 


R.  Tinct.  Lobeliae, . ^ j. 

Ammonii  Iodidi,  .  .  .  .  3  ij. 
Ammonii  Bromidi,  .  .  .  5 iij. 
Syrupi  Tolutani,  .  .  .  .  ;jij. 

M.  Sig. — A  teaspoonful  every  1,  2,  3  or 
4  hours.  (B.) 

R .  Spt.  Etheris.  Compos., 

Liq.  Morph.  Sulph. 

(gr-  j  ad  oJ)>  •  •  •  •  aa  gj. 

M.  Sig. — A  teaspoonful  every  half-hour 
or  hour  in  the  paroxysm. 


R.  Potassii  Bromidi,  ....  %qj. 

Potasii  Iodidi, . ^  ss. 

Aquae  Cinnamomi,  .  .  .  .  3  iv. 

M.  Sig. — A  teaspoonful  in  water  every 
half-hour  or  hour.  (B.) 


Astigmatism. 

Atropine,  a  weak  solution  to  aid  examination  of  eye  by  dilating  pupil,  and 
paralyzing  accommodation  (B.).  Duboisine,  as  substitute  for  atropine,  has  more 
rapid  action,  with  shorter  duration  of  effects,  and  less  conjunctival  irritation. 
Glasses,  of  suitable  form,  cylindrical  in  simple  astigmatism,  bi-cylindrical  in 
mixed  astigmatism.  Pray’s  Test  Letters,  to  determine  degree  and  direction  of 
the  defect  (C.). 

Atheroma. 

Phosphorus,  in  minute  doses,  for  atheroma,  with  cod-liver  oil  (B.).  Arsenic, 
often  of  great  value  in  atheroma,  especially  where  imperfect  action  of  kidneys 
(Br.) ;  indicated  when  there  are  puffy  eyes,  drowsiness,  intellectual  torpor  (B.). 
Quinine,  gr.  iij-x  daily,  in  atheroma,  with  advantage  (B.).  Ammonium  Bro¬ 
mide,  in  atheroma,  to  promote  absorption  of  deposit  (Wa.).  Digitalis,  may  be 
useful  in  general  capillary  atheroma ;  cautiously  !  (W.).  Cod-liver  Oil,  with 
phosphates,  hypophosphites,  or  the  lacto-phosphate  of  lime,  in  combination  (B.). 
[Compare  Aneurism.] 

Atrophy. 

Cod-liver  Oil,  has  proved  beneficial  (Wa.).  Olive  Oil,  by  inunction,  every 
12,  6,  or  4  hours,  successfully  employed  (Wa.)  Arsenic,  has  had  remarkable 
success  in  muscular  atrophy  (Tr.).  Electricity,  in  progressive  muscular  atrophy, 
the  induced  current  very  strong  at  first,  then  weaker  as  improvement ;  interrupted 
currents  from  vertebral  column  and  plexuses  to  nerves  of  affected  muscles ;  in 
more  extended  forms,  the  constant  current  to  the  nerves,  the  induced  to  the 
muscles  (Ros.).  Massage,  removes  the  waste  products  and  restores  the  muscular 
power  (Br.).  [Compare  Emaciation,  Locomotor  Ataxia.] 

Balanitis. 

Mercury,  Hydr.  Chlor.  Corr.  gr.  j  to  ^jss  aquae  calcis,  as  lotion,  if  not  much 
inflammation  (Br.).  Oil,  on  linen,  to  inflamed  part,  beneath  foreskin,  which 
must  be  again  drawn  forward ;  strict  cleanliness.  Astringent  Lotions,  Alum, 
Sulphate  of  Zinc,  with  warm  water  injections  (Br.).  Lime-water,  the  best  lotion 
if  much  inflammation  (D.).  Tannin,  in  alcohol,  equal  parts,  as  dressing  after 
washing  with  a  weak  solution  of  common  salt.  Carbolic  Acid,  a  5  per  cent, 
solution,  on  cotton  rag  after  washing,  thrice  daily,  is  generally  sufficient.  [Com¬ 
pare  Phimosis,  Gonorrhoea.] 


(V 


BED-SORES - BILIOUSNESS. 


495 


Bed-sores. 

Alcohol,  Brandy,  or  eau-de-cologne,  to  harden  skin  of  parts  exposed  to  pres¬ 
sure  (R.)  ;  as  wash  to  parts  threatened  (B.).  Glycerin,  or  glycerin-cream, 
rubbed  over  the  parts  exposed  to  pressure,  after  washing,  morning  and  even¬ 
ing,  is  one  of  the  best  preventives  (R.).  Alum,  3SS,  whites  of  four  eggs,  Tinct. 
Camphorae,  ifij,  an  excellent  application  (B.).  Charcoal,  sprinkled  over  the 
black  slough,  which  is  then  covered  with  poultice  (R.).  Galvanic  Couplet,  of 
zinc  and  silver,  connected  by  a  copper  wire  ;  one  element  on  sore,  the  other  on 
adjacent  part  (B.).  Silver  Nitrate,  a  solution  (gr.  xx-^j)  to  be  painted  on  the 
threatened  but  unbroken  skin,  as  soon  as  it  becomes  red,  will  prevent  sores ;  if 
Nitrous  Ether  solution  be  used,  5  grs.  to  the  oz.  is  enough  (R.).  Iodoform,  dusted 
over  sores  (R.).  Linen,  air-dried  better  than  that  which  is  ironed  or  mangled, 
by  reason  of  its  greater  softness. 


Biliousness. 


Podophyllum,  acts  as  a  cathartic  (B.);  corrects  deficient  secretion  of  bile,  espe¬ 
cially  in  children  and  infants  ;  gr.  ^  to  y1^,  every  six  hours,  to  correct  white  or 
clayey  stools  ;  also  in  general  hepatic  derangement  (P.).  Aconite,  in  occa¬ 
sional  doses,  improves  the  effect  of  Podophyllum  (R.).  Mercurial  Cathartics, 
act  only  as  purgatives,  Calomel  gr.  j-x,  or  Pil.  Hydrarg.  gr.  v-x  ;  Mercury 
as  purgative  restricted  to  cases  where  there  is  excess  or  deficiency  of  bile  (B.). 
Frequent  small  doses  of  gray  powder  for  deficiency  (R.)  ;  Calomel,  gr.  iij,  fol¬ 
lowed  by  gij  each  of  Rochelle  and  Epsom  Salts,  when  the  tongue  is  heavily 
coated  and  furred  (Gross).  Yellow  Oxide  of  Mercury,  in  doses  of  gr.  to 
in  trituration  with  sugar  of  milk,  exceedingly  efficient  in  many  disordered  con¬ 
ditions  of  the  alimentary  canal  and  its  appendages  (Schaffer).  Bryonia,  is 
worthy  of  commendation  in  the  ordinary  bilious  headache  with  vomiting,  and 
in  general  hepatic  derangement  known  as  sluggish  liver  (P.).  Hydrastis,  gtt. 
v-xv  fl.  ext.  daily  before  meals,  when  with  chronic  gastric  catarrh  and  dys¬ 
pepsia  (B.).  Mineral  Acids,  before  meals,  Hydrochloric  Acid  and  Pepsin  after 
meals,  in  atonic  dyspepsia  (B.).  Stillingia,  when  deficient  biliary  secretion  (B.); 
may  be  used  in  place  of  Mercury  (Br.)  Ammonium  Iodide,  gr.  j-iij  in  water  each 
2,  3,  or  4  hours,  when  catarrh  of  duodenum  and  biliary  ducts  (B.).  Ammonium 
Chloride,  is  much  employed  in  Germany  for  hepatic  derangements,  and  with 
good  success.  Euonymus,  is  considered  very  efficient  by  many  practitioners 
in  cases  of  hepatic  dyspepsia,  or  “bilious  attacks,”  so-called.  Manganese, 
gouty  subjects.  Rhubarb,  as  a  cholagogue.  Aloes,  with  constipation.  Angos¬ 
tura,  is  suitable  to  worst  forms  of  bilious  fevers  (P.).  Calumba,  is  of  benefit  in 
many  forms  (P.).  Alkalies,  and  their  laxative  salts,  when  bilious  state,  with 
uric  acid  diathesis  (B.).  Milk-cure,  in  obstinate  cases  ;  buttermilk  or  skimmed 
milk  often  agrees  best  (B.).  [Compare  Dyspepsia,  Hepatic  Congestion, 
Duodenal  Catarrh.] 

Prescriptions. 


R.  Ext.  Stillingiae  FL, . £v. 

Tinct.  Aloes, . 3  ij. 

Tinct.  Nucis  Vom., . 3j. 

M.  Sig. — Twenty  drops  in  water  thrice 
daily.  (B.) 


R  .  Ext.  Euonymi, . 3  ss. 

Ext.  Hyoscyami, . gr.  xv. 

Ext.  Gentianae, . gr.  vj. 

Fiat  massa,  et  div.  in  pil.  xij. 

Sig. — One  pill  every  other  day. 


R  .  Hydrarg.  Oxidi  Flavi . gr.  j. 

Sacch.  Lactis,  q.  s. 

Triturat.  et  div.  in  chart,  xlviij. 

Sig. — One  powder  dry  on  the  tongue 
twice  daily. 


R .  Massae  Ilydrargyri, 

Ext.  Colocynthidis  Co.,  aa  gr.  iij. 
M.  et  div.  in  pil.  ij. 

Sig. — Take  at  once,  and  follow  in  a  few 
hours  with  a  saline  cathartic. 


496 


BLADDER - BLEPHARITIS - BOILS. 


Bladder,  Irritable. 


Belladonna,  in  nocturnal  incontinence,  due  to  relaxation  of  sphincter,  or  irri¬ 
table  mucous  membrane  (B.) ;  gtt.  v-xx  of  tinct.  every  3  or  4  hours  give  gradual 
but  sure  relief  (P.).  Cantharis,  in  women,  without  acute  inflammation  (B.)  ; 
on  coughing  (R.).  Benzoic  Acid,  when  from  enlarged  prostate,  removes  fetor 
of  urine ;  also  renders  phosphatic  or  alkaline  urine  acid  (P.).  Ammonium  Ben¬ 
zoate,  may  be  used  instead  of  Benzoic  Acid  (Br.)  Gelsemium,  the  best  remedy 
for  irritable  bladder  of  women  of  hysterical  type,  with  constant  desire  to  urinate 
(B.).  Cubebs,  is  often  successful  in  women,  but  Cantharides  generally  better 
(B.)  ;  is  of  especial  value  when  vesical  catarrh  present  (P.).  Aqua-puncture, 
strange  to  say,  has  been  used  with  considerable  success  (B.).  Cannabis  Indica, 
in  spasm  of  the  bladder,  and  in  irritable  conditions  of  that  organ  is  generally 
useful.  Eucalyptol,  is  often  very  efficient,  but  frequently  fails,  tr^ij  on  sugar 
two  or  three  times  a  day.  [Compare  Cystitis,  Dysuria,  Enuresis,  Lithiasis, 
Calculi,  Urinary  Disorders.] 


R  .  Tinct.  Gelsemii.  . 
Sodii  Bromidi,  . 
Ext.  Tritici  Fluidi, 


Prescription. 


Sig. — A  teaspoonful  in  water  every  four 
hours,  for  irritable  bladder. 


Bladder,  Paralysis  of, 

Cannabis  Indica,  in  retention  from  spinal  disease  (R.).  Ergot,  in  paralytic 
dysuria,  especially  when  sensation  of  bladder  being  only  partially  emptied 
(P.) ;  when  incontinence  from  paralytic  sphincter,  and  in  paralysis  from  over 
distention  (B.,  Wa.).  Arnica,  has  proved  curative  (P.).  Strychnine,  gr.^  to  ^ 
useful  (B.).  Cantharides,  often  given  with  excellent  effect,  when  bladder  atonic 
(Wa.).  Galvanism,  may  greatly  benefit  (B.) ;  electro-magnetic  current  from 
the  bladder  to  the  spine,  of  great  use  (Wa.). 


Blepharitis. 

Pulsatilla,  internally  and  externally  (P.,  B.).  Mercury,  after  detaching  crusts, 
rub  in  brown  citrine  ointment  (B.) ;  should  be  diluted  with  vaseline  or  simple 
ointment  (Br.).  Tannin,  powdered,  or  tannic  acid  solution,  gr.  j-x  to  the  5 
(B.).  Alum,  after  acute  symptoms  subside  (B.). ;  a  solution,  gr.  viij-^j  aquae, 
every  %  or  %  hour,  an  excellent  application  (R.).  Hydrastis,  as  lotion,  very 
serviceable  (P.).  Bismuth,  equal  parts  of  the  subnitrate  and  glycerin  to  the 
inflamed  surface,  in  ciliary  and  glandular  blepharitis  (Wa.).  Ergot,  the  fluid 
extract  locally,  gives  excellent  results  (B.). 


Prescriptions. 


R  .  Aluminis, . gr.  x 

Aquee  Rosae, . 5  ij. 


M.  Sig. — Lotion  for  the  eyelids.  (B.) 


R.  Unguent.  Hydrarg.  Nitrat.,  %]. 

Vaselince  Albae, . ^iij. 

M.  Sig. — Ointment  for  the  margins  of 
the  eyelids. 


Boils. 

Belladonna,  as  plaster,  to  subdue  inflammation,  or  use  lint  wetted  with  Atro¬ 
pine,  gr.  iv,  Aquae  Rosae,  5j  (B.) ;  with  Glycerin  locally,  to  allay  pain  ;  inter¬ 
nally  often  successful  (R.,  Wa.).  Sulphides,  in  small  doses  (gr.  ^  to  of  Calx 
Sulphurata)  every  hour  or  two,  or  Sulphurous  Mineral  Waters  will  abort  or 
mature,  and  aid  to  expel  pus  (B.,  R.)  ;  of  no  use  in  the  boils  of  diabetes  (R.). 
Aromatic  Sulphuric  Acid,  for  the  tendency,  gtt.  x-xv,  in  plenty  of  water  thrice 
daily.  Silver  Nitrate,  gr.  v— XX-5J  of  nitrous  ether,  painted  over  adjacent  part, 
to  abort ;  specific  if  used  early  (B.,  R.).  Arsenic,  long-continued  for  succes- 


497 


BONE - BREATH - BRIGHT’S  DISEASE. 


sion  of  boils  (B.) ;  to  lessen  tendency  to  recurrence  (Br.).  Opium,  a  thick 
extract  locally  (R.).  Camphorated  Alcohol,  smeared  over  boils  in  the  earliest 
stage,  then,  when  skin  dry,  smear  with  camphorated  oil,  to  abort  (R.).  Sodium 
Phosphate,  the  best  remedy  for  the  systemic  condition  which  produces  boils 
(R.).  Carbolic  Acid,  undiluted,  on  a  thread  passed  through  centre  of  boil  while 
recent,  will  abort  it.  Counter-irritation,  by  blisters  or  Iodine  around  the  boil 
(R.).  Collodion,  at  papular  or  pustular  stage  (R.).  Salicylic  Acid,  locally  to 
destroy  the  parasitic  organism  (staphylococcus  pyogenes),  on  which  boils  de¬ 
pend.  See  formula  below.  (Heitzmann.)  Hydrarg.  Biniodide,  the  oint. 
locally,  with  Calcium  Sulphide,  gr.  j  daily  in  divided  doses  internally,  leaves 
little  to  be  desired  so  far  as  treatment  is  concerned.  Poultices  to  assist  matu¬ 
ration  and  allay  pain,  may  be' smeared  over  with  Belladonna  or  Opium  (R.). 
[Compare  Acne,  Carbuncle.] 


Prescriptions. 


R.  Calcis  Sulphurat.,  .  .  .  .  gr.  iij. 
Sacch.  Lactis,  q.  s. 

Triturat  et.  div.  in  chartas  xxx. 

Sig. — One  powder  every  2  hours. 


R.  Acidi  Salicylici, . ^ij. 

Emplast.  Saponat.,  .  .  .  .  ^  ij. 
Emplast.  Diachyl.,  .  .  .  . 

Sig. — Ointment.  ( Heitzmann. ) 


Bone,  Diseases  of. 

Iodine,  in  scrofulous  affections  of  bones,  should  be  used  locally,  with  the 
iodide  ot  iron  or  cod  liver  oil  internally,  nutritious  diet,  wine,  out-door  exercise 
(Wa.).  Cod-liver  Oil,  in  scrofulous  affections,  may  be  relied  on  if  perseveringly 
used,  and  accompanied  by  good  hygienic  conditions  (Wa.).  [Compare  Caries, 
Exostosis,  Nodes,  Periostitis,  Rachitis,  Spina  Bifida,  etc.] 


Breath,  Fetid. 

Potass.  Permang.,  gr.  j-^j  aquae  rosae,  as  a  wash  for  the  mouth  (B.).  Chlo¬ 
rine,  as  solution  of  chlorinated  lime,  to  remove  fetor  (B.).  Carbolic  Acid,  a 
dilute  solution,  as  wash  for  mouth  (W.).  Camphor,  is  used  as  a  corrective  (R.). 
Look  for  bad  teeth,  disordered  digestion  ;  in  very  offensive  cases,  gangrenous 
lungs,  cleanliness  of  teeth  and  mouth  are  essential.  Thymol,  in  solution,  as  a 
mouth-wash,  is  very  efficient  in  removing  the  odor  of  tobacco  from  the  breath. 


Prescriptions. 


R.  Calcis  Chlorat., . 5  iij. 

Aqute  Destillatae, 

Alcoholis, . aa  3  ij. 

Olei  Rosae, . rt^R. 


M.  Sig. — A  teaspoonful  in  a  glassful  of 
water  as  a  lotion  for  the  mouth.  (B.) 


R.  Acidi  Salicylici, . ’Z). 

Liq.  Ammonii  Acet.,  .  .  .  :jiij. 

Glycerini, . ]|j. 

Aquae,  q.  s . act  5  vj. 

M.  Sig. — A  tablespoonful  every  six 
hours.  ( Robinson. ) 


Bright’s  Disease,  Acute. 

Aconite,  should  be  given  immediately  on  the  appearance  of  the  nephritis  in 
scarlatina  (R.);  as  a  diuretic,  advocated  (P.).  Cantharis,  after  subsidence  of 
the  acute  stage,  one-minim  dose  every  3  hours  will  stop  the  hematuria  (R., 
B.).  Digitalis,  (infusion  ^ss)  the  best  remedy  in  renal  dropsy  from  acute 
desquamative  nephritis  (B.);  only  diuretic  as  long  as  dropsy  lasts  (R.).  Can¬ 
nabis  Indica,  as  diuretic ;  is  especially  useful  when  bloody  urine  (R.).  Eu¬ 
calyptus,  sometimes  effective ;  cautiously,  or  it  will  aggravate  symptoms  (B.). 
Hyoscyamus,  in  irritable  kidneys  (P.) ;  may  be  substituted  for  Belladonna 
(Wa.).  Jaborandi,  is  much  used  (Da  Costa) ;  large  doses  very  depressant  to 
the  heart,  but  rr^v-x  of  the  fluid  extract  every  half-hour  or  hour  will  produce 
sweating.  It  may  be  combined  with  tinct.  of  Digitalis  (A.  A.  Smith);  or  the 
Nitrate  of  Pilocarpine,  to  excite  skin  when  symptoms  urgent,  gr.  to  yi  for 


49  8 


bright’s  disease,  chronic. 


adult  (B.).  Turpentine,  in  drop  or  half-drop  doses  every  2  to  4  hours,  controls 
the  dropsy  in  a  remarkable  manner  (P.) ;  hot  turpentine  epithems  are  service¬ 
able,  but  may  increase  the  action  of  the  kidneys  (Wa.).  Belladonna,  has 
often  proved  useful  (P.);  may  be  used  with  benefit  (Wa.).  Jalap,  the  com¬ 
pound  powder  is  the  most  generally  useful  purgative,  used  in  the  early  morn¬ 
ing,  to  produce  free  watery  evacuations,  when  uraemic  symptoms  supervene 
(B.).  Gallic  Acid,  checks  albuminuria  (B.).  [See  Albuminuria,  for  formula.] 
Juniper,  as  diuretic;  often  aggravates  (P.).  Poultices,  large,  of  linseed  meal, 
made  light  and  soft  as  possible,  beneficial  (Wa.).  Cupping,  in  lumbar  region, 
ameliorates  acute  desq.  nephritis,  and  congestion  of  the  kidney  (B.) ;  cupping 
or  leeches  over  the  loins,  with  opiates  freely,  diluents,  and  demulcents,  with 
rest  and  an  antiphlogistic  regimen,  often  suffice  (Wa.).  Vapor-bath  or  Warm 
Pack,  to  increase  the  action  of  the  skin  (B.).  Diluents,  as  milk,  and  cream-of- 
tartar  in  solution,  should  be  used  freely  to  relieve  the  congestion  and  remove 
obstructions  from  the  tubules  (B.).  Iron,  after  the  acute  symptoms  have  sub¬ 
sided,  as  a  ionic,  the  most  suitable  preparation  being  Basham’s  mixture,  the 
now  official  Mist.  Ferri  et  Ammonii  Acetatis,  in  5SS  doses  thrice  daily.  (Da 
Costa).  [Compare  Albuminuria,  Hematuria,  Uremia.] 


Prescriptions. 


R  .  Potassii  Acetatis . 3  ijss. 

Infusi  Digitalis,  ....  5  lij. 

Infusi  Juniperi,  ....  i*iij. 

M.  Sig. — A  tablesp.  every  2  to  4  hours 

as  a  diuretic. 


R  .  Pulv.  Jalapse  Comp.,  .  .  3  iv. 
Div.  in  chartulas  no.  iv. 

Sig. — One  in  water  before  breakfast. 

o 


bt .  Mist.  Ferri  et  Ammonii  Ace¬ 
tatis,  .  .' . ]|viij. 

Sig. —  A  tablesp.  thrice  daily,  as  soon  as 
hematuria  disappears. 


bt .  Ext.  Pilocarpi  FI.,  .  .  .  %  ss. 


Vini  Ipecac., . gjss. 

Mucil.  Acaciae, . 3  j. 


Aq.  Cinnamomi,  ...  ad  %  ij. 

M.  Sig. — A  teasp.  every  four  hours 
until  free  diaphoresis. 


Bright’s  Disease,  Chronic. 

Milk-cure,  has  been  very  successful ;  skim-milk  alone  for  some  time,  then 
gradual  addition  of  other  diet  (B.).  Water,  in  large  draughts,  as  diuretic, 
when  excretion  of  solids  is  deficient  (Br.) ;  hot  fomentations  to  lumbar  region 
(B.).  Lead,  diminishes  the  albumen  (R.).  Gallic  Acid,  to  lessen  the  albu¬ 
minuria.  See  under  Albuminuria  for  formula  (A.).  Hydrastis,  lessens  excre¬ 
tion  of  albumen  (B.).  Potassium  Bitartrate,  to  prevent  dangerous  accumula¬ 
tions  in  cellular  tissue  or  important  cavities,  also  to  draw  off  effete  matters ; 
care  must  be  used  as  it  is  a  brisk  purgative,  and  is  weakening  (R.) ;  in  form  of 
“  cream-of-tartar  lemonade,”  an  agreeable  diuretic  (B.).  Jalap,  the  compound 
powder  occasionally,  as  derivative  cathartic,  to  relieve  the  kidneys  (Da  Costa.) 
Nitro-glycerin,  rtpTi^-  to  dilate  peripheral  vessels,  relieves  the  heart  and  the 
renal  congestion,  and  diminishes  albumen  (B.).  Fuchsin,  in  doses  of  gr.  vij-xv 
daily,  used  with  considerable  success  in  different  stages  of  the  disorder,  and  was 
well  borne  (Riess).  Oleum  Erigerontis,  lessens  albumen,  lowers  vascular  ten¬ 
sion,  improves  general  condition,  and  favorably  influences  the  headache,  nausea, 
and  other  uraemic  symptoms  (B.).  Tartrates,  excellent  diuretics  (R.).  Cod- 
liver  Oil,  is  very  useful  (R.).  Baths,  warm  and  Turkish,  when  uraemic  symp¬ 
toms  and  dropsy;  discretion  needful,  as  baths  may  weaken  (R.).  Cannabis 
Indica,  as  diuretic  when  bloody  urine  (R.).  Turpentine,  sometimes  given  in 
very  small  doses  as  a  diuretic,  and  to  check  hematuria  (R.) ;  half-drop  or  drop 
doses  every  2  to  4  hours  very  successful  in  dropsy  with  albuminous  urine  de¬ 
pending  on  non-desquamative  disease  of  the  kidneys.  Jaborandi,  in  uraemia 
is  very  satisfactory  (B.) ;  large  doses  very  depressant  to  the  heart  (A.  A.  Smith); 
up  xx  of  the  fluid  extract  ter  in  die  if  the  urine  decreases  much  (Da  Costa). 


BRONCHIECTASIS - BRONCHITIS,  ACUTE. 


499 


Iron,  to  improve  digestion  and  correct  anaemia  ;  the  tinct.  of  the  chloride  or 
tinct.  ferri  acetatis  preferred  (B.)  ;  in  chronic  tubular  nephritis  with  cardiac 
hypertrophy  the  mist,  ferri  et  ammonii  acetatis,  ^ss  ter  in  die,  with  an  occa¬ 
sional  vapor-bath  (DaCosta).  Chimaphila,  has  power  over  various  forms  of 
nephritic  disease,  especially  when  albuminuria  present  (P.).  Eucalyptus,  in 
chronic  desquamative  nephritis,  cautiously  used  will  cause  improvement  (B.). 
Elaterium,  for  the  dropsy,  as  a  derivative  cathartic  :  must  be  cautiously  used 
(R.).  Bromides,  are  useful  in  the  convulsions  (R.).  See  Uremia.  Potassium 
Iodide,  has  improved  some  cases,  which  were  possibly  due  to  syphilis  (R.). 
Aurum,  the  chloride  in  pill,  gr.  fa  to  fa  ter  in  die,  persistently,  in  the  chronic 
interstitial  nephritis,  to  arrest  hyperplasia  of  the  connective  tissue  ;  may  be 
combined  with  Arsenic,  which  has  a  similar  influence  (B.).  Mercuric  Chloride, 
acts  in  the  same  manner,  gr.  fa  bis  die  (DaCosta).  Food,  should  be  nourish¬ 
ing,  particularly  suitable  are  milk,  eggs  and  rare  beef  (Da  Costa).  Buffalo 
Lithia  Water,  of  Virginia,  has  many  advocates.  [Compare  Dropsy,  Uraemia.] 


Prescriptions. 

(Compare  those  under  Bright’s  Disease,  Acute.) 


R.  Strychninse  Sulphatis,  .  .  .  .  gr.  l/-. 
Tinct.  Ferri  Chloridi,  .  .  .  .  3  ss. 

Acidi  Acetici, . 3jss. 

Cura^oae, . fa). 

Liq.  Ammonii  Acetat.,  .  .  ad  Jvj. 

M.  Sig. — A  tablesp.  every  6  hours,  fol¬ 
lowed  by  a  glass  of  water.  For  the  anaemia. 


R.  Tinct.  Nitro-glycerini,  .  .  .  £j. 

Sig. — One  drop,  gradually  increased  to 


five,  four  times  daily  on  sugar.  (B.) 

R .  Auri  et  Sodii  Chlor.,  .  .  .  .  gr.  jss. 
Aquae  Destillatae. . i-iv. 


Solve.  Sig. — A  teasp.  ter  in  die. 


Bronchiectasis. 

Quinine,  the  most  useful  remedy  as  a  tonic  (B.).  Phosphates,  are  undoubt¬ 
edly  useful,  so  also  are  the  Hypophosphites,  (B.).  Chlorine,  in  solution  as  a 
stimulant  and  deodorizer,  or  as  inhalation  to  lessen  fetor  (Br.).  Palliation  of 
the  cough  and  expectoration,  with  care  of  the  general  health  of  the  patient,  is 
all  that  can  be  accomplished.  [Compare  Emphysema.] 

Bronchitis,  Acute. 

Aconite,  gtt.  ss-j  every  hour  (B.)  ;  in  catarrh  and  bronchitis  of  measles  (R.). 
Tartar  Emetic,  first  stage,  gr.  fa  to  fa,  especially  if  cough  is  violent  (B.)  ; — 
gr.  j  to  a  quart  of  water,  a  teasp.  of  this  every  hour  for  the  wheezing  and 
cough  of  slight  bronchitis  in  children  (A.  A.  Smith)  ; — gr.  %  to  every  2  or 
3  hours  (R.).  Ipecacuanha,  as  wine,  when  expectoration  profuse  and  difficult 
to  expel  (R.) ;  dry  stage  (P.)  ;  Ipecac,  when  secretion  is  scanty  and  dry;  Squill, 
when  the  secretion,  though  copious,  is  difficult  to  expel  (Brunton).  Lobelia, 
as  expectorant  (B.)  ;  for  paroxysmal  dyspnoea  (R.).  Sanguinaria,  after  subsi¬ 
dence  of  acute  symptoms,  as  expectorant  (B.) ;  very  successful  (P.).  Quinine, 
to  reduce  temperature  (R.).  Colchicum,  useful  when  gouty  diathesis  (P.). 
Opium.  Morphine  and  quinine  combined,  or  Dover’s  powder,  to  abort  an 
attack  ;  also  with  expectorants  to  allay  cough  (B.).  Frequent  and  violent 
coughs,  without  obstructed  oxidation  ;  also  to  check  excessive  secretion  (R.). 
As  sudorific  very  useful,  grs.  x  of  Dover’s  powder  (P.).  Carbolic  Acid,  as 
spray,  a  5  per  cent,  solution  with  steam  atomizer,  prompt  and  efficient.  Apo- 
morphine,  the  hydrochlorate  in  doses  of  gr.  fa  every  3  hours,  the  best  of  all 
expectorants.  Cimicifuga,  an  excellent  expectorant,  and  useful  when  acute 
symptoms  have  subsided  (B.).  Nitric  Acid,  n\,x  of  dilute  acid  relieve  (B.). 
Asafcetida  or  Ammoniacum,  the  last  best,  in  bronchitis  with  wheezing  of  old 
people  (R.).  Asafcetida,  is  an  excellent  stimulant  of  respiration,  especially 
when  the  capillaries  have  become  clogged  with  the  products  of  inflammation, 
and  suffocation  seems  imminent.  Here  also  the  Cold  Bath  is  a  means  of 
enabling  the  patient  to  expel  the  mucus,  the  equal  of  which  has  not  been  yet 


500 


BRONCHITIS,  CAPILLARY. 


advanced.  The  cold  bath  may  be  used  for  even  very  young  infants,  and 
should  be  but  momentary  (W.).  Ammonium  Carbonate,  when  the  expectora¬ 
tion  is  profuse,  and  the  condition  low  (R.).  Ammonium  Acetate,  from  its  sudor¬ 
ific  action  is  always  indicated,  especially  in  children  (Dessau).  See  formula 
below.  Cubebs,  very  useful,  especially  when  secretion  copious  and  system 
relaxed  (P.).  Copaiba,  after  subsidence  of  the  fever,  the  most  serviceable  ex¬ 
pectorant,  but  nauseous  (B.).  Counter-irritants,  mustard  as  poultice  (large), 
with  linseed  or  oatmeal,  or  both,  very  useful  (R.).  Iron,  Lead,  Zinc  Oxide! 
to  check  profuse  secretion  (R.).  Heat  to  chest  by  linseed  poultices,  of  great 
service.  Diet,  should  be  light  and  in  liquid  form.  Temperature  of  atmosphere 
in  room  about  8o°  F.,  and  the  air  moistened  by  steam.  [Compare  Cough.] 


Prescriptions. 


R.  Antim.  et  Pot.  Tart.,  .  .  .  .  gr.  ij. 

Liq.  Ammonii  Acet.,  .  .  .  .  3  iv. 

Spt.  Etheris  Nitrosi,  .  .  .  .  ~j. 

Tinct.  Aconiti, . 3  ss. 

Syr.  Simplicis,  .  .  .  q.s.  ad  Jvj. 

M.  Sig. — A  teaspoonful  every  2  or  3 
hours.  In  first  stage. 


R.  Liq.  Ammon.  Acetat.,  .  .  .  5  iv, 
Spt.  Etheris  Nitrosi, 

Syr.  Ipecac., . aa  3  iss. 

Syr.  Senegae, . 3  j. 

Syr.  Limonis, . j. 

M.  Sig. — A  teaspoonful  every  3  hours 
for  children.  (Dessau.) 

R.  Tinct.  Aconiti, . rtLviij. 

Aquae  Cinnamomi, . 3 j . 

M.  Sig. — A  teaspoonful  every  y  hour 
for  2  hours,  then  every  hour.  In  acute  in¬ 
flammatory  form. 


R.  Vini  Ipecac., . ^ij. 

Liq.  Potassii  Citratis,  .  .  .  .  3  iv. 
Tinct.  Opii  Camphorat., 

Syr.  Acaciae, .  aa  ^j. 

M.  Sig. — Tablesp.  ter  die.  In  first  stage 
of  ordinary  acute  bronchitis.  ( Da  Costa.) 


R.  Ext.  Cimicifugae  FI.,  .  .  .  .  ^ss. 
Tinct.  Opii  Deodorat.,  .  .  .  .  p,  ). 

Syr.  Tolutani, . ad  £  ij 

M.  Sig. — A  teaspoonful  every  4  hours. 

(B.) 


R .  Tinct.  Sanguinariae, 

Tinct.  Lobelias, . aa  %j. 

Vini  Ipecac., . ^ij. 

Syrupi  Tolutani,  .  .  .  q.  s.  ad  3  iv. 
M.  Sig. — A  teasp.  every  3  hours. 

(B.) 


R.  Apomorph.  Hydrochlor.,  .  .  gr.  y 
Ac.  Hydrochlor.  Dil. ,  .  .  .  rr\nj. 


Syrupi  Senegas, . ^  v. 

Aquae  Destillat., . p>). 


M.  Sig. — A  teaspoonful  every  2  hours. 
For  a  child  of  3  years  as  expectorant. 
Should  be  put  up  in  a  blue  bottle. 


R.  Ext.  Eriodyctii  FI., . 3  vj. 

Ext.  Senegae  FI., . g  iv. 

Syr. Pruni  Virginian.,  .  .  .  .  p  ij. 
Aquae, . q.  s.  ad  iv. 


M.  Sig. — Teaspoonful  every  3  hours. 


Bronchitis,  Capillary. 

Ipecacuhana,  as  emetic,  preferred  to  tartar  emetic  in  capillary  bronchitis  of 
very  young  or  very  old  (B.)  ;  as  wine,  when  expectoration  profuse  and  difficult 
to  expel  (R.).  In  very  young  infants  should  be  used  in  place  of  antimony 
(M.  &  P.).  Squill,  as  expectorant,  may  be  used  with  benefit  (Wa.).  Antimony, 
sulphurated,  gr.  Tx^  in  combination  with  Dover’s  powder,  every  2  or  3  hours, 
when  the  temperature  very  high,  and  pulse  full  and  strong.  Must  be  stopped  as 
soon  as  nausea  and  vomiting  begin  (M.  &  P.).  Lobelia,  for  paroxysmal  dysp¬ 
noea  (R.).  Ammonium  Carbonate,  when  expectoration  profuse  and  strength 
diminishing  ;  in  severe  bronchitis  or  broncho-pneumonia  of  children,  especially 
when  prostrate  and  livid  (R.)  ;  has  probably  a  specific  action  on  the  diseased 
tissue  and  its  products  (Clymer.).  Ammonium  Iodide,  in  small,  rapid  doses, 
often  gives  great  relief  to  the  catarrhal  process  (Da  Costa)  ;  often  gives  the 
most  astonishing  relief  (B.).  Ammonium  Muriate,  gr.  ij  every  2  hours,  either 
alone  or  with  potassic  chlorate  (Clymer).  Serpentaria,  in  capillary  bronchitis 
of  children  gives  excellent  results  (B.).  Turpentine,  one  of  the  best  stimulants 
when  vital  powers  are  depressed  and  peripheral  circulation  feeble  (B.).  Cam- 


I 


BRONCHITIS,  CHRONIC. 


501 


phor,  to  allay  cough  and  promote  expectoration  (B.).  Hydrocyanic  Acid,  for 
cough  and  tendency  to  spasm.  Hydrarg.  Subsulph.  effective  as  emetic  (B.). 
Mustard,  as  poultice  or  bath,  useful  (R.) ; — the  most  important  part  of  the  treat¬ 
ment  (M.  &  P.).  Poultices,  to  encirqle  the  whole  chest  in  children  (R.).  A 
jacket  of  cotton-wool  around  the  chest.  Steam,  by  inhalation,  may  be  impreg¬ 
nated  with  sedatives,  or  with  carbolic  acid  ; — is  of  great  importance  (M.  &  P.). 
Quinine,  in  that  form  of  capillary  bronchitis  occurring  in  tropical  climates,  and 
where  marked  debility  (M.  &  P.).  Stimulants,  are  often  necessary,  especially 
in  the  suffocative  form,  and  where  marked  prostration  (M.  &  P.).  Emetics  are 
necessary  when  suffocative  symptoms  become  prominent.  [Compare  Cough.] 


Prescriptions. 


pc .  Ext.  Serpentaria  FI.,  .  .  .  t^ss. 


Ammonii  Carb., . £  ij. 

Syr.  Tolutani, . jjjss. 


M.  Sig. — A  teasp.  every  2,  3  or  4  hours. 

(B.) 


R .  Quininae  Sulph., . gr.  vj. 

Ac.  Sulph.  Dil., . ir^xi). 

Syr.  Simplicis, . jfss. 

Aquae, . 3  ijss. 

M.  Sig. — A  teasp.  every  2  hours  to  child 
of  2  or  3  years;  older  children  require 
more  quinine.  (M.  &  P.) 


R.  Liq.  Ammonii  Acet.,  .  .  .  ^ss. 

Syr.  Ipecac., . gj. 

Liq.  Morp  Sulph. 

(gr.  j  ad  £j),  .  .  .  .  TT\xl. 

Syr.  Acaciae, . 3  j. 

Aquae, . Sjss- 

M.  Sig. — A  teasp.  every  2  hours  for  a 
child  2  years  old.  When  surface  pale  and 
expression  languid,  skin  cool.  (M.  &  P.) 


R.  Ammonii  Iodidi,  ....  ,"j-ij. 

Ammonii  Carb., . 3  ij— iij. 

Syr.  Glycyrrhizae,  .  .  .  .  ^ij. 

Syr.  Tolutani . ,3  ij. 

M.  Sig. — A  teasp.  every  2  or  3  hours. 


Bronchitis,  Chronic. 

Antimony,  when  expectoration  copious  and  difficult  to  expel  (R.).  Arsenic, 
where  emphysema,  in  cigarettes  (B.).  [See  ante,  Asthma,  for  formula.]  Sul¬ 
phur,  gr.  v-x,  in  severe  cases,  with  abundant  discharge,  especially  where  con¬ 
stitutional  debility  (R.).  Sulphurous  Acid  Gas,  inhalations,  or  the  acid  in  form 
of  spray,  sometimes  beneficial  (B.,  R.).  Lobelia,  for  paroxysmal  dyspnoea  (R.). 
Ammonium  Chloride,  combined  with  stimulating  expectorants,  such  as  Serpen¬ 
taria,  Sanguinaria,  or  Eucalyptus  (B.) ; — when  secretion  is  thick  and  abundant, 
may  be  applied  by  an  atomizer  (R.).  Carbolic  Acid  as  inhalation  of  spray,  1 
part  to  100  of  water;  may  be  combined  with  tincture  iodine  (B.  R.).  A  5  per 
cent,  solution  in  steam  atomizer  as  inhalation.  Hydrastis,  fluid  extract,  locally 
and  internally  (B.) ;  of  great  value  internally  and  externally  in  chronic  coryza 
(P.).  Senega,  especially  in  the  aged  (R.).  Iodine,  by  inhalation,  sometimes 
used  (R.)  ; — the  Iodides,  especially  the  iodide  of  ammonium,  are  very  service¬ 
able  in  combination  with  expectorants  (B.).  Colchicum,  in  gouty  subjects  (R.). 
Balsams  of  Peru,  and  Tolu,  when  copious  secretion  of  pus  (R.).  Ammonia, 
inhalation,  to  lessen  expectoration  (R.).  Oleum  Anthemidis,  in  pulmonary 
catarrh  with  excessive  secretion  and  difficult  expectoration,  a  very  useful 
remedy,  hpij-iv  (P.).  Ammoniacum,  the  mistura,  with  chloride  or  carbonate  of 
ammonium,  efficient  in  the  bronchitis  of  old  people,  with  wheezing  and  abund¬ 
ant  secretion  (R.).  [See  Bronchorriicea,  for  formula.]  Benzoin,  3j  of  the 
compound  tincture  to  boiling  water,  as  inhalation;  eases  cough  and  lessens 
expectoration  (R.).  Sometimes  used  by  atomization  (B.).  Phosphates,  for  the 
resulting  cachexia  (B.).  Phosphate  of  lime  ( R . ) .  Serpentaria,  as  stimulant. 
Alum,  powdered,  dusted  over  surface  (B.).  Silver  Nitrate,  locally  (gr.  v-»}j- 
3 j )  on  sponge  probang  (B.).  Camphor,  to  allay  cough  and  promote  expectora¬ 
tion  (B.).  Sumbul,  has  decided  efficacy  (P.).  Opium,  with  expectorants,  to 
allay  cough  (B.).  When  frequent  and  violent  cough,  without  any  signs  of  ob¬ 
structed  oxidation  ;  also  to  check  excessive  secretion  (R.).  Codeine,  gr.  ]/6 


502 


BR0NCH0RRHCEA. 


every  3  to  6  hours,  when  other  opiates  are  not  well  borne  (P.).  Ethyl  Iodide, 
by  inhalation,  is  very  valuable  by  reason  of  its  local  influence,  rr^v-xx  thrice 
daily  (B.).  Grindelia,  an  excellent  expectorant,  and  especially  when  cough  is 
troublesome  (B.).  Strychnine,  as  a  respiratory  stimulant  and  to  check  the  re¬ 
flex  vomiting  (B.).  The  syrup  of  the  phosphates  of  iron,  quinine  and  strych¬ 
nine.  Squill,  in  chronic  forms  with  tenacious  sputa,  but  not  when  fever  or 
acute  inflammation  (R.).  The  Pil.  Ipecac,  cum  Scilla,  of  the  Br.  Ph.  in  10- 
grain  doses  night  and  morning,  is  a  most  useful  remedy  (Br.).  Tar,  diminishes 
the  secretion  and  allays  the  cough  (P.) ;  gr.  ij  in  pill  every  3  or  4  hours  in 
chronic  paroxysmal  winter  cough  (R.).  Digitalis,  when  interstitial  pneumonia 
and  general  anasarca  (B.).  Eucalyptus,  valuable  in  chronic  cases  of  broncho¬ 
pulmonary  catarrh  (B.).  Gallic  Acid,  useful  in  some  forms  of  chronic  broncho¬ 
pulmonary  catarrh  (B.).  Iron,  with  free  expectoration,  mistura  ferri  composita  ; 
or  better,  the  phosphate  of  iron,  quinine,  and  strychnine  (B.).  To  check  pro¬ 
fuse  bronchial  secretion  (R.).  Myrtol,  in  fetid  bronchitis,  of  great  value 
(Gubler).  Copaiba,  when  purulent  secretion  (R.) ; — for  profuse  secretion,  the 
best  of  all  expectorants,  but  nauseous  (B.).  Cubebs,  when  profuse  expectora¬ 
tion,  has  similar  remedial  influence  (B.).  [See  Bronchorrhcea,  for  formula.] 
Terpine  Hydrate,  gave  immediate  and  curative  results  in  cases  of  long-stand¬ 
ing  and  obstinate  bronchitis,  which  had  resisted  all  other  treatment;  gr.  xlviij, 
in  Glycerin,  q.  s.  ut.  ft.  solutio,  Syr.  Lactucarii,  q.  s.  ad  3 ij ,  of  which  a  teasp. 
every  three  hours  (Boyland).  Terebene  is  proving  very  valuable  ;  requires  an 
equal  weight  of  light  carbonate  of  magnesium  to  suspend  it.  Koomiss-cure, 
possesses  great  value  (B.).  Cod-liver  Oil,  a  teaspoonful  ter  die  after  meals,  of 
great  service,  if  continued  (B.)  ;  to  control  expectoration  (R.).  Poultices,  made 
large,  of  hot  linseed  meal  to  cover  the  chest,  when  congestion  of  lungs.  Olive 
Oil,  inunctions  to  chest,  has  soothing  and  strengthening  effects.  Diet,  nutri¬ 
tious,  and  stimulants  necessary  when  great  prostration.  Koomiss  is  an  excel¬ 
lent  article  of  diet.  [Compare  Cough,  Emphysema.] 


R .  Ext.  Eucalypti  FI . if  j. 

Ammonii  Chloridi,  .  .  .  .  gij. 
Ext.  Glycyrrhizse,  .  .  .  .  £ij. 

Syrupi  Tolutani, . 3  iij. 

M.  Sig. — A  teasp.  4  to  6  times  daily. 


Prescriptions. 

R  .  Syrupi  Scillse, . if  ss. 

Tinct.  Opii  Camph.,  .  .  .  ^ij. 

Ammoniaci, . %  ss. 

Syrupi  Tolutani,  .  .  .  .  £x. 
M.  Sig. — A  teasp.  p.  r.  n. 


R.  Tinct.  Sanguinarire,  .  .  .  gj. 

Ammonii  Chloridi,  .  .  .  .  gj. 

Syrupi  Tolutani, . 3  ij. 

Spt.  Etheris  Nitrosi,  .  .  .  3  ss. 
Aqure, . 5  iijss. 


M.  Sig. — Tablesp.  p.  r.  n. 


R .  Ammonii  Carbonat.,  .  .  .  gr.  xl. 
Infusi  Serpentarite,  ...  5  iv. 
M.  Sig. — A  tablesp.  every  3  hours. 


R .  Ammonii  Chloridi.,  .  .  .  %  iij. 
Syrupi  Picis  Liquidoe,  .  .  if  vj. 
M.  Sig. — Tablesp.  4  times  daily. 


Bronchorrhcea. 

Ammonium  Iodide,  often  improves  the  condition,  especially  if  used  with 
arsenic  (B  ).  Oil  of  Eucalyptus,  of  great  utility  (B.) ;  rr^ij  ter  die  on  sugar,  or 
see  formula  above.  Sulphurous  Acid  Gas,  as  inhalations,  or  the  sulphurous 
acid  as  spray,  sometimes  improve  (B.).  Lead  Acetate,  as  astringent  to  restrain 
secretion  (B.) ;  gr.  j  — ij  every  2  hours.  Petroleum,  crude,  in  capsules,  has  been 
administered  with  rapid  amelioration  as  the  result  (Blache).  Grindelia,  an 
efficient  remedy  (B.).  Iodine,  as  liniment,  over  front  and  back  of  chest  (R.). 
Spinal  Ice-bag,  to  restrain  excessive  secretion  (R.).  Quinine,  and  the  Phos- 


BRUISES - BUBO. 


503 


phates,  also  Cod-liver  Oil,  as  restoratives  (Wa.).  Copaiba,  the  most  serviceable 
expectorant,  but  nauseous  (B.) ;  when  copious  secretion  of  pus  (R.).  Cubebs, 
has  remedial  effect  in  chronic  bronchial  affections  with  profuse  expectoration 
(B.).  Asafetida,  is  of  great  benefit  (B.).  Turpentine,  an  excellent  remedy 
when  fetid  expectoration  ;  may  be  used  internally  (tt^v)  or  by  inhalation  from 
atomizer.  Terpine  Hydrate,  seems  to  be  even  more  efficient  than  turpentine, 
in  doses  of  gr  x-xx  daily.  Carbolic  Acid,  internally  (try),  and  by  spray  (gr.  v 
ad  3j  aquae),  often  of  great  utility  (Da  Costa).  Benzoin,  by  inhalation,  for  its 
local  influence.  Myrtol,  is  largely  eliminated  by  the  lungs,  and  is  a  most  valu¬ 
able  agent  in  bronchorrhcea  and  fetid  bronchitis,  acting  as  a  stimulant  and 
antiseptic  (Gubler)  ;  dose  vryj  in  capsules  (Br.).  [Compare  Cough.] 


Prescriptions. 


R .  Copaib?e, 

Syrupi  Tolutani,  .  .  .  .  aa  3  ss. 
Spt.  Etheris  Nitrosi,  .  .  .  .  3_j.  - 
Aqu?e  Menth.  Pip.,  .  .  .  .  3  ij. 
M.  Sig. — A  teasp.  every  4  hours. 


R.  Copaibae  Bals.  Tolutan., 


Pulv.  Acaciae, . aa  3  ss. 

Ac.  Sulph.  Aromat.,  .  .  .  .  3  ss. 


Aquae  Destillat., . 3vj. 

M.  Sig. — Tablesp.  bis  vel  ter  in  die. 


R.  Ammonii  Chloridi, . 3_j. 

Mist.  Asafoetidae, . 3  iv. 

Misce.  Sig. — Tablesp.  as  required. 


R.  Potassii  Iodidi, . 3]. 

Ac.  Nitrici  Dil . 3iij. 


Tinct.  Belladonnae,  .  .  .  .  3_j. 

Ac.  Salicylici, . 3  j. 

Aquae  Camphorae,  .  .  .ad  3  iv. 

M.  Sig. — Dessertsp.  in  water  3  or  4 
times  daily,  for  fetid  bronchitis. 


Bruises. 

Arnica,  the  infusion  very  useful  as  an  external  application  for  bruises  and 
cuts  ;  also  an  excellent  internal  remedy  for  internal  bruises,  shake,  falls,  blows, 
or  shock  ;  npv-x  every  2  or  3  hours  (P.);  in  bruises,  sprains,  etc.  (Wa.).  Aconite, 
the  liniment  locally  to  painful  sprains  and  bruises  (Wa.).  Capsicum,  a  strong 
tinct.  applied  with  gum,  said  to  act  like  a  charm  on  discolored  bruises  (R.). 
Sulphurous  Acid,  a  solution  constantly  applied  (R.).  Oil  of  Bay,  as  stimu¬ 
lating  liniment  (P.).  Opium,  the  tincture  with  linimentum  saponis  (3j  to  3j) 
diligently  rubbed  in  two  or  three  times  a  day,  affords  great  relief  (Wa.). 


Bubo. 

Mercury,  necessary  in  the  indurated  buboes  diagnostic  of  syphilis  (Ricord)  : 
the  powder  of  calomel  locally  applied  for  indolent  buboes  refusing  to  heal  after 
opening  (H.).  Nitric  Acid,  indolent  and  broken  bubo  (R.).  Sulphides,  are 
less  useful  in  maturating  than  in  the  case  of  ordinary  boils  or  abscesses  (R.) ;  to 
check  suppuration  (St.).  Iodoform,  locally,  has  proved  useful  (Wa.).  Iodine, 
applied  to  produce  vesication  around  a  bubo,  relieves  inflammation  (R.)  ;  freely 
every  day,  with  rest  and  compression,  to  cause  absorption  (St.).  Silver  Nitrate, 
lightly  to  surface,  to  stimulate  indolent  buboes  (Wa.).  Potassio-tartrate  of  Iron, 
30  parts  to  250  aquae  destil.,  three  tablesp.  daily  ;  also  as  lotion  to  sore  (Ricord); 
phagedena  (St.).  Tartar  Emetic,  gr.  j  every  two  hours  reduces  inflammation 
in  many  cases  (Wa.).  Ice,  greatly  relieves  (E.).  Surgical. — Open  freely  with 
a  bistoury  when  suppurating;  if  pus  is  virulent,  the  open  bubo  is  a  chancroid, 
and  must  be  treated  as  such  (Keyes).  Pressure,  by  compressed  sponge  under 
a  spica  bandage,  or  a  shot  bag,  the  best  local  treatment  for  indolent  bubo 
{Keyes) ;  in  all  cases  cleanliness,  rest  in  recumbent  posture,  emollient  poul- 
ices.  Diet,  should  be  generous,  with  cod-liver  oil,  in  phagedenic  bubo.  'The 
treatment  of  Syphilitic  Bubo  is  that  of  general  syphilis,  local  measures  are  use¬ 
less,  and  no  treatment  called  for  until  a  general  eruption  appears  (Keyes). 
[Compare  Chancroid,  Syphilis.] 


504 


BUNION - BURNS - BURSITIS - CACHEXIA. 


Bunion. 

Iodine  paint,  or  Emplastrum  Hydrargyri,  for  indolent  form,  thick  but  not 
tender  (D.).  Rest,  fomentations,  and  anti-arthritic  remedies  for  thickened 
bunion  ;  burst  it  by  pressure  if  recent  and  sac  thin  (D.).  [Compare  Bursitis,] 


Burns  and  Scalds. 

Carbolic  Acid,  i  part  to  30  of  lin.  calcis,  or  1  part  to  6  of  olive  oil  ;  the  latter 
speedily  relieves  pain,  and  promotes  healing  without  suppuration  (Wa.) ;  1  part 
to  10  of  olive  oil,  applied  on  layers  of  cotton  batting,  the  best  application  for 
burns  of  all  degrees.  Boracic  Acid,  a  saturated  watery  solution,  used  with 
great  success  by  Lister  (B.).  Lead  Carbonate,  white  lead  paint,  an  excellent 
application  to  burns  of  small  extent  (B.).  Salicylic  Acid,  3j— 3 viij  ol.  olivae  is 
an  efficient  local  application  (B.).  Collodion,  flexible,  to  burns  of  first  degree 
(B.,  R.,  P.).  Phytolacca,  relieves  pain  (B.).  Lime,  as  lime-water  and  oil,  equal 
parts  (R. );  or  lime-water  with  linseed  oil,  a  favdrite  application  (P.).  Rhus 
Toxicoden.,  externally  5  to  the  pint,  in  superficial  but  extensive  burns  (P.). 
Cantharis,  the  tincture  diluted  with  40  parts  of  water  and  applied  on  rags,  is  a 
most  excellent  application.  Sodium  Carbonate,  in  solution  as  lotion,  immedi¬ 
ately  relieves  pain  and  promotes  rapid  healing.  Turpentine,  in  dangerous 
cases,  where  great  constitutional  depression  (P.)  ;  as  wash  to  severe  burns,  then 
locally  basilicon  ointment  mixed  with  turpentine  (B.).  Cotton-wool,  to  allay 
pain  and  exclude  air  (P.).  Warm  Bath,  immerse  for  some  days  (R.) exclu¬ 
sion  of  air  the  main  indication  (H.)  Pinus  Canadensis,  the  concentrated 
extract,  painted  on  freely,  relieves  the  pain  effectually. 


Lime  and  Linseed. 

R  .  Olei  Lini, . 

Aquas  Calcis, . 

M.  Sig. — Apply  on  sheet 

cover  with  oiled  silk. 


Prescriptions. 


SV1J- 

Sp¬ 


lint,  and 


R.  Iodoformi, . 7,]. 

Cetacei, . p)). 

Ext.  Conii  Alcohol.,  .  .  .  .  gr.  xl. 

Acidi  Carbolici, . gtt.  x. 

M.  Sig. — Spread  on  lint  and  cover  the 
parts  therewith. 


R  .  Sodii  Carbonatis,  ....  5  vj. 

Aquae, . Oiij. 

M.  Sig. — Apply  freely  for  3  days  on 
old  cloths  or  lint. 


R.  Pulv.  Carbonis  Ligni,  .  .  .  ^viij. 

Sig. — To  be  dusted  thickly  over  the 
burned  parts. 


Bursitis. 

Iodine,  painted  on  outside,  after  removal  of  fluid  with  aspirator  (D.)  ;  after 
blistering  (Wa.)  Blisters,  in  rheumatic  enlargement  of  bursae,  are  almost 
indispensable  for  a  rapid  cure  (Wa.).  Fomentations,  with  rest,  to  relieve  pain 
and  swelling.  If  unavailing,  a  crucial  incision  into  the  bursa,  care  being  taken 
not  to  open  the  capsule  of  the  knee  (D.).  Excision,  when  chronic,  tumor  hard, 
resisting  other  measures  (C.). 


Cachexiae. 

Lime,  the  phosphate,  in  scrofulous  affections  and  anaemia  (Wa.) ;  in  phthisis, 
and  affections  marked  by  mal-nutrition  (B.).  Iron,  in  splenic,  syphilitic,  and 
strumous,  and  especially  in  all  anaemic  states ;  also  in  the  malarial  and  phthis¬ 
ical ;  chalybeate  waters  (B.).  The  ammonio-citrate  the  best  tonic  in  the  ca¬ 
chexia  of  gastric  ulcers,  especially  in  chlorotic  females  (Wa.).  Arsenic,  a 
prompt  remedy  in  the  malarial  cachexia ;  also  in  cancerous  of  real  value 
(Wa.).  Hydrastine,  in  paludal  and  splenic  cachexiae,  stands  in  high  esteem 
(B.).  Nitric  Acid,  is  adapted  to  the  cachexia  following  acute  disease  or  intern- 


CALCULI. 


505 


perance  ;  also  as  alterative  after  long  course  of  mercury  (Wa.).  Potassium 
Iodide,  in  constitutional  syphilis,  and  resulting  affections  of  bones  and  skin 
(Wa.).  Mercury,  in  the  syphilitic  ;  but  its  utility  much  questioned  (Wa.). 
Aurum,  in  cancerous,  mercurial,  and  syphilitic  cachexias,  especially  when 
bones,  glands,  and  oculo-nasal  mucous  membrane  affected.  Phosphates,  in 
bone  diseases,  wasting,  bronchitic,  leucorrhceic,  etc.  (B.).  Arnica,  in  very 
developed  cachexiae,  has  excitant  action  on  the  nervous  system  (Wa.).  Euca¬ 
lyptus,  a  serviceable  tonic  and  stimulant  in  cachectic  states  generally  (B.). 
Manganese,  the  syrup  of  the  iodine  of  iron  and  manganese  in  anaemic,  syphi¬ 
litic,  strumous,  malarial,  cancerous,  etc.  (B.).  Grape-cure,  often  modifies  most 
happily  many  conditions  (P.).  Air,  in  good  condition,  an  important  element 
(B.).  Water,  the  Turkish  bath  and  wet  pack  as  aids  to  remedial  action,  in 
plumbic,  mercurial  and  paludal  (B.).  Oils  and  Fats,  to  promote  constructive 
metamorphosis  in  many  cachexiae,  especially  cod-liver  oil  (B.) ;  the  latter  a 
most  valuable  remedy  in  scrofula,  phthisis,  atrophy,  tubercular  and  jail  ca¬ 
chexiae,  anaemia,  etc.  (Wa.).  Massage,  has  been  productive  of  remarkable 
results  in  many  forms  of  cachexiae  (B.).  Aliment,  of  prime  importance  (B.). 
[Compare  the  various  titles.  Anaemia,  Scrofula,  Syphilis,  etc.,  and  the 
formulae  for  tonics,  on  pages  484  and  488,  ante.] 

Calculi,  Biliary. 

Chloroform,  is  supposed  by  some  to  act  as  a  solvent  in  20  to  6o-drop  doses 
every  3  or  4  hours  ;  it  cannot  act  as  a  solvent,  but  undoubtedly  affords  some 
relief  (B.) ;  as  an  inhalation  it  may  be  used  to  relieve  the  pain  of  the  paroxysm 
(Br.).  Ether  and  Turpentine,  equal  parts  of  each,  Zj  once  daily  for  a  year,  is 
Durande’s  solvent  remedy  ;  is  not  solvent,  and  as  an  anodyne  inferior  to  mor¬ 
phine  or  chloral  (B  ).  Morphine,  gr.  %  with  Atropine  gr.  T^,  hypodermically, 
the  best  anodyne  for  the  pain  and  vomiting  during  the  paroxysm  (Br.).  Chloral, 
sometime  relieves  the  pain  (R.).  Counter-irritants,  as  mustard  poultices  to 
relieve  the  pain  during  the  paroxysm  (Br.).  Olive  Oil,  3 ij  at  night,  followed 
next  morning  by  3  or  4  seidlitz  powders  an  hour  apart,  efficient  in  facilitating 
the  expulsion  of  accumulated  gall-stones.  Nitro-muriatic  Acid,  as  bath,  found 
useful  in  India  to  relieve  the  pain  and  promote  expulsion  of  the  calculus,  3 iij 
of  the  acid  to  a  gallon  of  water  (Scott.).  Sodium  Phosphate,  in  Z  doses  before 
each  meal  for  several  months,  to  prevent  recurrence  (B.)  ;  should  be  given  in 
plenty  of  water  (Br.).  Sodium  Salicylate,  increases  the  secretion  of  bile  and 
renders  it  more  watery.  It  is  therefore  indicated  in  cases  where  there  is  a 
tendency  to  the  formation  of  gall-stones  (Br.).  Succinate  of  the  Peroxide  of 
Iron,  hydrated,  contains  a  large  proportion  of  nascent  oxygen,  and  is  given  in 
teaspoonful  doses  after  meals  for  several  months,  and  resumed  at  intervals 
afterwards  to  prevent  reformation  of  the  calculi  (Buckler).  Diet,  is  import¬ 
ant;  withhold  all  starches,  sugars  and  fats,  also  malt  liquors  and  spirits  ;  mod¬ 
erate  exercise  out  of  doors,  lean  meats,  eggs,  fish,  fruits  and  succulent  vegetables 
to  be  used  freely.  Mineral  Waters,  the  alkaline  are  useful,  especially  Vichy, 
which  is  deemed  of  great  benefit.  [Compare  Colic,  Jaundice.] 

Prescriptions. 

R.  Succinat.  Hydrat.  Ferri  Per-  R.  Spt.  Etheris  Comp.,  .  .  .  gij. 

oxidi, . 3  jss.  Liquor.  Magendie,  ....  Vtpxxx. 

Aqua;, . 3  vjss.  Syr.  Zingiberis,  .  .  .  .ad  J  j. 

M.  Sig. — Teasp.  after  each  meal  for  M.  Sig. — Teasp.  doses,  an  hour  apart, 
several  months.  |  until  pain  is  relieved. 


Calculi,  Renal  and  Vesical. 

Alkalies,  especially  potassium  salts,  if  long  continued  will  effect  solution  of 
uric  acid  calculi  (R.)  ;  sodium  salts  should  not  be  used  (B.).  Potassium  Citrate, 
in  large  doses  for  bloody  urine  containing  uric  acid  crystals  (R.)  ;  the  citrate 


506 


CANCER. 


and  carbonate  of  potassium  are  the  most  desirable  solvents  for  uric  acid 
gravel  (Sir  H.  Thompson).  Potassium  Tartra-borate,  if  long  used,  is  very 
efficient  as  a  solvent  for  uric  acid  calculi  (B.).  Potassium  salts  are  much  more 
efficient  than  those  of  Lithium  as  solvents  for  uric  acid  (Prof.  Rogers).  Alka¬ 
line  Mineral  Waters,  those  rich  in  potassium  preferred,  especially  Vichy  (B.). 
Ammonium  Benzoate,  long-continued,  will  dissolve  phosphatic  calculi  (B.). 
Ammonium  Biborate,  will  prevent  attacks  of  colic  where  uric-acid  calculi,  in 
20-grain  doses  every  two  hours  until  free  urination,  then  gr.  15  thrice  daily  in  a 
glass  of  flaxseed  tea.  Magnesium  Boro-citrate,  is  a  good  solvent  of  uric  acid 
calculi  (Madsen).  Lithium  Citrate,  to  promote  oxidation  (Da  Costa).  Hy¬ 
drangea,  in  decoction,  used  by  the  Cherokees  in  all  calculous  affections  with 
uniform  success  (Butler).  Lead  Acetate,  gr.  y2  to  the  5  of  distilled  water,  in¬ 
jected  into  the  bladder  to  prevent  formation  of  phosphatic  calculi,  or  a  solu¬ 
tion  of  Dilute  HC1  Acid,  up  ij-iij  to  the  5  (Sir  H.  Thompson).  Nitric  Acid, 
very  dilute,  as  injection  for  phosphatic  calculi  (R.) ;  gtt.  j  to  the  3,  as  injection 
into  the  bladder  in  chronic  cystitis  and  phosphatic  deposits  (B.).  Cotton-root,  in 
decoction,  as  a  demulcent  for  strangury  and  graVel  (P.).  Castor  Oil,  of  value  as 
a  purgative  (P.).  Calumba,  to  relieve  the  vomiting  (P.).  Counter-irritants,  as 
mustard-poultices,  or  turpentine  stupes,  to  relieve  pain  of  the  paroxysm  (R.). 
Anaesthetics,  for  the  same  purpose  (B.).  Morphine,  hypodermically,  as  an  ano¬ 
dyne  and  to  relieve  the  vomiting  (B.).  Hot  Fomentations,  to  alleviate  spasm 
and  pain  while  calculus  is  passing.  Diet.  Restrict  the  use  of  sugar  in  any 
form  or  combination,  also  fats  and  alcoholic  beverages.  Fresh,  green  vege¬ 
tables  may  be  used  freely,  also  skimmed  milk  or  buttermilk.  Mineral  waters, 
preferably  Vichy,  Friedrichshall  and  Carlsbad.  Frequent  abstinence  from 
animal  food.  Lemon-juice  and  soft  water  in  large  draughts,  are  useful.  Sur¬ 
gical  Measures. — Lithotomy  or  Lithotrity  for  removal  of  stone  from  bladder. 
Solvents  are  of  no  use  except  for  a  very  small  calculus,  and  even  then  a  con¬ 
siderable  time  must  be  occupied  in  the  process.  No  operation  in  surgery  more 
certainly  safe,  rapid  and  successful  than  lithotrity  (Sir  H.  Thompson.)  [Com¬ 
pare  Colic,  Lithiasis,  Oxaluria,  etc.] 


Prescriptions. 


Magnesium  Boro-citrate. 

R .  Magnesii  Carbonat.,  .  .  .  3j. 

Sodii  Biborat., 

Acidi  Citrici, . aa  zij. 

Aquee  Bullientis,  ....  5  viij. 

M.  Sig. — Tablespoonful  3  or  4  times 
daily.  (B.) 


Potassium  Tartra-borate. 

R .  Potassii  Bitariratis,  ....  partes  iv. 

Ac.  Borici, . partem  j. 

Aquae, . partes  x. 

By  heating  the  above  together,  the  salt 
is  obtained  as  a  white  powder,  of  which 
gr.  xx  in  a  large  draught  of  water  3  or  4 
times  daily. 


Cancer. 

Arsenic,  in  cancer  of  the  stomach,  diminishes  pain  and  checks  vomiting  ;  also 
in  scirrhus  of  stomach  and  epithelioma  ;  is  believed  to  retard  the  growth  of 
uterine  cancer  (Br.).  Arsenious  acid,  pure  or  with  starch,  as  a  caustic;  enough 
should  be  used  to  set  up  active  inflammation  (R.).  Belladonna,  locally  and 
internally  (rrp  v-x),  of  great  benefit  as  palliative  in  severe  pains  of  cancer  (P.). 
Conium,  as  poultice,  and  internally  to  relieve  pain  (R.)  Is  particularly 
applicable  to  pain  of  cancer  (P.).  As  palliative  (Wa.).  Hydrastis,  has  a 
renewed  interest  (Pf.)  Carbolic  Acid,  undiluted,  to  sore,  and  injected  beneath 
it,  limits  and  retards  (B.) ;  pure,  as  anaesthetic,  before  applying  caustics;  with 
glycerin,  as  application  to  fetid  cancers  (R.).  Mercuric  Chloride,  in  small 
doses,  long-continued,  will  retard  the  growth  of  gastric  cancer  (Da  Costa.). 
Citric  Acid,  3j— 3 viij  aquae,  useful  in  allaying  pain  of  cancerous  ulcerations 
(Wa.).  Acetic  Acid,  i  to  3  aquae;  up  xxx  injected  into  the  tumors,  has  been 
used  with  varying  success  (Wa.).  Chloral,  in  gr.  x  doses,  3  times  a  day,  has 
relieved  most  severe  pain  of  cancer  (R.).  Chloroform,  as  vapor  to  raw  surface 


CANCRUM  ORIS - CARBUNCLE. 


507 


(R.).  Pyoctanine,  or  Methyl  Violet,  in  solution,  by  injection  into  the  neoplasm, 
to  bring  about  the  shrivelling  up  and  final  disappearance  of  carcinoma  (von 
Mosetig).  Hyoscyamus,  bruised  leaves,  locally  (P.).  Bismuth,  relieves  pain 
and  vomiting  of  gastric  cancer  (B.).  Glycerin  of  Tannin,  with  glycerin  of  car¬ 
bolic  acid,  checks  discharge  and  stench  of  uterine  cancer  (R.).  Carbonic 
Acid,  injected  up  vagina  in  cancer  of  uterus,  to  relieve  pain  (R.).  Iodoform, 
applied  to  diseased  surface,  relieves  pain  and  removes  fetid  odor  (B.,  P.). 
Resorcin,  15  parts  to  20  of  Vaseline  as  an  ointment  twice  daily  after  washing 
with  a  solution  of  pot.  permanganate  has  successfully  stopped  epithelioma 
(Antonio).  Potassium  Chlorate,  in  impalpable  powder,  dusted  on  epithelioma, 
said  to  be  curative  (B.).  Pepsin,  injections  into  tumor  (B.).  Salicylic  Acid, 
pure,  applied  in  powder  (B.).  Zinc  Chloride,  the  most  efficient  and  safe 
escharotic.  Parts  j-ij-v  flour,  or  “caustic  arrows”  inserted  at  base  of  tumor 
(B  )„  Potassa  Fusa,  as  escharotic  (B.).  Opium,  to  cancerous  sores.  Mor¬ 
phine,  dissolved  in  glycerin,  and  spread  on  lint,  very  useful  where  there  is 
much  pain.  Opium  is  also  used  in  cancer  of  the  stomach  (R  ).  Codeine 
(gr.  TV  to  y1^),  a  good  hypnotic  (P.).  Zinc  Sulphate,  dusted  over,  dry.  An 
excellent  caustic.  Remove  the  eschar  by  poultice  (B.)  Bromine,  for  destruc¬ 
tion  of  uterine  cancer,  is  preferred  by  some  (B.).  Chromic  Acid,  a  power¬ 
ful  escharotic  (B.).  Carbonate  of  Lime,  as  calcined  oyster-shell,  very  efficient 
in  arresting  growth  of  cancerous  tumors,  and  in  alleviating  the  pain  thereof 
(Hood).  Rumex  Acetosa,  an  excellent  local  application  ;  has  a  popular 
reputation.  Iron  and  Manganese,  the  syrup  of  the  iodide,  for  resulting  cachectic 
state  (B.).  Poultices,  of  starch,  applied  cold  (R.) ;  or  poultices  of  bread, 
sprinkled  with  charcoal  or  freshly  ground  coffee,  as  deodorizers  to  open  cancers. 
Water  Enemata,  to  relieve  pain  and  straining  in  intestinal  cancer  (R.). 


Prescriptions. 


R.  Bismuthi  Subnit., . ^ij. 

Morphince  Sulph.,  .  .  .  .  gr.  j. 
Fiant  pulv.  vj.  Sig. — One  thrice  daily 
in  milk,  when  gastric  pain  and  vomiting. 

(B.) 


R.  Acidi  Arseniosi, . gij. 

Mucil.  Acacise, . sjj. 


As  paste  on  cancerous  sore,  followed  after 
2  or  3  days  by  bread  poultices  until  slough 
separates. 


Cancrum  Oris. 

Arsenic,  in  medicinal  doses  (R.).  Nitric  Acid,  to  surface  (R.)  ;  strong  nitric 
acid  the  best  caustic  for  worse  forms  of  the  disease  (Wa.).  Potassic  Chlorate, 
gr.  xx-xl  in  24  hours,  has  been  strongly  recommended  (D.).  Quinine,  made 
into  a  syrup,  or  as  enema,  to  support  the  strength  (Wa.).  [Compare  Aphthae, 
Stomatitis.) 

Carbuncle. 

Belladonna,  with  glycerin,  as  local  application  to  relieve  pain  (R.,  P.,  Wa.). 
Ammonium  Acetate,  to  support  the  system  (Cezard).  Carbolic  Acid,  on  lint, 
with  glycerin  or  oil,  into  discharging  sinuses  (R.) ;  or  hypodermically  into  the 
sloughing  tissues.  Iodine,  to  produce  vesication  around  carbuncle  ;  reduces 
inflammation  (R.) ;  part  j  of  the  tincture  to  iij  aquae,  locally,  has  most  striking 
effect  (Wa.);  may  be  used  with  benefit  internally  or  hypodermically  (Cezard). 
Calcium  Sulphide,  gr.  yL  hourly,  or  every  two  hours,  of  great  service  (R.). 
Opium,  a  thick  extract,  locally  (R.).  Potassium  Chlorate,  highly  recommended, 
also  Quinine  and  Iron,  freely  to  support  the  system  and  counteract  the  carbun- 
cular  poison.  Poultices,  the  inflamed  surface  having  been  previously  smeared 
with  belladonna  and  glycerin  (R.).  Long-continued  poulticing  thought  to 
create  tendency  to  a  fresh  crop.  Strapping,  with  plaster,  concentrically  from 
border  inwards,  leaving  the  centre  free,  will  sometimes  arrest  extension  (R.). 
Collodion,  as  protective  covering  (P.) ;  as  zone  around  base,  leaving  the  centre 
exposed  (Wa.).  Collodium  cum  cantharide  in  a  broad  zone  painted  around  the 
carbuncle,  to  relieve  the  tension  (A g.).  Ice,  or  Ice-bags  or  iced-water  on  cloths 
in  early  stage,  changing  to  warm  fomentations  as  soon  as  suppuration  has 
begun  (Hebra).  Galbanum  and  Opium  as  plaster  to  relieve  pain,  the  separa- 


508 


CARIES - CATALEPSY — CATARACT. 


tion  of  the  core  then  proceeding  painlessly  (Hill).  Crucial  Incisions  are  not 
so  frequently  made  now  as  formerly ;  they  relieve  tension  but  often  give  rise 
to  severe  hemorrhage.  Diet  should  be  very  supporting,  and  stimulants  may 
be  used  freely  when  the  patient  is  debilitated.  Saline  purges  occasionally 
(Hill).  Cauterization,  with  fuming  nitric  or  carbolic  acid,  on  top  of  a  free 
crucial  incision,  followed  by  dressing  with  carbolized  oil,  is  the  course  to  pursue 
in  malignant  pustule.  Caustic  Potash,  applied  before  an  opening  occurs,  or 
small  pieces  inserted  into  openings  made  by  scalpel,  to  cause  the  rapid  separa¬ 
tion  of  the  slough.  The  resulting  ulcer  should  be  treated  on  general  principles. 
[Compare  Boils.] 


Prescriptions. 

B-  Calcis  Sulphurat.,  .  .  .  gr.  iij.  B* 

Sacchari  Lactis,  .  .  .  .  q.  s. 

Triturat.  et  div.  in  chart,  xxx. 

Sig. — One  powder  every  2  hours,  to  be 
taken  dry  on  the  tongue.  M. 


Tinct.  Ferri  Chloridi,  .  .  .  %  j. 

Potass.  Chlorat., . £iij. 

Liq.  Ammonii  Acetat.,  .  .  3  iij. 
Syrupi  et  Aqure  .  .  q.  s.  ad  g  viij 
Sig. — Dessertsp.  every  2  hours. 


Caries. 

Aurum,  in  syphiloma  of  bones  (B.).  Calcium  Chloride,  where  strumous 
cachexia  (B.).  Phosphoric  Acid,  with  8  parts  water,  locally  applied,  has  been 
of  benefit  (Wa.).  Phosphates,  best  is  syrup  of  lacto-phosphate  of  lime,  or 
Parrish’s  phos.  (B.,  R.).  Villate’s  Solution,  to  dissolve  the  carious  bone,  has 
cured  many  cases  (B.) ;  see  formula  below.  Sarsaparilla,  a  very  useful  medi¬ 
cine  (P.).  Iodine,  locally,  with  iron  or  cod-liver  oil  internally  (Wa.)  ;  see 
Bone.  Potassic  Iodide,  in  syphilitic  caries,  holds  the  first  place  (Wa.).  Cod- 
liver  Oil,  to  promote  constructive  metamorphosis  (B.,  R.).  Mechanical  Contri¬ 
vances,  necessary  in  most  cases;  Sayre’s  plaster  jacket,  Agnew’s  jacket  of 
leather  and  steel,  Taylor’s  apparatus,  etc.,  are  used  in  spinal  caries  to  separate 
the  diseased  bones,  and  extend  the  spinal  column.  [Compare  Necrosis.] 


Prescriptions. 


Vi l fate's  Solution. 

B  •  Cupri  Sulphat., 

Zinci  Sulphat.,  aa  partes  xv. 
Liq.  Plumbi  Subacetat.,  p.  xxx 

Aceti, . p.  cc. 

To  be  injected  through  the  sinuses. 


B  •  Syrupi  Caleb  Lacto-phos- 

phatis  (U.  S.  P.),  .  .  .  3  viij. 

Sig. — A  dessertsp.  to  a  tablesp.  3  or  4 
times  daily. 


Catalepsy. 

Turpentine,  in  enemas,  and  embrocations  along  the  spine,  affords  the  best 
chance  of  stopping  the  paroxysms  (Wa.).  Treatment  must  be  essentially  tonic 
and  restorative  (H.).  No  constant  line  can  be  stated  (A.) ;  external  stimulation 
to  arouse  consciousness,  by  Ammonia,  cold  douches,  Faradism,  etc.  Apomor- 
phine,  gr.  to  ^ ,  in  the  paroxysm  ;  with  the  onset  of  nausea,  consciousness 
returns  and  spasm  ceases  ;  in  the  intervals  between  the  attacks  the  treatment 
should  be  .that  of  hysteria  (Gowers). 

Cataract. 

Phosphorus,  with  oil.  by  frictions  to  the  forehead,  and  instillation  of  the  same 
into  the  eye,  may  cause  absorption  of  the  lens  or  capsule  (Wa.).  Codeine,  in 
diabetic  cases  (Br.).  Sodium  Sulphate,  a  solution  suggested  as  injection  into 
anterior  chamber,  in  hope  to  dissolve  the  nebula  (Wa.).  Galvanism,  has  been 
successfully  employed  in  incipient  stage  (Wa.).  Mydriatics,  Atropine,  Duboi¬ 
sine,  etc.,  to  secure  full  dilatation  of  pupil,  as  a  means  of  ascertaining  when 
the  operation  should  be  made,  which  is  when  the  cataract  is  mature,  there  being 


CATARRH,  ACUTE  NASAL. 


509 


no  vision  even  with  dilated  pupil  (Wa).  Diet  and  Regimen,  may  do  much 
to  retard  degeneration  of  the  lens,  in  cases  due  to  diabetes,  or  malassimilation 
in  gouty  or  rheumatic  persons  (C.).  Iridectomy,  made  early  and  effectually 
may  postpone  the  progress  of  lenticular  opacity,  if  due  to  increased  intraocular 
tension  (C.).  In  partial  cataracts,  which  have  become  stationary,  iridectomy 
for  artificial  pupil  may  be  done  to  expose  clear  portion  of  lens  (Roosa).  Medi¬ 
cine  accomplishes  nothing  except  to  improve  general  health  and  so  delay  the 
progress  of  the  opacity.  Removal  may  be  performed  by  one  of  several  opera¬ 
tions  (Roosa). 

Catarrh,  Acute  Nasal. 

Sodium  Salicylate,  to  abort  a  cold  (see  ante  page  351).  Aconite,  in  severe 
coryza  with  much  chilliness,  aching  limbs,  hot  and  dry  skin,  and  quick  pulse  ; 
also  in  catarrhs  of  children  and  that  accompanying  measles  (R.);  in  acute 
coryza  (P.) ;  with  Belladonna  in  ordinary  colds  with  sore  throat  and  high  fever 
(B.) ;  in  doses  of  J/3  every  X  hour,  very  useful  for  a  commencing  cold  in 
the  head  (A.  A.  Smith).  Belladonna,  in  acute  nasal  catarrh  with  profuse  watery 
secretion,  tt\,  v  of  tincture,  then  np  j  each  hour  (B  ).  Nux  Vomica,  has  great 
effect  upon  a  dry  cold  in  the  head  (P.)  Euphrasia,  is  of  decided  utility  in 
coryza  (P.).  Pulsatilla,  a  warm  lotion,  Sj-ij  in  5A  aquae,  syringed  into  the 
nasal  passages  in  subacute  coryza  with  muco-purulent  secretion  (P.) ;  acts  simi¬ 
larly  to  Aconite,  but  is  contraindicated  if  much  gastric  or  intestinal  irritation 
exists  (B.).  Iodine,  by  inhalation  in  daily  attacks  with  itching  nose  (R.)  ;  gij 
of  the  tincture  with  3j  of  carbolic  acid  inhaled  from  a  sponge  in  the  bottom  of  a 
wide-mouthed  bottle  placed  in  hot  water  (B.).  Iodides,  are  unquestionably 
serviceable,  their  action  being  local  and  substitutive  ;  Ammonium  Iodide,  gr.  j 
every  two  hours,  the  best  mode  of  using  them  (B.).  Sodium  Iodide,  gr.  x  ter 
die,  with  Pil.  Ferri  Iodidi,  in  catarrhs  of  specific  origin  (B.).  Potassium  Iodide, 
gr.  x  at  bedtime  at  the  onset,  to  cut  short  an  acute  cold  in  the  head  ;  also  useful 
in  chronic  colds  (R.).  Quinine  and  Morphine,  gr.  x  with  gr.  1,  at  incipiency, 
will  often  abort  (B.).  Opium,  at  night,  if  taken  early,  will  often  abort  an 
attack  of  coryza;  a  glass  of  hot  grog  assists  its  action  (R.)  ;  Dover’s  powder, 
in  a  full  dose  at  the  onset  may  abort  (B.).  Codeine,  is  useful  in  common  colds, 
as  a  palliative  (B.).  Ammonia,  may  be  inhaled  in  the  early  stage  (R.).  Potas¬ 
sium  Chlorate,  8  or  10  lozenges  a  day  will  abort  many  a  cold  (R.).  Cam¬ 
phor,  as  inhalation,  the  spirit  in  form  of  vapor  (R.) ;  with  Opium  and  ammonium 
carbonate  as  powder  (see  formula  below),  to  break  up  or  modify  a  cold  (Beard). 
Tartar  Emetic,  gr.  ^  to  in  the  first  stage  (B.) ;  in  acute  catarrh  of  children 
often  accompanied  by  vomiting  and  diarrhoea  (R.).  Arsenic,  when  sneezing, 
itching  of  nostrils,  frontal  headache  (R.) ;  as  cigarettes  (B.) ;  see  under  Asthma, 
for  formula.  Veratrum  Viride,  if  arsenic  fails  (R.).  Ipecacuanha,  for  acute 
nasal  and  bronchial  catarrh,  and  ordinary  colds  in  children  (B.).  Cimicifuga, 
when  headache,  stiff  muscles,  dull  aches,  bone-pains,  etc.  (R.)  ;  an  excellent 
expectorant  (B.)  ;  rheumatic  colds,  neuralgic  pains  in  jaw  (P.).  Jaborandi, 
the  fluid  extract  in  doses  of  tt\,x  to  xxx,  every  half-hour  until  profuse  diaphoresis 
sets  in,  is  one  of  the  best  modes  of  aborting  a  cold  ;  or  Pilocarpine  Hydro¬ 
chlorate,  gr.  ]/e  in  water  at  bed-time,  will  give  prompt  relief,  and  cure  in  a 
few  days  (Wyss).  Cocaine,  a  4  or  5  per  cent,  solution  locally  as  spray,  to 
empty  the  engorged  venous  sinuses  of  the  nasal  mucous  membrane,  by  their 
contraction,  which  it  induces.  The  fluid  extract  of  Erythroxylon  diluted  with 
water  is  equally  efficient  if  enough  be  used  (Cohen).  Resorcin,  the  best  of 
all  applications  (see  Catarrh,  Chronic).  Cubeb,  or  Ammonium  Chloride, 
in  the  dry,  congestive  stage  of  a  cold  in  the  head ;  Cubeb  cigarettes  may  be 
smoked  as  a  temporary  palliative  with  great  relief.  Sulphurous  Acid,  in  coryza, 
by  inhalation,  spray  or  fumigation,  is  very  efficient  (R.).  Oil  Inunctions,  daily 
to  the  whole  body,  in  cases  of  undue  susceptibility  to  taking  cold,  will  prevent 
the  frequency  of  the  attacks  (B.).  Baths,  a  warm  foot-bath  before* going  to 
bed;  Turkish  bath,  at  onset  in  coryza,  may  prove  abortive;  also  useful  later  on. 
Cold  sponge  bath,  in  cases  of  extreme  susceptibility,  supplemented  by  occa¬ 
sional  Turkish  baths  (R.).  [Compare  Cough,  Hay-Fever,  Influenza.) 


CATARRH,  CHRONIC  NASAL. 


51° 


Prescriptions. 


R.  Quininse  Sulph., . gr.  xviij. 

Liq.  Arsenicalis  (B.  P.),  .  rip  xij. 
Liq.  Atropinae  (B.  P.)  .  .  rr^  j. 

Ext.  Gentianae, . gr.  xx. 

Pulv.  Acaciae, . q.  s. 

Ft.  pil.  no.  xij.  Sig. — One  every  3,  4  or 
six  hours,  for  acute  colds.  (  Whalen.) 


R  .  Camphorae, . gr.  1. 

ZEtheris, . q.  s. 

Dissolve  to  creamy  consistence, 
then  add — 

Ammonii  Carbonat.,  .  .  .  gr.  xl. 

Pulv.  Opii, . gr.  x. 

Divide  into  thirty  papers. 

One  or  two  powders,  according  to  age, 
twice  or  thrice  daily.  [Beard.) 


R.  Acidi  Carbolici, . gr.  lxxx. 


Alcoholis, . 5  ss. 

Aq.  Ammoniae, . rtplxxx. 

Aquae, . 3  bss* 

M.  Sig. — A  few  drops  as  an  inhalation 
from  a  cone  of  blotting  paper.  [Brand.) 


R  .  Morph.  Acetat., . gr.  iv. 

Bism.  Subnitrat., 

Pulv.  Talc., . 

Ft.  Chartulas,  No.  xxx. 

Sig. — Use  as  snuff  in  acute  rhinitis. 

[Sajous) . 


R.  Codeinae, . gr.  ij. 

Syrupi  Tolutani, 

Syr.  Scillae  Comp.,  .  .  .  .  aa  3  j. 

M.  Sig. — Teaspoonful  occasionally  for  a 
common  cold.  (B.) 


R  .  Tinct.  Aconiti, . rip  x. 

Tinct.  Belladonna;,  .  .  .  ^ss. 
Syrupi  Zingiberis,  .  .  .  ad 5  ij. 

M.  Sig. — Half  to  one  teasp.  according  to 
age,  every  hour. 


Ferrier1  s  Snuff. 

R.  Morph.  Hydrochlor.,  .  .  .  gr.  ij. 
Bismuthi  Subnit.,  .  .  .  .  £vj. 

Pulv.  Acaciae, . 3 ij. 

M.  Sig. — Use  as  snuff,  %  to  y2  the  above 
in  24  hours. 


Catarrh,  Chronic  Nasal. 

Sanguinaria,  the  tincture  in  io-drop  doses  thrice  daily,  or  gr.  TU  of  the  alka¬ 
loid,  internally,  and  the  powder  in  small  quantity  locally  to  the  mucous  mem¬ 
brane,  is  successful  treatment  for  chronic  nasal  catarrh  (B.).  Hydrastis  is  of 
value  in  chronic  coryza,  also  in  ulceration  of  the  septum  or  any  other  part  of 
the  nasal  fossae,  gtt.  v  of  the  tincture  thrice  daily  internally,  and  3j  to  3 viij  of 
water  locally  with  syringe  (P).  Pulsatilla,  is  excellent  in  subacute  inflamma¬ 
tion  of  nasal  passages,  with  offensive  muco-purulent  discharge,  3j-ij  ad  ^iv 
of  water,  as  wash  (P.).  Potassium  Bichromate,  is  an  excellent  local  application 
in  a  solution  of  gr.  j-x  to  5A  water  (B.).  Iodoform  and  Tannin,  1  of  the  former 
to  2  or  3  of  the  latter,  carefully  triturated,  and  applied  by  an  insufflator  every 
other  day  only,  is  the  very  best  of  all  applications  (B.).  Sodium  Chloride  or 
Phosphate,  a  teasp.  to  the  pint  of  warm  water  as  cleansing  solution,  or  the 
Bicarbonate  in  the  same  proportion.  A  sea-water  gargle  in  the  naso  pharyn¬ 
geal  space,  has  been  used  with  success  (Mosler).  Wei  de  Meyer’s  Catarrh 
Cure  is  simply  bicarbonate  of  sodium  and  a  little  pink  coloring  matter  (Robin¬ 
son).  Potassium  Permanganate,  gr.  j-x  to  the  pint  of  warm  water,  as  a  deodo¬ 
rant  solution  when  necessary.  Ammonia,  by  inhalation,  when  painful  inflam¬ 
mation  of  nasal  mucous  membrane  and  frontal  bones  (R.).  Carbolic  Acid,  a 
1  per  cent,  solution  as  spray,  or  inhalations  of  the  vapor  with  that  of  iodine 
from  a  bottle  in  hot  water,  or  vaporized  by  the  warmth  of  the  hand  (B.).  Sali¬ 
cylic  Acid,  in  weak  solution,  1  to  500  of  water,  as  a  disinfectant  and  astringent 
injection,  used  with  a  retro-pharyngeal  syringe,  and  followed  by  applications 
of  powdered  Calomel,  through  a  speculum,  upon  the  ulcerated  parts  of  the 
mucous  membrane  (Massei).  Cubebs,  finely  powdered  and  blown  into  the 
nares  by  an  insufflator  (B.),  have  proven  very  useful  (P.) ;  may  be  smoked, 
and  administered  internally  in  teasp.  doses  (Wa.) ;  in  freshly  ground  powder, 
as  a  confection  (see  below  for  formula),  very  efficient  in  follicular  disease  of  the 
naso-pharyngeal  space  (Robinson).  Ammoniacum,  in  the  same  condition,  verv 
small  doses,  gr.  j-iij,  with  ipecac,  or  carbonate  of  ammonium,  will  greatly  lessen 
the  amount  of  secretion  (Robinson).  Bismuth,  in  powder,  with  gum  acaciae,  as 


CATARRH,  CHRONIC  NASAL. 


5  1  1 

in  Ferrier’s  snuff  (see  above  for  formula),  or  with  tannin,  calomel,  iodoform,, 
etc.,  used  by  insufflation,  daily  (Robinson).  Aurum  Chloride,  in  mercurialized 
and  syphilitic  subjects,  with  offensive  discharge,  depressed  spirits  and  soreness 
of  the  nasal  bones  Iodides,  of  iron  and  sodium,  in  catarrh  of  specific  origin 
(B.).  Silver  Nitrate,  in  powder,  as  alterative  application,  gr.  x-xv  to  the  5  of 
menstruum,  is  often  a  useful  adjunct  to  treatment,  used  once  every  4  or  5  days 
(Robinson).  Cod-liver  Oil,  should  be  used  in  strumous  subjects  (R.).  Alum, 
in  powder,  dusted  over  the  affected  surface,  is  a  useful  application  (B.).  Resor¬ 
cin,  the  best  of  all  applications,  in  acute  and  chronic  catarrh.  After  cleansing 
the  nose  with  a  Boracic  Acid  solution,  or  Dobell’s,  use  a  2  to  10  per  cent,  oint¬ 
ment  (vaseline),  also  a  spray  every  other  day,  of  2  to  4  per  cent,  solution.  It 
gives  the  same  results  as  Cocaine,  but  is  slower  in  action  and  more  lasting,  and 
does  not  suppress  the  normal  function  of  the  mucous  membrane,  as  Cocaine 
does.  Eucalyptus,  has  been  employed  with  benefit  (Wa.).  Bromine,  the 
vapor  may  greatly  benefit,  but  must  be  used  with  caution  (B.).  Senega  has 
been  found  serviceable  (Wa.).  Douche  is  dangerous,  being  likely  to  cause 
extension  of  the  catarrh  to  the  Eustachian  tube  and  the  middle  ear.  It  has 
been  very  generally  abandoned.  Sprays  by  hand-ball  atomizers,  or  com¬ 
pressed  air  apparatus,  of  warm  watery  solutions,  vaseline,  etc.,  are  used  with 
considerable  success  (Cohen).  The  Hank’s  atomizing  tubes,  with  a  2-ball 
rubber  syringe,  are  very  serviceable  for  office  use,  and  for  the  application  of 
Rumbold’s  hot  vaseline  spray.  (See  formula  below.)  Sulphur  Waters,  inter¬ 
nally,  of  great  benefit  in  follicular  disease  (Robinson).  [Compare  Oza:na.] 


Prescriptions. 


R  .  Acidi  Carbolici, . trpx. 

Glycerini, . g  ij. 

Vaselini, .  5  ij. 

M.  Sig. — Warm  and  use  as  a  spray 
every  4  hours.  ( Rumbold .) 


R.  Pulv.  Argenti  Nitrat.,  .  .  .  gr.  vij. 

Pulv.  Acaciae . ^j. 

Bismutbi  Subnitrat.,  .  .  .  %  iij. 
Triturat.  Sig.  —  Apply  with  insufflator 
once  in  4  or  5  days.  [Robinson.) 


R  .  Bismuthi  Subcarb  ,  .  .  .  .  3  vj. 
Morph.  Muriatis,  .  .  .  .  gr.  ij. 

Pulv.  Amyli, . 3  ij. 

Triturat.  Sig. — Burness’  modification  of 
Ferrier’s  snuff. 


R.  Acidi  Carbolici, . npxl. 

Sodii  Boratis, 

Sodii  Bicarbonat.,  .  .  .  aa  3  ij . 

Glycerini, .  ov'J- 

Aquae, . q.  s.  ad  $vnj. 


M.  Sig. — Use  daily  as  spray. 

[Dobell.) 


Sodii  Boro  benzoatis,  . 

•  •  Ei- 

Ext.  Plydrastis  FI., 

■  •  5  J- 

Glycerini,  .... 

•  .  si- 

Ac.  Carbolici,  .  .  , 

.  .  TAXX. 

Aquae  Camphorae,  .  . 

.  .  Evi- 

Aquae, . q. 

M.  Sig. — Use  with  syringe  or  atomizer 
thrice  daily.  (  Chamberlain .) 


R  .  Bismuthi  Subcarb., 

Pulv.  Acaciae, . aa^ss. 

Ztnci  Sulphat., . gr.  x. 

Morph.  Sulphat.,  .  .  .  .  gr.  ij. 

M.  Sig. — Snuff,  to  be  used  thrice  daily. 

[Sajous.) 


R.  Sodii  Iodidi, . £  ss. 

Syrupi  Picis  Liq.,  .  .  .  .  5  vj. 

M.  Sig.  —  Dessertsp.  thrice  daily  with 
Pil.  Ferri  Iodidi  (U.  S.)  one  thrice  daily,  in 
chronic  nasal  catarrh  of  specific  origin. 


(B.) 


R.  Pulv.  Cubebae, . £  ij. 

Syr.  Aurantii, . .  3  iij. 

Aq.  Menth.  Pip.,  .  .  .  .  ^  ij. 

Aquae, . q.  s.  ad  ^  viij. 

Ft.  mistura.  Sig. — A  teaspoonful  every 
3  or  4  hours.  [Robinson.) 


R.  Ext.  Pini  Canad.,  ....  TT\^xx. 

Glycerini, . Trpxxx. 

Aquae, . Oj. 

M.  Sig. — Use  with  post-nasal  syringe. 


512  CEREBRAL  ANAEMIA - CEREBRAL  SOFTENING. 


R  .  Acidi  Carbol., . gtt.  xv. 

Extr.  Hydrastis  FL,  .  .  .  £). 

Sodii  Bicarb., 

Sodii  Biborat.,  ....  aa^j. 

Glycerini, . 3  j. 

Aquae  Camphorae,  .  .  .  ad^\\\). 

M.  big.  —  Use  with  posterior  nasal 
sprayer. 


R  .  Sodii  Salicylatis, . 3  ij. 

Sodii  Boratis, . g  nj. 

Glycerini, . ^ss. 

Aquae, . q.  s.  ad^V). 


M.  Sig. — Of  this  put  a  dessertspoonful 
into  a  pint  of  warm  water,  and  snuff  it  fiom 
the  hollow  of  the  hand  thrice  daily. 

(Sajous.) 


Cerebral  Anaemia. 

Iron,  the  tincture  of  the  chloride,  or  mild  chalybeate  waters,  in  chronic 
cases  from  general  antemia  (B.).  Amyl  Nitrite,  in  vaso-motor  spasm  ;  affords 
relief  in  sudden  attack  (B.).  Chloral,  in  small  doses  with  stimulants,  warm 
baths  (Ros.).  Camphor,  or  other  cerebral  excitants,  as  asafoetida,  valerian, 
serpentaria  (B.).  The  mono-bromide  of  camphor  in  one  to  five-grain  doses 
(Hammond).  Glonoinum,  rr\j  of  1  per  cent,  solution  (P.).  Phosphorus,  sup¬ 
plies  the  needed  material  for  healthy  brain-action  (B.).  Strychnine,  stimu¬ 
lates  the  circulation  generally  ;  as  a  tonic  with  iron  preparations.  Galvanism, 
a  mild  current  transversely  through  the  head,  gives  excellent  results  in  the 
confusion  of  mind,  vertigo,  etc.,  due  to  imperfect  nutrition  of  the  brain  from 
atheroma  of  the  cerebral  vessels  (B.).  Arsenic,  is  highly  efficient  in  some 
hypochondriacal  cases  (B.).  Aurum,  is  of  great  utility  in  vertigo,  melan¬ 
cholia,  etc.,  when  due  to  or  accompanied  by  cerebral  anaemia  (B.).  (Compare 
Insomnia.] 

Cerebral  Concussion. 

Arnica,  when  from  a  fall,  cannot  be  too  highly  spoken  of  (P.).  Warmth,  to 
extremities,  rest,  expectant  treatment,  will  suffice  in  mild  cases  (Ag.).  The 
indications  are :  (1)  to  recover  from  insensibility  and  collapse;  (2)  to  prevent 
inflammation;  (3)  to  restore  impaired  faculties  (D.).  Stimulants  or  Venesec¬ 
tion,  cannot  be  too  strongly  reprobated  (Ag.). 


Cerebral  Congestion. 

Aconite,  in  active  form,  renders  important  service  (B.).  Is  much  the  best 
remedy  in  this  condition  (P.).  Belladonna,  one  of  the  best  remedies  in  all 
hyperaemic  conditions  of  the  brain  or  spinal  cord  (P.).  Gelsemium,  rr^v  of  the 
fluid  extract  every  2  hours,  very  useful  (B.).  Bromides,  are  very  useful  (B.) ; 
must  be  used  in  full  doses.  Colocynth,  as  counter-irritant,  appears  to  act  well 
(P.).  Cathartics,  lessen  blood-pressure  (B.).  Colchicum,  in  plethoric  subjects 
(B.).  Galvanism,  of  brain  and  cervical  sympathetics  (B.).  Chloral,  when  tem¬ 
perature  high  (B.).  Arsenic,  sluggish  venous  circulation,  torpor  (B.).  Hydro¬ 
cyanic  Acid,  TT\jj-v  of  Scheele’s  dilute  acid  (B.).  Venesection,  will  prevent 
injury  to  brain.  Not  to  be  adopted  as  a  matter  of  course.  It  is  contraindicated 
when  anaemia,  aortic  valvular  disease,  or  in  cases  commencing  with  syncope 
(A.).  Water,  cold  douche  to  head,  feet  in  warm  water;  ice  and  hot  water 
alternately  to  head  and  nape  of  neck,  often  more  effective  than  ice  alone  (B.). 
Hot  water  to  head  on  flannels  ;  mustard  and  hot-water  packing  for  20  to  30 
minutes,  around  legs,  when  active  congestion.  Protect  bowels  well  (R.).  Diet, 
should  be  low,  but  not  too  low,  until  all  fear  of  relapse  past.  Full  animal 
diet  should  be  avoided,  also  undiluted  wines  (A.).  [Compare  Apoplexy, 
Coma.] 

Cerebral  Softening. 

Venesection,  and  antiphlogistic  treatment  generally,  most  beneficial  in  red 
softening,  result  of  inflammation.  Require  wise  discretion,  and  should  be  used 
early.  Not  to  be  thought  of  in  the  yellow  form,  from  want  of  nutrition;  where 
restoratives  and  food,  perhaps  wine  (A.).  Phosphorus,  in  threatened  softening 
of  the  brain ;  is  the  only  drug  which  affects  the  nerve-centres  (W.). 


CHANCRE - CHAPPED  HANDS - CHEST-PAINS. 


513 


Chancre. 

Mercury,  small  doses  steadily,  ptyalism  must  not  be  induced.  Black-wash 
(calomel  gr.  viij,  aq.  calcis  3j),  or  yellow-wash  (hydr.  chlor.  corr.  gr.  j,  aq. 
calcis  ^j)  on  lint,  to- erosions  and  ulcerated  indurations  (B.).  Calomel  alone 
as  dry  dressing.  Internal  use  of  mercury  best  postponed  until  secondary 
symptoms  appear  (St.).  Carbolic  Acid,  as  wet  dressing,  gr.  ij  of  crystals  to 
3D  aquae  ter  die  (St.).  Iodoform,  heads  the  list  of  dry  dressings  ;  with  lyco¬ 
podium,  equal  parts,  or  1  to  2  zinci  oxidi  ;  2  to  I  hydr.  chlor.  mite  (St.).  Hy¬ 
drogen  Peroxide,  said  to  destroy  the  specific  character.  Wash  lesions  ter  die, 
and  apply  lint  soaked  in  it  (R.).  Caustics,  should  never  be  used  unless  chan¬ 
cre  attacked  by  phagedena  (St.).  Caustic  Alkalies,  to  hard  edges  (R.).  Bro¬ 
mine,  Chromic  Acid,  best  escharotics  (B.).  Dressings,  are  effective  as  far  as 
the  local  trouble  is  concerned  in  the  majority  of  cases;  sometimes  a  piece  of 
lint  on  the  erosion  will  suffice.  Never  cauterize  an  initial  lesion  unless  it  is 
attacked  by  phagedena  (St.).  Cleanliness,  of  great  importance;  tepid  water 
locally  frequently  suffices  for  the  outward  treatment  of  infecting  chancre. 
[Compare  Syphilis.] 

Chancroid. 

Mercury,  the  acid  nitrate  one  of  the  best  caustics  ;  apply  with  a  glass  rod 
(B.).  Nitric  Acid,  fuming,  as  caustic  (B.,  R.)  ;  3j  to  ^ viij  aquae  is  an  excel¬ 
lent  dressing  (St.).  Carbolic  Acid,  injected  into  sore  (B.) ;  3ij-v  to  Oj  aquae 
locally  in  phagedena  (St.).  Ferri  et  Potas.  Tartras,  the  “  born  enemy  of 
phagedena”  (Ricord) ;  §j  to  3  vj  aquae,  internally,  teasp.  doses  thrice  daily; 
also  locally  (St.).  Ferric  Iodide,  in  sloughing  phagedena,  or  simple  c.  in  de¬ 
bilitated  constitutions  (B.).  Iodoform,  powdered  and  dusted  over  the  sore, 
allays  pain,  changes  morbid  action,  and  is  antiseptic  (B.,  R.) ;  1  part  to  2  of 
lycopodium,  or  one  of  tannic  acid  ;  as  stimulant  and  alterative  (St.).  Does 
no  good  except  to  relieve  pain  (Gross).  Potassium  Chlorate,  in  impalpable 
powder,  is  better  than  Iodoform  (B.).  Chloral,  gr.  iij  ad  3j  aquae,  the  best 
local  application  to  relieve  pain  (Gross).  Caustics,  in  severe  cases,  the  white 
iron  strong  sulphuric  acid,  pure  nitric  acid,  pure  carbolic  acid,  are  effective  in 
the  order  named  (St.).  [Compare  Bubo.J 


Chapped  Hands  and  Lips. 

Sulphurous  Acid,  as  solution,  or  by  fumigation,  will  speedily  cure  (R.) 
Glycerin,  diluted,  or  better  still,  glycerin  of  starch,  or  with  ]/z  the  quantity  of  eau 
de  cologne  (R.).  Benzoin,  the  comp,  tinct.,  1  part  to  4  of  glycerin  ;  an  admira¬ 
ble  application  (P.).  Hydrastis,  on  compress  as  lotion  (P.).  Collodion,  is 
usefully  employed  (P.).  Carbolic  Acid,  1  to  2  of  glycerin,  locally;  one  appli¬ 
cation  is  generally  sufficient.  Unguentum  Aquae  Rosae  alone,  is  often  efficient ; 
may  be  combined  with  oxide  of  zinc. 


Prescriptions. 


R.  Resinae, . %j. 

Cerx  Albae, . 3  ij. 

Adi  pis, . 3  ij. 

Zinci  Oxidi, . 3  vij. 


R.  Cetacei, . gj. 

Glycerini, . 3  ij. 


Cerae  Albae,  •  •  .  .  .  .  gr.  xv. 

01.  Amygd.  Amarae,  .  .  .  ftp  iij. 


Chest-pains. 

Belladonna,  as  ointment,  when  tenderness  is  in  skin  (pleurodynia)  (R.). 
Iodine,  oint. ;  pain  in  muscles  (myalgia)  of  chest,  they  being  tender  on  pressure, 
while  the  skin  may  be  pinched  without  pain  (R.).  Strychnine,  affords  relief  in 
functional  irritability  of  the  nervous  system,  manifested  by  wandering  neural¬ 
gic  pains  (B.).  Arnica,  for  a  “stitch”  in  the  side.  Bryonia,  when  painful 
catching  of  breath.  Cimicifuga,  for  intercostal  rheumatism  and  pains  under 
the  breasts  in  women. 

33 


CHICKEN-POX - CHILBLAINS - CHLOROSIS. 


5H 


Chicken-pox. 

Aconite,  is  of  great  value  (B.)  Water,  hot  and  cold  baths  and  packs  are  of 
great  utility;  cold,  if  hyperpyrexia;  cold  compress  if  sore-throat;  hot  or  warm 
pack  when  free  diaphoresis  required  (B.).  Treatment-,  precautionary  only 
required.  Avoid  exposure  to  cold  and  wet ;  maintain  the  action  of  skin  and 
bowels  (H.).  Acetate  of  Ammonium,  in  diaphoretic  and  antifebrile  mixture. 
See  Fever,  Simple,  for  formula.  Inunction,  with  camphorated  oil,  or  thin 
starch,  to  relieve  itching  and  allay  inflammation  (P.). 


Chilblains. 


Arnica,  a  useful  application  (Wa.).  Iodine,  ointment,  the  best  application 
(R.).  Carbolic  Acid,  an  efficient  application  is  an  ointment  of  carbolic  acid  and 
iodine  (B.).  Benzoin,  the  tincture  in  glycerin,  applied  after  thorough  washing 
in  soap  and  water  and  drying,  the  best  application.  Sulphurous  Acid,  an  effi¬ 
cient  application  ;  3nj-3j  each  of  water  and  glycerin  (B.) ;  as  solution  or  fumi¬ 
gation  (D.).  Balsam  of  Peru,  in  ointment  for  broken  chilblains  (R.).  Capsi¬ 
cum,  tinct.  painted  over  unbroken  chilblains  (R.).  Cajuput  Oil,  applied 
locally  (R.).  Turpentine,  as  wash,  then  apply  basilicon  ointment  mixed  with 
turpentine  (B.). 


R .  Acidi  Carbolici,  .  .  .  . 

Tinct.  Iodi, . 

Ac.  Tannici, . 

Cerati  Simplicis,  .  .  . 
M.  Sig. — Ointment. 


3J- 
S’j- 
7>  rF 
5 1V- 


Prescriptions. 

R. 


(B.). 


M. 


Tinct.  Benzoini,  .  . 
Olei  Lini,  .  . 

Cere  Flave,  .  .  . 

Glycerini . 

Sig. — Ointment. 


•  34 

.  3  iv. 

•  £ij- 

.  q.  s. 

( Reveil. ) 


Chlorosis. 

Iron,  combined  with  arsenic  or  strychnine.  Occasional  purgation  and  active 
exercise.  Also  chalybeate  waters  for  blood  deficiencies  (B.,  R.)  ;  is  not  a  specific 
in  chlorosis,  and  acts  best  in  the  purest  types  (Tr.) ;  the  iodide,  when  much 
torpor  of  the  system,  is  often  speedily  efficacious  (Wa.).  Arsenic,  if  iron  fails, 
or  disagrees  (B.).  Ergot,  in  chlorotic  amenorrhoea  (P.).  Manganese,  the  sac- 
charated  carbonate  of  manganese  and  iron  (B  ).  Nux  Vomica,  stimulates  the 
blood-making  organs,  and  may  be  combined  with  iron.  A  very  generally  useful 
preparation  is  the  syrup  or  elixir  of  iron,  quinine  and  strychnine  (B.).  Cocculus 
Indicus,  with  amenorrhoea  and  exhausting  leucorrhoea  (P.).  Hypophosphites, 
of  lime  or  sodium  (R.).  Benzoin,  has  been  used  with  advantage  (P.).  Pepsin* 
benefits,  especially  where  digestive  derangement  (B.).  Sulphur,  of  great  benefit 
in  cases  where  iron  is  of  no  effect;  also  to  prepare  the  system  for  benefit  from 
iron  (Schulz).  Purgation,  is  very  important,  to  prevent  auto-infection  from 
putrid  intestinal  decomposition,  which  is  the  true  cause  of  this  disease  (Duclos) ; 
absorption  of  such  products  tending  to  impoverish  the  blood,  and  produce  a 
“fecal  anaemia”  (Sir  A.  Clark).  Oils  and  Fats,  as  inunctions  after  baths,  of 
great  benefit  (B.).  Galvanization,  central:  will  aid  the  action  of  the  remedies 
(B.).  [Compare  Anaemia,  Amenorrhcea.] 


Prescriptions. 


R.  Ferri  Arseniatis,  .  .  .  gr.  ij. 
Extracti  Cinchone,  .  .  gr.  xij. 

Fiant  pil.  xij.  Sig. — One  after  each  meal. 

_  (B.) 

R.  Ferri  Sulph.  Exsiccat.,  .  gr.  xl. 
Quinine  Sulphatis,  .  .  gr.  xx. 
Strychnine  Sulphat.,  .  gr.  ss. 

Ft.  pil.  xx.  Sig. — One  thrice  daily. 


R.  Pulv.  Aloes  Socot.,  .  .  .  gr.  v. 

Ferri  Sulph.  Exsiccat.,  .  gr.  xv. 

01.  Tanaceti  vel 

01.  Sabine, . gtt.  xxx. 

Myrrhe,  Croci, 

Cantharidis,  .  .  .  .  aa  gr.  xxx. 

Ft.  pil.  lx.  Sig. — Two  thrice  daily 
gradually  increased  to  four. 

(  Wallace .) 


CHOKING - CHOLERA. 


515 


Choking. 

Potassic  Bromide,  benefits  a  curious  affection,  sometimes  found  in  children 
who  from  their  birth  can  swallow  solids  with  ease  but  choke  at  drinks  (B.).  Oil 
of  Cajuput,  in  one  case  of  persistent  “  choking”  sensation  in  the  throat,  a  few 
doses  removed  the  symptoms  which  had  lasted  several  weeks  (Hale). 


Cholera  Asiatica. 

Camphor,  a  drop  or  two  of  the  saturated  tincture,  or  v-x  drops  of  the  spirits 
with  a  little  opium  every  half-hour  (B.) ;  gtt.  iv-vj  of  strong  spirits  every  ten 
minutes  until  symptoms  abate,  then  hourly  (R.).  Arsenic,  in  epidemic  cholera ; 
some  cases  of  arsenic  poisoning  not  distinguishable  from  cholera  (B.) ;  for  the 
vomiting  and  in  collapse  (R.).  Copper  salts  have  been  given  (R.).  Turpen¬ 
tine,  npx-xx  every  two  hours  promises  to  be  a  remedy  of  value  (Wa.).  Chloral, 
as  injection,  the  most  efficient  treatment,  especially  when  morphine  and  atropine 
are  given  coincidently  (B.).  Chloroform,  a  few  drops  frequently  repeated,  or 
x-xxx  drops  of  chlorodyne,  of  great  value  (B.).  Opium,  T\y  to  X  gr.  morph, 
hypodermically  in  preliminary  diarrhoea  (B.,  P.);  l/%  to  %  gr-  °f  the  greatest  value 
even  in  collapse  (R.) ;  dangerous  if  kidney  complications  exist  (P.).  Lead,  the 
acetate  in  early  stages  (R.).  Carbolic  Acid,  with  iodine,  has  given  good  results 
(B.).  Sulphuric  Acid,  the  aromatic,  with  opium,  is  very  effective  (B.);  two  parts  of 
the  former  with  one  of  laudanum,  of  this  5  to  30  drops  as  per  age,  is  one  of  the 
best  prophylactics  (McClellan).  Strychnine,  as  prophylactic  during  the  pre¬ 
liminary  diarrhoea,  and  in  epidemic  when  nearing  collapse  (B.).  Alcohol,  small 
doses  of  iced  brandy  for  vomiting  (B.).  Spinal  Ice-bag,  for  cramps  (R.). 
Saline  Injections,  into  the  veins,  have  been  successful  in  the  collapse  (B.). 
Transfusion,  of  milk,  in  collapse  (B.).  Absolute  Rest,  recumbent  posture,  no 
food,  ice  ad  libitum;  enemata  of  warm  milk;  fresh  air,  friction,  and  heat  to 
abdomen,  legs  and  feet;  stimulants  worse  than  useless. 


Prescriptions. 


R.  Chloralis  Hydrat.,  ....  3  iij. 
Morphinse  Sulph.,  ....  gr.  iv. 
Aquae  Laurocerasi.  .  .  .  %]. 

M.  Sig. — Fifteen  to  twenty  drops  as  in¬ 
jection  hypodermically.  (B.) 


R .  Chloroformi, . ^  ij. 

Tinct.  Opii, 

Spt.  Cam  phone, 

Tinct.  Capsici,  .  .  .  .  aa  g  vss. 

Alcoholis, . j. 

M.  Sig. — 30  to  60  drops  in  water. 

{Squibb' s  Cholera  Mixture. ) 


R .  Acidi  Carbolici, . gr.  iv. 

Tinct.  Iodi, . gtt.  xvj. 

Aq.  Menth.  Pip., . 5  iv. 

M.  Sig. — A  tablesp.  every  hour  or  oft- 
ener.  (B.) 


R.  Acidi  Carbolici, . gr.  viij. 

Bismuthi  Subnit., . :qij. 

Mucil.  Acaciae, 

Aquae  Laurocerasi,  .  .  .  aa  ^j. 

M.  Sig. — Teasp.  every  hour  or  two  for 
vomiting  and  diarrhoea. 


Cholera  Infantum. 

Ipecacuanha,  greenish  stools  with  mucus  and  often  blood  (B.).  Arsenic,  for 
vomiting  and  collapse  (R.).  Mercury,  gr.  of  gray  powder  hourly  of  great 
service  in  infantile  cholera  with  incessant  sickness,  profuse  almost  continuous 
diarrhoea,  offensive  and  nearly  colorless  stools.  A  starch  injection,  with  a 
minute  quantity  of  laudanum,  assists  the  gray  powder,  and  should  be  given  in 
urgent  cases  (R.).  Zinc  Oxide,  with  bismuth  and  pepsin,  is  very  useful  (B.)„ 
Camphor,  ^j-jjiv  of  milk,  very  serviceable  (B.) ;  an  admirable  remedy  for 
summer  and  choleraic  diarrhoea  (R).  Opium,  generally  necessary.  Enemata 
of  starch  and  laudanum  (see  above  under  Mercury).  Morphine,  hypoder¬ 
mically,  in  doses  of  gr.  to  according  to  age,  the  latter  dose  for  a  child  of 


5i6 


CHOLERA  SIMPLEX. 


one  year,  with  5  or  6  drops  of  ether,  to  be  repeated  in  an  hour,  the  most  effi¬ 
cient  treatment  (E.  Smith).  Copper  Sulphate,  often  very  successful  (B.).  Car¬ 
bolic  Acid,  with  Bismuth,  may  arrest  the  disorder  promptly  (Br.).  Lead  Ace¬ 
tate,  is  one  of  the  most  useful  astringents  in  this  complaint  (Br.).  Potassium 
Bromide,  when  due  to  nervous  irritation  or  cerebral  congestion  (B.).  Silver 
Nitrate,  is  beneficial  after  the  acute  symptoms  have  passed  (B.).  Caffeine, 
when  due  to  nervous  irritation  (R.).  Coto  Bark,  the  tinct.  gtt.  j-iij  is  highly 
recommended  by  Rohrer  for  choleraic  diarrhoeas  in  children.  Alcohol,  in  grave 
cases,  with  tendency  to  collapse,  gtt.  x-xx  of  brandy  with  milk  every  30  to  60 
minutes.  Diet.  Farinaceous  food  a  common  cause.  Cow’s  milk  O X  with 
sacch.  lactis  5J  to  O X  aquse-bul.,  or  cold  milk  with  lime-water  (R.) ;  milk,  ani¬ 
mal  broths ;  no  starches  or  fats  (B.).  Drinks,  as  water,  weak  tea,  etc.,  freely, 
to  keep  vessels  filled  and  prevent  paralysis  of  the  heart  (Meinert).  Spice  Poul¬ 
tice,  to  abdomen,  composed  of  cloves,  ginger  and  cinnamon,  mixed  with  brandy 
or  whiskey.  Mustard  Bath,  in  stage  of  collapse,  with  mustard  over  the  heart, 
and  ether  hypodermically  (Smith).  Lactic  Acid,  a  2  per  cent,  solution  in 
drachm  doses,  5  to  8  times  in  24  hours,  in  epidemic  diarrhoea  of  infants  with 
green  discharges,  with  local  antisepsis  as  to  linen  and  diapers,  on  the  theory  of 
a  bacillary  origin  for  the  disease  (Hayem). 


Prescriptions. 


R  .  Acidi  Carbolici, . gr.  iv. 


Bismuthi  Subnit.,  .  .  .  .  gij. 
Mucil  Acacke, . 


Aquae  Menth.  Pip.,  .  .  .  5  iij. 

M.  Sig. — Teasp.  every  2,  3,  or  4  hours. 

(B-) 


R  .  Acidi  Carbolici, . gr.  xxiv. 

Spt.  Vini  Gallici,  ....  gtt.  xxiv. 

Aquae  Menth.  Pip.,  .  .  .  5jss. 

Mucil.  Acacias, . ^vj. 

Syr.  Papaveris, . gvj. 

Tinct.  Opii  Deod.,  .  .  .  gtt.  x. 


M.  Sig. — A  teasp.  every  2  hours. 


R .  Hydrarg.  Chlor.  Mitis,  .  .  gr.  -jL 
Bismuthi  Subnitrat.,  .  .  .  gr.  ij-v. 

In  powder  every  half-hour  for  the  vomit¬ 
ing  and  purging. 


R .  Cupri  Sulphat., . gr.  j. 

Tinct.  Opii  Deod.,  .  .  .  .  gtt.  viij. 

Aquae  Destil., . ^iv. 

M.  Sig. — Teasp.  every  2,  3,  or  4  hours 
for  a  child  of  one  to  two  years  old.  (B.) 


R.  Plumbi  Acetat., . gr.  xxiv. 

Pulv .  Opii, . gr.  xij. 

Pulv.  Camphorae  .  .  .  .  3  ss. 

Sacch.  Lactis., . q.  s. 

Triturat.  et  div.  in  chart,  xij. 

Sig. — One  every  hour.  (B.) 


R .  Hydrarg.  Chlor.  Mitis,  .  .  gr.  i. 
Piumbi  Acetatis,  .  .  .  .  gr.  i. 

Opii, . gr-itoTo- 

Ft.  pulv.  no.  j.  Repeat  every  half-hour 
or  hour  for  the  acute  gastric  symptoms. 


Cholera  Simplex. 

Camphor,  an  admirable  remedy  (R.,  B.).  Veratrum  Album,  for  the  vomiting 
(R.).  Copper  Salts,  have  been  given  (R.).  Arsenic,  for  vomiting;  also  for  col¬ 
lapse  in  latter  stages  (R.).  Chloral,  by  injection,  the  most  efficient  treatment 
(B.).  [See  C.  Asiatica  for  formula.]  For  the  cramps,  Chloral  £j,  in  Lin. 
Saponis  ^iv-vj,  applied  with  friction  to  the  abdomen  (Da  Costa).  Carbolic 
Acid,  with  bismuth,  very  effective  (B.).  [See  above,  C.  Infantum.]  Lead, 
the  acetate,  in  early  stages  (R.).  Opium,  gr.  X-X  morphine,  hypodermically; 
very  useful  (B.).  Gr.  jf,  X»  or  X  °pii,  every  2,  4,  or  6  hours  in  early  stage  (P.). 
Calumba,  as  anti-emetic,  of  great  value  (P.).  Ipecacuanha,  has  been  used 
with  much  advantage  (Wa.).  Sumbul,  said  to  have  proved  successful  (P. ). 
Mustard,  as  an  emetic  in  collapse,  to  stimulate  a  failing  heart  (P.).  Cajuput 
Oil,  much  used  in  India  for  choleraic  affections  (P.).  Alcohol.  Iced  brandy 
in  small  doses  for  vomiting  (B.).  The  value  of  stimulants  justly  doubted ;  if 
given,  should  be  largely  diluted  (Wa.).  [Compare  Cholera  Asiatica  and 
Infantum,  above.] 


CHORDEE - CHOREA. 


517 


Chordee. 

Aconite,  gtt.  j  hourly,  will  relieve  (R.  P.).  Belladonna,  combined  with  cam¬ 
phor  or  opium,  gives  the  best  results  of  remedies  administered  internally  (St.). 
Camphor,  3j  doses  of  the  spirits  will  relieve  (R.).  Cantharis,  gtt.  j  ter  die,  will 
prevent  (B.,  R.).  Cannabis  Indica  or  Cannabis  Sativa  (P.).  Lupulin,  valu¬ 
able  (P.);  said  to  prevent  (B.).  Morphine,  hypodermically,  the  one  sure 
remedy;  should  be  injected  into  the  perineum  at  bedtime  (St.).  Cocaine,  a  few 
drops  of  a  4  per  cent,  solution,  locally  to  the  glans  ;  or  injected  into  urethra, 
promptly  relieves  chordee.  Diet  should  be  plain,  even  low,  no  stimulants  ; 
copious  draughts  of  barley-water,  or  linseed  tea. 


Prescriptions. 


R.  Liq.  Morph.  Magendie,  .  giv. 
Atropinae  Sulphat.,  .  .  .  .  gr.j. 

Acidi  Acetici, . q.  s. 

Aquae  Destillat.,  .  .  .  ad  gj. 

M.  Sig. — rrc  v— viij  hypodermically  at 
bedtime.  (St.) 


R.  Pulv.  Opii . gr.  xij. 

Pul.  Camphorae, . gr.  xxiv. 

Sacch.  Alb., . q.  s. 

Fiant  capsulae  xij. 

Sig. — One  at  bedtime,  to  be  repeated  in 
2  hours  if  required.  (St.) 


Chorea. 

Cimicifuga,  in  cases  due  to  menstrual  derangement,  is  very  useful  (B.,  P.) ; 
when  rheumatic  history  (R.) ;  a  very  valuable  remedy  (P.).  Strychnine,  in 
doses  gradually  increasing  to  toxic  (Tr.) ;  minute  doses  (gr.  ^  to  ^y)  have 
been  of  much  use  when  from  fright  or  commencing  puberty  (B.) ;  Arsenic, 
large  doses  required  v  ter  die,  when  non-ansemic  (B.) ;  very  successful  in 
uncomplicated  cases  (R.).  Zinc,  the  Sulphate,  has  similar  action  to  Arsenic, 
but  is  inferior  (B.).  In  large  and  increasing  doses  it  is  very  useful  (R.).  Iron, 
large  doses  of  the  Subcarbonate  in  anaemic  cases,  about  the  time  of  puberty 
(B.)  Chalybeate  waters  often  relieve  or  cure.  Arsenic  generally  better,  unless 
anaemia  coexists  (R.).  Hyoscyamine,  gr.  ter  die,  gradually  increased,  has 
cured  cases  which  resisted  all  other  remedies  (Da  Costa).  The  mydriatics  are 
very  suitable  in  nervous,  delicate  children.  Copper.  Cupr.  Ammoniatum  has 
been  used  successfully  (B.).  Veratrum  Viride,  has  been  employed  (R.).  Coc- 
culus,  picrotoxine,  large  doses  (B.,  P.).  Conium,  in  large  doses,  to  quiet  mus¬ 
cular  agitation  (B.) ;  is  only  palliative  (R.) ;  evidence  contradictory  as  to  its  value 
(P.).  Valerian,  said  to  restrain  the  movements  (R.).  Useful  when  from  worms 
(P.).  Chloral,  contributes  to  a  cure  by  inducing  quiet  sleep  (B.,  R.).  Chloro¬ 
form,  inhalations,  often  of  great  service  in  severe  cases  (R.).  Morphine,  with 
Chloral,  hypodermically  in  large  doses  for  severe  cases  (Tr.)  ;  when  the  move¬ 
ments  prevent  sleep  (R.).  Physostigma,  is  recommended  (R.) ; — of  doubtful 
benefit  (B.).  Musk,  has  been  given  (R.).  Cod-liver  Oil,  in  low  nutrition  (B., 
R.).  Water.  Cold  affusion  to  head  and  spine,  and  cold-baths,  important  (B.); 
not  to  be  used  if  rheumatism,  fever,  or  pain  in  joints.  Tepid  water  first  (R.). 
Galvanism,  the  constant  current,  used  by  Benedict  in  twenty  cases,  all  recov¬ 
ering.  Galvanic  chain  around  neck  and  down  the  back. 


Prescriptions. 


R.  Tinct.  Ferri  Chloridi,  .  .  %j. 

Liq.  Acidi  Arseniosi,  .  .  .  7,  ij. 

Syr.  Limonis, . 3  ss. 

Syr.  Simplicis, 

Aquae,  .  .  .  .  aa  q.  s.  ad  3  iv. 

M.  Sig. — Half  a  teaspoonful  thrice 
daily,  after  meals,  gradually  increased,  and 
effects  carefully  watched. 


R.  Chloralis  Hydrat.,  ....  giv. 
Tinct.  Hyoscyami,  .  .  .  .  3  j. 

Syr.  Limonis, . 3j. 

Aquae  Cinnamomi,  .  .  .  .  3  iv. 


M.  Sig. — A  teasp.  3  or  4  times  daily, 
according  to  age. 


5i8 


CHOROIDITIS - COLIC,  INTESTINAL. 


Choroiditis. 

Mercury,  as  in  iritis;  cannot  be  borne  to  the  same  extent  as  in  latter  dis¬ 
ease  (A.).  Opiates,  necessary  externally  and  internally  to  overcome  pain  (A.). 
Treatment,  is  generally  the  same  as  in  corresponding  forms  of  iritis,  but  when 
atrophic  spots  appear  on  the  choroid,  no  treatment  can  repair  the  damage 
(A.).  Rest  of  eyes  and  protection  from  light  by  blue  glasses.  In  suppurative 
form  (panophthalmitis)  use  Atropine  in  strong  solution,  with  ice  compresses 
and  leeches  in  early  stage.  Paracentesis  repeatedly  to  relieve  tension  and 
give  exit  to  pus.  Canthoplasty  of  outer  canthus  to  relieve  the  pressure  of  the 
lids  (Roosa). 

Climacteric  Disorders. 

Aconite,  for  nervous  palpitations,  and  restlessness  or  “fidgets;”  gtt.  j  hourly 
(R.).  Cimicifuga,  for  distressing  headache  (R.).  Nitrite  of  Amyl,  in  small 
doses  when  the  “  heats  ”  predominate,  followed  by  cold,  clammy,  pale  skin 
(R.).  Ergot,  for  the  flooding,  gr.  ij  of  Squibb’s  extract,  in  fresh  pill  every  hour 
until  relieved.  Cannabis  Indica  may  be  well  combined  with  it.  Cannabis 
Indica,  is  used  in  the  headaches  of  the  menopause  with  uniformly  good  results. 
[See  Headache,  for  formula.]  Nux  Vomica,  Opium,  and  Belladonna,  when 
symptoms  described  under  Iron  are  limited  to  head  and  face  (R.)  Iron,  for 
flutterings  of  the  heart,  with  fullness  of  head,  heat  and  weight  on  the  vertex, 
frequent  flushings,  and  hot  and  cold  perspirations.  Large  doses  of  Sesqui- 
chloride  ter  die  (R.).  Ammonia,  Raspail’s  sedative  lotion  to  painful  part  of 
head,  in  headaches  (R.)  Potassium  Bromide,  for  despondency,  with  sleep¬ 
lessness  and  irritability,  often  also  with  heats,  flushings,  perspirations  (R.). 
Physostigma,  the  extract,  gr.  every  yi  hour  for  7  or  8  doses  for  flatulence 
and  a  sensation  of  fluttering  at  the  pit  of  the  stomach  (A.  A.  Smith).  Cam¬ 
phor,  for  drowsiness  and  headache.  Eau-de-cologne  saturated  with  camphor 
rubbed  to  head  (R.).  Zinc  Valerianate,  hysterical  symptoms  (R.).  Change  of 
air  and  scene,  where  other  treatment  only  partially  successful  (R.).  Warm 
Bath,  to  promote  free  perspiration,  go0  to  950  Fah.  for  an  hour  once  a  week, 
will  obviate  many  of  the  symptoms  (R.).  [Compare  Metrorrhagia.] 

Coccyodynia. 

Chloroform,  injected  as  deeply  as  possible  about  seat  of  greatest  pain  (B.). 
Electricity,  has  cured  one  severe  case  of  12  years’  standing,  and  helped  others. 
Surgical  treatment  the  only  resource  in  rebellious  and  painful  cases  (Ros.). 
Nott  extirpated  the  coccyx ;  Simpson  performed  subcutaneous  section  of  mus¬ 
cles  and  ligaments.  Goodell  removes  the  bone,  after  first  treating  the  case  as 
a  local  expression  of  a  general  neurosis. 

Coldness. 

Strychnine,  for  cold  hands  and  feet  (R.).  Cold  Baths,  with  friction  to  the 
skin,  nightly  for  cold  feet  (R.).  Spinal  Ice-bag,  is  often  efficiently  employed 
in  general  coldness  of  the  surface,  and  persistent  coldness  of  the  hands  and 
feet  (R.). 

Colic,  Intestinal. 

Nux  Vomica,  quickly  subdues  abdominal  cramps  and  spasms  (P.)  Bella¬ 
donna,  especially  in  children  (R.).  Chamomile  Oil,  Try  iv-vj,  in  colicky 
attacks  of  hysterical  women  (P.).  Cocculus,  of  great  value,  especially  during 
pregnancy  (P.).  Chloral,  sometimes  relieves  (R.).  Chloroform,  effective  in 
flatulent  colic  ;  also  useful  in  hepatic  and  saturnine  (B.).  Often  used  combined 
with  Opium  (D.).  Potassium  Bromide,  in  a  peculiar  form  in  young  children 
(R.).  Given  in  anise  or  peppermint  water  is  of  greater  efficacy  for  the  colic  of 
infants  than  the  opium  preparations  in  general  use,  and  perfectly  safe  (B.). 


COLIC,  LEAD. 


519 


Asafcetida,  no  better  remedy  in  flatulent  colic  of  infants.  Teasp.  doses  of  the 
mistura  asafcetidae  (B.).  Morphine,  gr.  \  hypodermically,  repeated  in  15 
minutes,  gives  more  relief  than  any  other  remedy,  in  all  forms  of  colic  (B.). 
Frequent  small  doses  (R.,  P.).  Arsenic,  will  cure  in  a  surprising  manner  when 
enteralgia  is  idiopathic  (B.).  Essential  Oils,  especially  those  of  Cloves  and 
Cinnamon  (R.),  Anise,  Cardamom,  etc.  Oil  of  Rue  in  flatulent  colic  of 
children  (P.).  Magnesia,  the  carbonate  with  Opium  and  Asafetida,  as  in 
Dewees’s  Carminative,  now  official  as  Mistura  Magnesias  et  Asafcetidae,  the  dose 
being  rtRxx  for  an  infant  of  2  to  4  weeks  old.  Tobacco,  as  enema  ;  dangerous  ! 
(B.)  ;  as  clyster,  or  by  stomach  (R.).  Ammonia,  in  spasm  of  intestinal  canal 
and  in  colic  of  children  or  infants  from  bad  feeding  (R.)  Lime  Water,  for 
young  children  who  eject  milk  in  lumpy  masses,  with  colic  and  flatulence 
(R.).  Water.  Hot  fomentations  to  ease  pain  (R.).  A  copious  enema  of 
warm  water  often  gives  immediate  relief. 


Prescriptions. 


R .  Spiritus  Chloroformi, 

Tinct.  Cardamomi  Co.,  .  aa  3  ij. 

M.  Sig. — Teasp.  in  water  every  yz 
hour.  (B.) 


R .  Atropinse  Sulph . gr.  j. 

Zinci  Sulphatis, . gr.  xxx. 

Aquae  Destil., . 5  j. 

M.  Sig. — 3  to  5  drops  2  or  3  times 
daily.  (B.) 


R .  Ext.  Gentianae, 

Pulv.  Rhei,  aa^j. 

Ft.  pil.  xx.  Sig. — One  or  two  thrice 

daily  for  tendency  to  colic. 


R .  Pulv.  Camphorae, 

Pulv.  Capsici, 

Pulv.  Zingiberis,  .  .  .  aa  gr.  ij. 
Ft.  pil.  ij.  Sig. — One  as  required. 


Colic,  Lead. 

Alum,  singularly,  is  the  best  remedy  (B.) ;  gr.  x  hourly  (R.) ;  converts  the 
poisonous  salt  of  lead  in  the  system  into  a  comparatively  innocuous  sulphate  ; 
3jss-ij  daily  with  ttbxl-1  Tinct.  Opii,  and  an  occasional  dose  of  castor  or  croton 
oil  to  procure  one  or  two  motions  daily  (Wa.).  Opium,  gives  more  relief  than 
any  other  remedy,  gr.  X  to  X  of  morphine  hypodermically  (B.)  ;  gr.  ij-iv  of 
opium,  with  a  moderate  dose  of  castor  oil  (P.).  Sulphuric  Acid,  diluted 
well,  as  a  prophylactic,  and  is  useful  in  the  treatment  of  the  disease  (B.)  ;  con¬ 
sidered  remarkably  efficient  when  used  in  association  with  repeated  sulphur 
baths  (Wa.).  Calomel,  a  full  dose,  with  or  without  opium,  followed  in  a  few 
hours  by  castor  oil  and  a  turpentine  enema,  often  affords  speedy  and  marked 
relief  (Wa.).  Tobacco,  may  control,  but  is  dangerous  (B.).  Croton  Oil,  in 
half-drop  closes,  with  sufficient  opium  to  relieve  the  pain,  repeated  every  3 
or  4  hours  until  free  evacuations  are  produced  ;  proves  effectual  when  other 
remedies  fail  (Wa.).  Magnesium  Sulphate,  for  the  constipation,  and  to  remove 
the  poison  from  the  system ;  should  be  combined  with  Iodide  of  Potassium, 
3j  of  the  former  given  ter  in  die  and  about  two  hours  after  gr.  v-x  of  the 
iodide.  This  treatment  dissolves  the  lead  in  the  tissues,  causes  its  elimination 
by  the  intestinal  mucus,  renders  it  insoluble  after  it  has  entered  the  intestinal 
canal,  and  quickly  removes  it  from  the  body  (Br.).  [Compare  the  treatment 
of  Lead-poisoning,  ante ,  page  319.] 


Prescriptions. 


R .  Aluminis, . 3  ij. 

Ac.  Sulph.  Dil., . zj. 

Syr.  Limonis, . ^j. 

Aquae,  . lij. 

M.  Sig. — Tablsp.  every  hour  or  two 
for  colic.  (B.) 


R.  Magnesii  Sulphatis, . !|j. 

Ac.  Sulph.  Dil., . Zj. 

Aquae, . 5  iv. 


M.  Sig. — Tablesp.  every  3  hours  (B.) ; 
or  thrice  daily,  each  time  preceded  by  a 
5  to  10  grain  dose  of  Potassium  Iodide. 

(Br.) 


520 


COLIC - COMA - CONJUNCTIVITIS. 


Colic,  Renal  and  Hepatic. 

Ether,  inhaled  in  paroxysms  of  hepatic  colic  (R.).  Chloroform,  inhalation 
in  renal  and  biliary  colic,  inferior  only  to  morphia  injection,  superior  to  opium, 
warm  baths,  etc. ;  two  or  three  administrations  may  be  required  (R.).  [See  also 
Colic,  Intestinal.]  Counter-irritation,  flying  blisters  for  renal  colic  (R.). 
Opium,  small  doses  with  spt.  chloroform,  every  five  or  ten  minutes  until  the 
pain  gives  way,  or  morphia  hypoderm.  (R.).  Turpentine,  has  been  given  with 
benefit  in  biliary  colic  (R.).  Dioscorea,  is  used  successfully  in  so-called  bilious 
colic,  rr^xv-xxx  of  the  fluid  extract.  Water,  warm  baths  to  ease  the  pain  (R.). 
Aliment.  Withhold  all  starches  and  fats.  Alkaline  mineral  waters  are  useful 
(B.).  [Compare  Calculi.] 

Coma. 

Blisters,  in  a  comatose  condition,  large  blisters  or  mustard  poultices  should 
be  applied  in  quick  succession  to  different  parts  of  the  body — chest,  abdomen, 
thighs  and  calves;  often  very  valuable  in  the  critical  condition  near  the  end  of 
an  acute  illness  (R.).  Cold  Douche,  for  stupor  of  drunkenness  or  of  opium 
poisoning.  May  have  to  be  repeated  if  relapses  occur.  It  should  be  kept  up 
for  a  long  time  if  pulse  and  breathing  improve,  or  no  worse  (R.).  Croton  Oil, 
as  purgative,  X  or  X  every  hour  (R.).  Potassium  Bitartrate,  as  purgative 
when  blood  is  poisoned  (R.).  Mustard,  as  poultice  to  the  feet  and  ankles  in 
the  coma  of  narcotic  poisoning  (P.).  Exercise.  In  coma  from  poisoning  the 
patient  should  be  persistently  walked  about.  [Compare  Cerebral  Conges¬ 
tion,  Uraemia,  and  the  treatment  of  Narcotic  Poisoning,  a,7ite,  page  297.] 


Condylomata. 

Nitric  Acid,  §j  to  Oj  aquae,  as  wash,  frequently  used  (B.,  R.).  Thuja, 
locally  a  strong  tinct.  with  gtt.  v  in  water,  night  and  morning,  internally,  for 
warts  with  narrow  base  and  pendulous  body.  Warts  about  anus  or  pudenda  of 
either  sex,  whether  syphilitic  or  not,  often  rapidly  cured  by  Thuja  (P.).  In  non¬ 
syphilitic  warts  of  penis  or  vulva,  I  have  employed  it  with  satisfaction  (Pf.). 
Mercury,  Calomel  dusted  over,  after  washing  with  a  solution  of  chlorinated 
soda  (Ricord,  R.,  B.) ;  the  nitrate  locally  or  a  20  per  cent,  oleate  (R.).  Zinc, 
the  chloride,  iodide  or  nitrate  as  local  applications  (R.).  Arsenic,  arsenious 
acid  as  a  caustic  (R.).  Carbolic  Acid,  as  a  mild  escharotic  (B.).  Chromic 
Acid,  gr.  c-5j  aquae  dest. ;  a  good  local  application  (B.).  [Compare  Syphilis, 
Warts.] 

Conjunctivitis,  Catarrhal. 

Zinc,  a  weak  solution  of  the  sulphate  or  acetate  as  astringent  collyrium  (B.) ; 
gr.  ij  ad  §j  aquae  destil.  as  mild  astringent  lotion  every  few  hours,  with  ice  locally 
in  the  earlier  stage  (Roosa).  Borate  of  Sodium,  gr.  v  ad  §j  aquae  dest.  a  good 
and  mild  astringent  for  ordinary  cases.  Boric  Acid,  gr.  vj  ad  §j  each  of  aq. 
camph.  and  aq.  destil.,  as  collyrium  (Fox).  Boro-glyceride  3  ss  ad  Jj  of  aq  , 
camph.  and  aq.  dest.  a  very  efficient  application.  See  a.7ite,  page  59.  Carbolic 
Acid,  a  5  percent,  solution  applied  every  two  hours  by  spray  of  steam  atomizer, 
which  dilutes  it  one-half,  an  extremely  efficient  application,  relieving  the  pain 
and  contracting  the  vessels.  Cocaine,  the  hydrochlorate  in  3  to  5  per  cent,  solu¬ 
tion  or  oleate,  applied  to  the  palpebral  conjunctiva,  is  a  very  efficient  palliative, 
especially  where  much  pain  and  photophobia  (Roller).  Alum,  potassa  alum 
after  acute  symptoms  subside  (Br.) ;  gr.  iij-v  ad  3 ij  aq.  destil.  brushed  over  the 
conjunctiva  twice  daily.  Pulsatilla,  3j-ij  of  tincture  to  $iv  aquae  as  wash  sev¬ 
eral  times  daily,  also  internally  every  3  or  4  hours  (P.).  Opium,  the  wine 

dropped  into  the  eye  relieves  pain  and  improves  the  condition  of  the  conjunc¬ 
tiva  (R.) ;  Morphine,  gr.  j-ij  ad  3 j ,  is  often  used  in  colly ria  with  zinc  salts  or 
alum.  Mercury,  Calomel  dusted  over  the  palpebral  conjunctiva,  in  severe 
cases  ;  should  be  finely  levigated  and  dusted  from  a  camel’s-hair  brush  (B.) ;  the 


CONJUNCTIVITIS. 


521 


oleate  of  mercury  and  morphine  to  the  outside  of  the  lids  in  palpebral  conjunc¬ 
tivitis  (R.) ;  the  red  oxide  as  ointment,  gr.  x  ad  §j  vaseline  (Bader) ;  the  yellow 
oxide,  gr.  viij-x  ad  £j  vaseline  (Seely).  Cadmium,  as  collyrium  gr.  ij  of  the 
sulphate  to  2;j  aquae  rosae  (B.).  Tannin,  in  glycerin,  3j  ad  3 j ,  every  second  day 
in  chronic  catarrhal  conjunctivitis,  presenting  diffused  injection  of  vessels  with 
oedema  (Hansell).  Silver  Nitrate,  solutions  of  strength  gr.  j-iv  ad  3j  applied  by 
physician  to  conjunctiva  (R.) ;  should  not  be  given  to  patient.  Zinc  and  copper 
salts  are  preferred  (B.).  Copper,  the  sulphate  crystal  in  chronic  cases  where 
great  swelling  or  hypertrophy  of  the  papillary  layer.  Is  too  irritating  to  be 
entrusted  to  the  patient.  Lead  salts  should  never  be  used  lest  deposits  occur 
in  slight  abrasions  or  ulcerations  of  the  cornea.  Sulphates,  of  zinc,  copper 
and  iron  with  alum,  aa  gr.  j  to  3j  of  aq.  destil.  as  collyrium,  extremely  effi¬ 
cient  ;  in  severe  cases  may  be  used  in  saturated  solution  by  the  physician 
(Holmes).  Castor  Oil,  a  drop  placed  in  the  eye  often  allays  the  pain  and  pho¬ 
tophobia  caused  by  an  irritant  (R.).  Belladonna,  locally  and  internally  (B.). 
Atropine  in  strong  solution,  gr.  iv  to  3 j ,  is  one  of  the  best  local  applications 
where  mydriasis  is  not  objectionable.  Euphrasia,  as  a  mild  astringent  (P.). 
Blisters,  behind  the  ears  in  bad  cases  (R.).  Ergot,  the  fluid  extract  locally 
gives  excellent  results  in  acute  conjunctivitis  (B.).  Staphisagria,  especially  in 
tarsal  ophthalmia  (P.).  Colchicum,  when  gouty  diathesis  (A.).  Spigelia,  in 
rheumatic  form  (P.). 

Prescriptions. 


R  .  Zinci  Sulphatis, . gr.  ij. 

Morphinse  Sulph., . gr.  ij. 

Atropinse  Sulph., . gr.  ss. 

Aquae  Rosae, . 3j. 

M.  Sig. — Eye-water.  (B.) 


R.  Liq.  Plumbi  Subacetat.,  .  .  .  3  j. 

Aquae  Destill atae, . 3iij. 

M.  Sig. — For  local  use.  To  be  brushed 
over  conjunctiva  of  everted  lids  by  the  sur¬ 
geon  and  washed  off  with  water.  [B idler i) 


R.  Hydrarg.  Oxidi  Rub.,  .  .  .  gr.  x. 

Atropinae  Sulph., . gr.  j. 

Vaselini, . ^j. 

M.  Sig. — A  minute  portion  as  an  oint¬ 
ment  for  the  eye.  ( Bader .) 


R.  Ung.  Hydrarg.  Nitrat.,  .  .  .  gr.  xx. 
Cocainae  Hydrochlorat.,  .  .  gr.  v. 

Vaselini  Albi, . £ij. 

Use  a  fresh  ointment,  triturate  thor¬ 
oughly,  and  label  “  Ointment  for  the  eye.” 


Conjunctivitis,  Diphtheritic. 

Zinc  Chloride,  gr.  ij-iv  ad  3 j ,  as  collyrium,  has  succeeded  admirably 
(Wa.).  Atropine,  locally,  throughout  the  disease.  Treatment  not  very  effectual 
(Roosa) ;  is,  for  severe  cases,  powerless ;  cornea  sure  to  be  attacked  and  liable 
to  slough  (Noyes).  Boric  Acid,  4  per  cent,  solution,  as  antiseptic,  the  best 
application,  with  Quinine,  internally  in  full  doses  (Noyes).  Iron,  the  pyro¬ 
phosphate  for  children,  3j  in  3 i i j  of  simple  syrup,  of  which  a  teasp.  thrice  daily 
after  meals,  with  quinine  in  1  to  3-grain  doses  thrice  daily,  and  good  food 
(Derby).  Cold  by  compresses,  as  in  purulent  ophthalmia,  in  early  stages. 
Silver  Nitrate  in  solution  locally,  a  10-grain  solution  or  the  mitigated  stick  in 
the  second  stage.  Tannin,  gr.  xx  to  the  3  of  glycerin,  later  on,  applied  every 
day,  with  hot  water  lotions  if  corneal  complications. 


Conjunctivitis,  Gonorrhoeal. 

Zinc  Chloride,  gr.  j-ij  ad  £j  aquae,  as  collyrium,  with  marked  benefit  (Wa.). 
Silver  Nitrate,  a  2-gr.  to  the  3  solution,  after  syringing  out  the  eye  with  warm 
water,  followed  by  ice  compresses,  in  hope  to  abort  the  attack,  if  seen  early 
(Roosa).  Cold,  by  ice  or  wet  compresses,  essential  in  the  early  stage  (C.). 
Atropine,  may  be  used  from  the  beginning,  as  corneal  complications  begin 
very  early.  Treatment,  generally  the  same  as  for  Purulent  Conjunctivitis. 
Isolation  and  cleanliness  are  of  prime  importance. 


522 


CONJUNCTIVITIS. 


Conjunctivitis,  Granular. 

Silver  Nitrate,  the  diluted  stick  (see  page  113)  applied  lightly  and  quickly 
(C.) ;  strong  solutions  to  granular  lids,  gr.  xx  ad  jjj  cautiously  when  corneal 
ulcers  exist  (B.) ;  mild  solutions  better,  gr.  v  ad  3j,  daily  in  the  papillary 
form  ;  in  miliary  trachoma  it  should  not  be  stronger  than  gr.  ij  ad  3J  (Noyes). 
Applications  lose  their  effect  after  a  time,  and  should  be  changed  (Roosa). 
Copper  Sulphate,  the  solid  crystal  lightly  touched  to  the  membrane  once  a  day, 
the  favorite  astringent  and  caustic  in  all  forms  of  trachoma  (Roosa) ;  when 
membrane  torpid  to  other  stimulation  and  when  lymphoid  substance  is  pre¬ 
dominant.  As  ointment  gr.  v-x  ad  §j  vaseline,  when  for  use  by  patient 
(Noyes).  Alum,  a  smooth  crystal  is  a  useful  daily  application  (Noyes). 
Tannin,  gr.  x-xxx  ad  glycerini  3) ,  an  application  to  change  to  from  others 
(Roosa).  Bismuth  is  one  of  the  numerous  applications  in  chronic  conjuncti¬ 
vitis  and  granular  lids  (B.).  Phytolacca  internally,  is  undoubtedly  efficient  in 
granular  conjunctivitis  (W.).  Jequirity,  to  excite  substitutive  inflammation. 
See  ante,  page  55.  Atropine,  gr.  ij  ad  3j  aquae,  thrice  daily,  is  often  advisable, 
where  moderate  irritation  and  haziness  of  the  cornea  (Noyes).  Hygienic  Meas¬ 
ures,  of  great  value.  Protection  by  blue  or  smoked  glasses.  Rest  of  eyes,  best 
secured  by  using  atropine  collyria.  Hot  or  cold  water  as  local  bath  frequently. 
Tobacco  must  be  avoided,  also  all  locations  contaminated  by  impure  air. 
Canthoplasty  of  outer  commissure  when  lids  press  on  globe. 


Conjunctivitis,  Phlyctenular. 

Mercury.  Calomel  finely  levigated  and  dusted  from  a  camel’s-hair  pencil 
over  the  membrane  in  phlyctenular  ophthalmia,  an  excellent  local  applica¬ 
tion  ;  which  should  never  be  used  when  iodine  is  being  taken.  In  more  obsti¬ 
nate  cases  a  small  bit  of  Pagenstecker’s  ointment,  the  size  of  a  pin-head  (Hy- 
drarg.  Ox.  Flav.  gr.  j-iij,  Vaselini  5j),  placed  between  the  lids  (Noyes).  Ergot, 
the  fluid  extract,  applied  undiluted,  gives  excellent  results  in  the  phlyctenular 
ophthalmia  of  children  (B.).  Antimony.  Tartar  emetic  gr.  to  ^  3  or  4 
times  daily  in  strumous  ophthalmia,  with  sharp  purgation  at  the  outset  (R.). 
Belladonna,  or  Atropine,  locally  in  strumous  ophthalmia,  of  great  service  in 
relieving  pain  ;  constitutional  treatment  also  required  (Wa.).  Arsenic,  invalu¬ 
able  in  inveterate  cases  of  strumous  ophthalmia,  especially  when  complicated 
with  cutaneous  eruptions  (Wa.).  Tannin,  finely  powdered  and  dusted  over  the 
everted  lid,  gives  remarkably  good  results  in  this  and  other  forms  of  conjunc¬ 
tivitis,  causing  very  little  pain  and  no  inflammatory  reaction  (B).  Carbonic 
Acid  Gas,  applied  to  the  eye  is  said  to  relieve  the  pain  and  photophobia  of 
strumous  ophthalmia  (R.).  Hydrastis,  as  lotion,  is  serviceable  when  Meibo¬ 
mian  follicles  are  implicated,  causing  adhesion  of  lids  in  the  morning  (P.). 
Eserine,  locally,  to  reduce  the  pupil  and  shut  out  the  light  (P. ).  Iodine,  is  em¬ 
ployed  locally  in  strumous  ophthalmia,  for  its  alterative  stimulation  (W.).  Zinc 
Chloride,  gr.  ij-iv  ad  jjj,  as  collyrium,  has  succeeded  admirably  in  pustular 
ophthalmia  (Wa.).  Zinc  Sulphate,  gr.j-iv  ad  5  j,  is  very  serviceable;  the  addi¬ 
tion  of  liquor  plumbi  improves  its  efficacy  (Wa.).  Rhubarb,  the  mistura  rhei  et 
sodae  where  much  disturbance  of  digestion  present.  Tonics,  may  be  given 
later,  preparations  of  Cinchona  and  Iron.  Cod-liver  Oil,  in  strumous  subjects, 
tends  to  remove  the  manifestations  of  the  disease  (R.). 


Conjunctivitis,  Purulent. 

Alum,  gr.  ij  ad  £j  aquae,  a  sufficient  astringent  application  in  ophthalmia 
neonatorum  (Roosa);  gr.  viij  ad  3j  aquae,  applied  every  %  or  XA  hour  in  the 
purulent  ophthalmia  of  children,  its  success  depending  on  the  frequency  of  the 
application  (R.).  Copper  Sulphate,  gr.  j  ad  31  aquae  camph.  as  collyrium  in 
purulent  ophthalmia  of  infants  (Wa.).  Silver  Nitrate,  gr.  iij-x  ad  3j  aquae  destil., 
rarely  so  strong  as  gr.  x,  once  daily  applied  by  brush  to  everted  lids  in  purulent 


CONSTIPATION. 


523 


ophthalmia  of  infants  (Noyes) ;  solution  gr.  ad  %j  twice  daily  under  lids 
(Meigs) — by  many  it  is  considered  needless  and  injurious  (Roosa).  Boric  Acid, 
a  4  per  cent,  solution,  as  antiseptic,  is  all  that  is  necessary  in  mild  cases;  in 
others  it  is  the  proper  fluid  for  cleansing  the  eye  (Noyes).  Atropine,  when  the 
cornea  becomes  invaded,  and  shows  haziness,  a  solution  gr.  ij  ad  5),  must  be 
instilled  every  3  hours  (R.)  Cold,  by  ice  or  wet  compresses,  essential  in  the 
early  stages  of  acute  purulent  ophthalmia  (C.).  Cleanliness,  a  matter  of  great 
importance.  As  the  discharge  is  infectious  the  patient  should  be  isolated  and 
care  taken  to  prevent  inoculation  of  the  other  eye  therewith. 


Prescriptions. 


R.  Sodii  Boratis, . .  gr.  xij. 

Zinci  Sulphatis, . gr.  j. 

Aquae  Camph., . %}. 

Aquae  Destillat., . ,3j. 

M.  Sig. — Apply  to  lids  2  or  3  times  daily 
in  oph.  neonatorum,  with  solution  of  Silver 
Nitrate,  gr.  ^  ad  injected  under  lids 
twice  daily.  (Meigs.) 


R.  Sodii  Boratis, . gr.  iij. 

Aquae  Rosae, 

Aquae, . aa  25 j. 

M.  Sig. — Apply  beneath  lids  three  or 
four  times  daily  after  cleansing. 

R  .  Atropinae  Sulph., . gr.  j. 

Glvcerini,  ^ss.  Aquae,  .  .  .  ppj. 

M.  Sig. — Two  drops  into  the  eye. 


Constipation. 

Nux  Vomica,  gtt.  j-ij  of  tincture  bis  vel  ter  in  die  (R.)  ;  gtt.  v-x  in  a  glass  of 
cold  water  before  breakfast  and  dinner,  often  overcomes  the  most  obstinate 
constipation  (P.)  ;  especially  useful  when  great  fecal  accumulations  from  torpor 
of  bowel  (B.).  Sulphur,  gr.  x  with  confectio  sennae,  often  succeeds  after  other 
remedies  fail  (R.).  Sulphurous  mineral  waters  (B.) ;  or  sulphates  in  purgative 
waters ;  frequent  small  doses  (R.).  Podophyllum,  the  most  generally  used 
cathartic  when  deficient  secretion  (B.).  Gr.  to  p<s  night  and  morning  when 
constipation  with  nervous  and  bilious  headaches  (P.).  Senna,  as  in  the  pulvis 
glycyrrhizae  compos.  U.  S.,  which  may  be  taken  in  doses  of  a  teasp.  to  a  tablesp. 
as  required,  and  kept  up  for  months  (Goodell).  Mercury,  Calomel  or  gray 
powder  as  cathartic  (R.).  Hydrastis,  very  valuable,  when  constipation  refer¬ 
able  to  a  sluggish  liver  (P.).  Magnesium,  the  bi-carbonate,  a  useful  and  mild 
aperient  (R.)  Alum,  cheap  and  serviceable  laxative  (B.).  Aloes,  in  minute 
doses,  in  pill  with  Sulphate  of  Iron,  as  the  official  Pil.  Aloes  et  Ferri,  is  one  of 
the  best  agents  in  the  management  of  chronic  cases : — purgation  should  not 
be  aimed  at.  Ipecacuanha,  gr.  j  every  morning,  fasting,  when  great  torpor  of 
bowel  (R.).  Cocculus,  flatus,  hard  lumpy  motions  (P.).  Turpentine,  in  purely 
atonic  constipation,  with  gaseous  distention  of  colon,  has  triumphed  when  all 
other  remedies  failed  (P.).  Physostigma,  very  effective  in  intestinal  torpor  (B.). 
Stillingia,  rr^x  of  fluid  extract  in  habitual  constipation  (B.).  Castor  Oil,  a  mild, 
efficient  cathartic  (B.).  Ammonium  Chloride,  in  the  so-called  bilious  state,  with 
constipation  (B.).  Arsenic,  small  doses  (npij)  of  Fowler’s  solution  often  over¬ 
come  constipation  (R.).  Belladonna,  gr.  ]/2  of  the  extract  at  night,  in  habitual 
constipation  (B.)  ;  gr.  ]/(,-}£  once  a  day,  especially  when  dyspepsia  (R.).  Acts 
directly  on  the  bowel  as  a  stimulant  (P.).  Croton  Oil,  the  most  efficient  ca¬ 
thartic,  when  simple  impaction  without  inflammation.  Gtt.  j-ij  (B.) ;  when 
evacuation  of  blackened  feces  (R.).  Cascara  Sagrada,  the  fluid  extract  in 
doses  of  3j,  produces  large,  soft  evacuations  without  griping,  and  leaves  behind 
it  a  laxative  influence.  Frangula,  in  similar  doses,  is  equally  efficient,  but  if 
from  a  fresh  bark  may  produce  griping.  Cathartics,  especially  confectio  sennae, 
pil.  rhei  compos.,  pil.  aloes,  the  comp,  cathartic  pill,  as  well  as  those  above 
(B.).  Purgation  as  usually  practiced  denounced  by  editor  of  the  Lancet ,  Octo¬ 
ber  1,  1870.  Saline  Waters,  are  useful  (B.).  Pullna,  Friedrichshall,  or  Hun- 
yadi ;  the  first  two  with  milk,  are  good  for  children  (R.).  Enemata,  of  soap¬ 
suds  and  salt,  or  a  pint  of  cold  water  (B.) ;  or  turpentine,  castor  oil,  aa  ^ss,  to 
Oss-j  of  gruel  (P.).  The  habitual  use  of  warm  enemata  increases  torpor  of  the 


524 


CONVALESCENCE - CONVULSIONS. 


bowels  (R.).  Tamar-Indien,  a  favorite..  mild  aperient,  is  proprietary,  and  sup¬ 
posed  to  contain  cocculus,  Glauber’s  salts,  etc.  Aliment,  important  in  habitual 
constipation  ;  corn  bread,  cracked  wheat,  oatmeal,  bread  of  unbolted  flour, 
fruits,  green  corn,  tomatoes,  and  celery.  ]/2  dozen  each  of  almonds  and  rai¬ 
sins  daily.  A  glass  of  cold  water  before  breakfast  may  overcome  habitual 
constipation  (B.).  An  orange  or  a  smoke  after  breakfast  (R.).  Tobacco 
habitues  rarely  suffer  from  constipation.  [Compare  Intestinal  Obstruc¬ 
tion.] 


Prescriptions. 


R.  Ext.  Colocynth.  Co.,  .  .  .  gr.  xij. 

Ext.  Belladonnae,  .  .  .  .  gr.  ij. 

Ext.  Gentianee, . gr.  vj. 

Olei  Cari, . gtt.  iij. 

Ft.  pil.  vj.  Sig. — One  pill  at  bedtime. 

(Goodell.) 


R .  Podophylli  Resime,  .  .  .  .  gr.  ij. 
Quininae  Sulphatis, 

Ext.  Aloes  Aquosi,  .  .  aa  gr.  viij. 

Fellis  Bovini . gr.  xvj. 

Ft.  pil.  no.  xvj.  Sig. — One  or  two  at 
bedtime.  (Goodell.) 


R.  Ext.  Cascarae  Sag.  FI.,  .  .  p)). 

Ext.  Belladonnae  FI.,  .  .  .  ^j. 

Tinct.  Nucis  Vom.,  .  .  .  .  ,"ij. 
Syrupi  et  Aquae,  .  .  aa  ad  5  iv. 

M.  Sig. — Teasp.  thrice  daily  in  obsti¬ 
nate  constipation.  (Clarke.) 


Castor  Oil  Emulsion. 

-V 

R.  01.  Ricini, 

Glycerini, . aa  %). 


Tinct.  Aurantii, . rrpxx. 

Tinct.  Senegae, . rrpv. 


Aq.  Cinnamomi,  .  .  .  ad  g  ss. 
M.  ft.  emulsio.  Sig. — One  dose. 


Artificial  Hunyadi  Water. 

R .  Magnesii  Sulph., 

Sochi  Sulph., . aa  ^ss. 

Potas.  Sulph., . gr.  ij. 

Sodii  Bicarb., . gr.  viij. 

Sodii  Chloridi, . gr.  xx. 

Aquae, . q.  s .ad  ^ viij. 

M.  Sig. — A  winegl.  before  breakfast. 


Convalescence. 

Lime,  as  lime-water,  or  the  carbonate,  in  convalescence  from  serious  dis¬ 
ease  (R.).  Quinine  or  Hydrastine,  to  promote  digestion  and  appetite  (B.). 
Fats,  especially  cod-liver  oil  (R.).  Alcohol,  before  or  during  meals  (R.). 
Koumiss,  possesses  great  value  (B.).  Bitters,  especially  gentian  and  calumba 
(B.);  the  latter  especially  when  stomach  weak(R.).  Eucalyptus,  a  serviceable 
tonic  (B.).  Coca,  3 ss— ij  of  the  fluid  extract  as  a  dose  (B.).  Guarana,  gr.  xv- 
3j  may  be  given  (B.).  Opium,  as  laudanum,  injected  per  rectum,  for  insomnia 
of  convalescents  (R  ).  Sea-Baths,  valuable  in  many  cases  (R.).  Diet,  requires 
the  most  careful  attention  ;  the  prevalent  error  of  giving  food  of  difficult  diges¬ 
tion  too  early  must  be  guarded  against,  especially  in  intestinal  and  gastric  dis¬ 
orders.  The  strictest  moderation  should  be  enjoined.  The  symptoms  must 
be  watched  closely,  and  combated  by  appropriate  medication.  [Compare 
Adynamia  for  Tonic  Prescriptions.] 


Convulsions. 

General  Directions. — In  all  cases,  horizontal  posture,  fresh  air,  loosen  the 
clothing  ;  insert  a  plug  of  soft  wood,  or  a  cork,  between  the  teeth,  to  prevent 
biting  the  tongue ;  sprinkle  the  face  and  chest  with  cold  water.  Epileptic. — 
The  general  directions  above  will  usually  suffice.  [See  also  Epilepsy.]  Hys¬ 
terical. — The  diagnostic  peculiarities  are  :  pupils  not  dilated,  but  are  sensitive 
to  light ;  no  wounding  of  tongue;  face  not  livid  ;  pulse  usually  normal.  [See 
also  Hysteria.]  Infantile. — Administer  some  anti-spasmodic,  as  Ether,  alone 
or  combined  with  Musk  or  Belladonna;  then  search  for  any  mechanical  cause, 
as  a  pin  in  the  dress,  etc.  Lance  gums  if  dentition  the  cause  (A.).  [See  Con¬ 
vulsions,  Infantile.]  Uraemic. — [See  Uraemia  ;  Puerperal  Convulsions.] 


CONVULSIONS - CORNEAL  OPACITIES - CORNS. 


525 


Convulsions,  Infantile. 


Belladonna  is  of  the  highest  value  in  certain  congestive  forms,  as  in  fits  due 
to  the  irritation  of  teething,  or  those  referable  to  whooping  cough  (P.).  Ignatia, 
is  efficient  in  convulsions  of  children  from  intestinal  irritation,  no  cerebral  con¬ 
gestion  being  present  (P.).  Valerian,  has  been  successfully  used  when  from 
worms,  to  which  parasites  it  is  fatal  (P.).  Potassium  Bromide  in  all  forms  of 
convulsions  in  children  (7?.)  ;  children  bear  it  in  large  doses,  gr.  v  thrice  daily 
or  oftener  for  a  child  a  year  old  in  convulsions  from  teething  (Br.).  Chloral, 
in  large  doses,  gr.  v,  by  mouth  or  rectum  (Br.);  best  used  as  a  suppository 
rather  than  by  liquid  injection,  and  often  very  useful  (R.).  It  gives  better  results 
than  any  other  agent.  Chloroform,  inhalations  of  great  service  (R.)  ;  useful  in 
all  forms  (B.) ;  should  be  used  to  arrest  the  convulsion  and  prevent  recurrence 
(A.  A.  Smith).  Alcohol,  has  remarkable  power  in  arresting  convulsions  of  den¬ 
tition  ;  small  doses  of  wine  or  brandy  (Wa.).  Asafetida,  in  the  convulsions  of 
teething,  a  small  portion  in  enema,  appears  to  mitigate  them  (Wa.).  Opium, 
efficient,  but  dangerous  in  young  children.  Veratrum  Viride,  has  been  em¬ 
ployed  successfully  (R.).  Amyl  Nitrite,  gtt.  v  with  gr.  of  morphine  used  in 
one  case  as  a  last  resort,  after  five  hours’  convulsions  in  a  child  of  18  months, 
which  resulted  in  producing  quiet  sleep  (Engel).  Hot  Baths,  are  important, 
with  cold  affusions  or  ice  to  the  head  (B.).  Spinal  Ice-bag,  may  be  very  effi¬ 
cient  (R.). 


R .  Chloralis  Hydratis,  .  .  .  gr.  v. 

Lactis, . ^  j- 

M.  Sig. — As  rectal  injection.  Or  the 
dose  may  be  made  into  a  suppository  with 
cacao-butter  and  inserted  well  up  into  the 
rectum. 


Prescriptions. 

R  .  Sodii  Bromidi, 

Chloralis  Hydratis, 

Sodii  Bicarb., . aa  gr.  viij. 

. 5  J- 

M.  Sig. — A  teaspoonful  every  hour  to 
a  child  under  four  months  old. 


Corneal  Opacities. 

Cadmium,  is  said  to  promote  their  absorption ;  gr.  ij  of  the  sulphate  to  5j  of 
rose-water  as  collyrium  (R.,  Wa.).  Mercury,  Calomel  by  insufflation,  or  the 
red  iodide  gr.  ij,  cerate  gr.  xl,  oil  gtt.  xx,  as  ointment,  successfully  used  (Wa.) ; 
weak  solutions  of  the  bichloride,  or  ointments  of  the  oxides,  gr.  ^  ad  3 j ,  as 
remedies,  among  many  others  to  hasten  their  absorption  in  recent  cases  (Arlt). 
Oils,  eel-liver  and  cod-liver  oils,  ox-gall,  juniper  oil,  oil  of  turpentine  combined 
with  olive  oil,  and  others,  dropped  into  the  eye  once  or  twice  daily  for  the  same 
purpose  (Arlt).  Opium,  the  wine  at  first,  then  insufflations  of  calomel  and  red 
precipitate  or  yellow  oxide  of  mercury  ointment,  most  frequently  used  by  me  in 
recent  cases  (Arlt).  Potassium  Iodide,  as  ointment  with  carbonate  of  potassium 
after  cod-liver  oil  or  oil  of  turpentine  with  olive  oil,  in  cases  of  longer  standing 
(Arlt).  Silver  Nitrate,  gr.  v-x  ad  §j  aquas,  as  lotion  (C.).  Iodine,  internally 
and  as  collyria,  has  been  efficacious,  especially  in  strumous  cases  (Wa.). 
Sodium  Chloride,  gr.  %  ad  Jj  aquas  destil.,  of  which  rq,  v-x  injected  subcon- 
junctivally,  to  hasten  disappearance  of  turbidity  (C.).  Operative  Measures, 
only  in  case  of  incrustations,  as  of  lead  and  lime,  situated  superficially  by 
removal  of  epithelium  and  anterior  elastic  layer.  Deeper  interference  may  lead 
to  suppurative  keratitis.  Excision  of  opaque  cornea  and  transplanting  of  one 
from  an  animal’s  or  a  recently  enucleated  human  eye  (keratoplasty),  has  always 
failed.  Artificial  pupil  by  iridectomy,  for  central  opacities  which  are  unre¬ 
movable.  Tattooing  to  relieve  deformity  of  disfiguring  leucomata  (Arlt).  Pannus 
and  leucoma  are  best  let  alone  (D.).  Stenopaic  Spectacles,  for  semi-transparent 
opacities  in  pupillary  region  (Donders).  [Compare  Keratitis. J 

Corns. 

Silver  Nitrate,  solid,  aftersoakingand  paring(Wa.);  the  best  application  for  soft 
corns,  and  very  irritable  ones  (D.).  Acetic  Acid,  strong,  to  remove  corns  (Wa.). 
Mercury,  corrosive  sublimate  in  alcoholic  solution  locally  to  remove  corns  (Wa.). 
Iodine,  gr.  xl  ad  5j  alcoholis,  locally  (Wa.).  Poultices  are  useful ;  or  a  plaster 


526 


COUGH. 


of  soft  material  with  hole  in  centre  (D.).  Water,  hot  and  cold,  alternately 
applied  to  inflamed  corns.  Keep  a  corn  thin  by  frequent  washing  and  paring. 
In  performing  the  latter  operation,  the  knife  should  work  downwards  to  the  apex 
of  the  corn,  so  as  to  remove  pressure  from  its  centre. 


Prescription. 


R .  Acidi  Salicylici,  .  .  .  .  gr.  xv. 

Extract.  Cannabis  Ind.,  .  gr.  vijss. 

Alcoholis,  90°, . TTL  xv. 

/Etheris,  62°, . tTLxxxvij 

Collodii  Flexilis,  .  .  .  .  Tr^  lxxv. 


Mix,  and  keep  in  closely-corked  vial. 
Paint  the  corn  every  other  day  for  a  week, 
then  it  can  be  easily  squeezed  out. 

(  Vigier.) 


Cough. 

Opium,  in  some  form,  is  much  used  in  cough-mixtures ;  morphine  and  gly¬ 
cerin  to  fauces  (B.) ;  moderate  doses  only  are  useful  in  irritative  affections  of  the 
air-passages,  to  allay  irritation  and  hypersecretion,  but  it  may  do  even  fatal 
mischief  in  cases  where  secretion  is  copious  and  expulsory  power  feeble  (P.) ; 
opiates  inadmissible  when  with  copious  expectoration  there  is  any  indication  of 
bronchial  congestion  (Wa.) ;  very  useful  in  violent  and  frequent  cough  with 
little  rhonchus  and  no  signs  of  obstructed  oxidation  ;  also,  when  cough  is  due  to 
red,  inflamed  and  ulcerated  throat ;  opium  or  morphine  given  so  as  to  cling  for 
some  time  in  contact  with  the  pharyngeal  structures  (R.).  Codeine  is  often  effi¬ 
cient  in  cough  when  morphine  cannot  be  borne  (Br.).  Apomorphine  Hydro¬ 
chlorate,  very  valuable  in  cough  where  a  persistent  hacking  without  expectora¬ 
tion,  or  with  difficult  expectoration.  The  dose  is  only  gr.  to  Txg  in  the  24  hours. 
The  solution  rapidly  alters  unless  a  few  drops  of  hydrochloric  acid  are  added 
(Stocquardt).  Terpine  Hydrate,  in  bronchial  cough,  and  night-cough  from 
habit,  is  very  efficient  in  a  2-grain  dose  at  bed-time,  repeated  early  in  the 
morning  (Boyland).  See  under  Bronchitis,  Chronic,  for  formula.  Aconite, 
irritable,  tickling  throat-cough  ;  short,  dry  cough  of  asthmatics,  with  anxious 
look,  full,  strong  pulse  (P.).  Belladonna,  often  useful.  No  indications  (R.). 
Internally  and  externally  as  plaster  to  the  chest,  very  serviceable  in  spasmodic 
and  nervous  coughs  (Wa.).  Hyoscyamus,  very  useful  in  spasmodic,  tickling 
night  coughs  (P.).  Hydrocyanic  Acid,  for  nervous,  irritable  cough,  and  cough 
of  phthisis  and  mother’s  sympathetic  cough  (B.) ;  no  more  certain  palliative  for 
simple,  nervous  cough  due  to  irritable  state  of  the  system  (Stille)  ;  a  valuable 
adjunct  to  ordinary  remedies  in  cough  of  phthisis  (Wa.).  Potassium  Cyanide* 
is  equally  useful,  gr.  iij  with  §j  each  of  Ext.  Grindeliae  FL,  Syr.  Scillae  and  Syr. 
Tolutan.,  makes  a  good  non-opiate  cough  mixture,  of  which  the  dose  is  3j 
every  4  hours  (Waugh).  Prunus  Virginiana,  has  some  influence  due  to  its 
hydrocyanic  acid  ;  is  much  used  in  cough-mixtures  (B.,  P.).  Laurocerasus,  used 
as  substitute  for  hydrocyanic  acid  in  spasmodic  coughs  (B.).  Conium,  supposed 
to  be  useful  (R.) ;  is  very  useful  in  spasmodic  cough  (Wa  ).  Ipecacuanha,  the  fl. 
ext.  for  troublesome  night-cough  (B.) ;  in  obstinate  winter-cough,  with  wheezing* 
the  wine  as  spray  to  fauces  efficacious  (R.) ;  in  coughs  of  childhood  ipecac  is  one 
of  the  most  generally  serviceable  expectorants  we  can  use  (Wa.).  Lobelia,  dry 
cough,  continued  tickling  sensation,  even  in  sleep  (P.).  Sanguinaria,  combined 
with  hyoscyamus,  in  nervous,  spasmodic  cough  (P.).  Senega,  as  a  stimulant 
expectorant  in  the  cough  of  chronic  bronchitis  and  subacute  chest  affections. 
Gelsemium,  excessive  irritability  of  the  respiratory  centre  (R.) ;  often  remarkably 
relieves  convulsive  or  spasmodic,  reflex,  nervous  coughs  (B.).  Nux  Vomica, 
has  specific  action  on  the  pneumogastric,  and  is  one  of  the  most  efficient  reme¬ 
dies  in  cough  of  any  kind,  whether  from  bronchitis,  pneumonia,  phthisis  or 
emphysema,  but  especially  in  nervous  coughs  and  periodic  coughs  which  come 
on  in  evening  and  stay  all  night.  (Jour,  de  Med.)  Pulsatilla,  as  anemonine, 
y2  gr.  and  gr.  doses,  very  useful  in  irritative  cough,  asthma,  whooping-cough 
(P.).  Iodine,  by  inhalation  for  children  in  hoarse,  hollow  cough,  wheezing  (R.). 
Alum,  internally  in  spasmodic  cough,  gr.  x  to  aq.  as  spray,  in  chronic  cough 
also  (R).  Drosera  Rotundifolia,  the  fluid  extract  in  ]/2  teaspoonful  dose  to  an 
adult  every  2  or  3  hours,  of  high  value  when  spasm  predominates.  See  ante 


COXALGIA. 


527 


page  202.  Potassium  Bromide,  serviceable  in  various  reflex  coughs  (uterine, 
renal,  etc.),  and  in  cough  of  phthisis  occasionally  ameliorative  as  a  gargle  (B.) 
Cubebs,  3ss-j  of  the  tinct.  in  half-glass  of  linseed  tea  thrice  daily,  often  cures 
like  a  charm  the  coughs  of  chronic  catarrh,  of  emphysema,  or  acute  catarrh,  or 
following  an  attack  of  influenza  (R.).  Asafcetida,  Garrod  ascribes  its  value  to 
the  sulphur  in  it  (P.).  Very  serviceable  in  after-cough  from  habit,  and  in 
mother’s  sympathetic  whooping-cough  (B.).  Carbolic  Acid,  as  spray,  a  5  per  cent, 
solution  in  a  steam  atomizer  will  often  prevent  as  well  as  cure  a  cough  from  cold. 
Valerian,  in  asthmatical  and  hysterical  coughs  (P.).  Chloroform,  with  morphine 
and  molasses  in  paroxysmal  dry  cough.  May  be  painted  on  throat  also  (R.) ; 
in  irritable  reflex  cough  the  vapor  of  a  teaspoonful  of  the  spirit  may  be  inhaled 
from  the  surface  of  hot  water  and  repeated  every  five  minutes  for  four  or  five 
times  (B.).  Chloral,  in  convulsive  coughs,  ameliorates  symptoms  after  hypnotic 
effect  (Wa.).  Camphor,  equal  parts  of  camphor  and  chloral  triturated  together 
are  said  to  allay  spasmodic  cough  when  painted  over  larynx  (B.).  Glycerin  of 
Tannin,  applied  to  throat  when  chronically  inflamed  and  so  producing  cough  ; 
often  the  case  with  children  (R.).  Grindelia,  used  in  cough  of  habit  and 
spasmodic  cough  (B.).  Squill,  in  catarrhal  cough,  should  not  be  employed 
until  active  inflammation  has  subsided  (Wa.) ,  the  syrup  or  vinegar  of  squill  is 
the  best  preparation  for  cough  with  tickling  in  the  throat  (P.).  Cod-liver  Oik 
in  chronic  coughs  (R.,  Wa.).  Lactucarium,  the  syrup  as  vehicle  in  cough-mix¬ 
tures  (B.).  Chamomile  Oil,  gtt.  ij-viij,  in  coughs  due  to  heightened  reflex 
irritability,  especially  in  hysterical  women  (P.).  Pix,  Tar-water,  in  winter  cough , 
especially  when  paroxysmal  (R.).  Allays  the  cough  of  bronchitis  and  phthisis 
(P.).  Emplastrum  Picis,  as  rubefacient  and  counter-irritant  in  chronic  coughs 
(Wa.).  The  frequency  and  violence  of  nervous  coughs  may  be  controlled  by 
a  determined  effort  of  the  patient’s  will.  [Compare  Bronchitis,  Pertussis,. 
Phthisis.] 

Prescriptions  for  Cough  Mixtures . 


Adults. 

R.  Spiritus  Etheris  Nitrosi,  .  .  sjij. 

Vini  Ipecac., . t^ss. 

Tinct.  Opii  Deodorat.,  .  .  gj. 
Syrupi  Tolutani,  .  .  .  ad 5  lj 
M.  Sig. — A  teaspoonful  twice  or  thrice 
daily.  ( Bowditch .) 


R.  Liq.  Morph.  (Magendie),  .  £j. 


Syr.  Scillse  Comp., 

Syr.  Tolutani, . aa^j. 

Syr.  Ipecac. 

Spt.  Lavand.  Co.,  .  .  .  aa^ss 

Spt.  Limonis, . gj. 

Syr.  Pruni  Virgin.,  .  .  .  ad  $  vj 


M.  Sig. — A  teasp.  as  required. 
Each  dose  has  of  Morph,  gr. 


Children. 

R.  Mist.  Glycyrrh.  Co.,  .  .  .  3  ij. 

Syr.  Pruni  Virginian., 

Syr.  Tolutan  . . 

M.  Sig. — Half  teaspoonful  3  or  4  times 
daily  for  infants,  teaspoonful  doses  at  1  to 
2  years,  larger  doses  for  older  children. 

[Potter.) 


R.  Tinct.  Opii  Deodorat., 

Vini  Antimonii,  aagss. 

Ext.  Valerianae  FI., 

Syr.  Simplicis,  aagij. 

Aquae,  ^jss. 

M.  Sig. — A  teaspoonful  every  hour  or 
two  until  cough  controlled,  for  those  4 
years  and  upward.  ( Aleigs  <2r=  Pepper.) 


Coxalgia. 

Barium  Chloride,  in  considerable  doses  (gr.  j— ij)  persevered  in  for  a  month, 
thought  to  be  a  most  valuable  remedy  in  scrofulous  diseases  of  joints  (Wa.). 
Sulphuric  Acid,  3j  ad  gj  adipis,  as  ointment,  persevered  in,  has  resulted  in 
great  benefit.  A  powerful  irritant  (Wa.),  Counter-irritation,  by  blisters 
around  the  hip,  with  perfect  rest  in  the  straight  posture,  cod-liver  oil,  etc.  (I).). 
Iodide  of  Iron,  in  scrofulous  disease  of  the  joints,  with  cod-liver  oil  and  nutri¬ 
tious  diet  (Wa.).  Iodoform,  very  successfully  used  by  many  continental  prac¬ 
titioners  in  scrofulous  diseases  of  the  joints  (Wa.).  Cod-liver  Oil,  the  remedy 
on  which  most  reliance  is  to  be  placed  (R.).  [Compare  Ap.scess,  Caries,  Sup¬ 
puration,  Synovitis.] 


528 


CROUP. 


Croup,  Catarrhal. 

Aconite,  valuable  (R.,  Wa.) ;  has  been  employed  with  the  best  results  (P.)  ; 
from  gtt.  to  j  every  half-hour,  until  an  impression  is  made  on  the  fever- 
movement,  then  every  hour  or  two  (B.).  Hot  Water,  applications  beneath  the 
chin  and  along  the  whole  course  of  the  larynx  (Wa.).  Hot  fomentations  or 
turpentine  stupe  to  throat  (El.) ;  hot  bath  (95°-io2°)  in  the  paroxysm  a  good 
method  (M.  &  P.).  Potassium  Bromide,  locally,  a  solution  by  atomization  has 
proved  highly  efficient  in  spasmodic  croup  (Wa.).  Lobelia,  has  been  used  with 
occasional  success  (P.).  Ipecacuanha,  the  syrup  or  fluid  extract  as  an  emetic 
at  the  outset  (El.) ;  is  a  slower  emetic  than  tartar  emetic  (P.) ;  the  syrup  to 
vomiting  during  the  paroxysm,  and  tr^v-x  every  2  or  3  hours  next  day  (M.  & 
P.).  [Compare  Laryngismus  Stridulus.] 


Prescriptions. 


R.  Potassii  Citratis, . ^j. 

Syr.  Ipecac, . £ij. 

Tr.  Opii  Deodorat.,  .  .  .  gtt.  xij. 

Syr.  Simplicis, . ^ij. 

Aqua?, . 3jss. 

M.  Sig. — Teaspoonful  every  two  hours 
at  2  years  of  age.  In  severe  form  of  spas¬ 
modic  laryngitis.  ( M, \  o°  Pi) 


R  .  Tinct.  Belladon.,  ....  gtt.  iv. 
Tinct.  Opii  Camph.,  .  .  .  gtt.  1. 

Pulv.  Aluminis, . gr.  vj. 

Syr.  Acaciae, . ,25  ss. 

Aquae,  .  .  *  * . 5jss. 

M.  Sig. — Teaspoonful  every  2  or  3 
hours  at  6  months  old  when  cough  frequent 
and  harassing.  [ M .  P.) 


Croup,  Membranous. 

Mercury,  a  remedy  of  established  value,  gr.  ss-j  of  calomel,  with  gr.  Y%-% 
of  ipecac,  according  to  age,  every  2  hours,  with  local  and  other  general  meas¬ 
ures,  especially  the  use  of  a  hot  (7o°-73°)  and  moist  atmosphere  (Wa.).  The 
sub-sulphate,  given  early,  is  the  best  emetic,  gr.  iij— v  ;  calomel  is  strongly  urged  as 
a  laryngeal  sedative  and  aplastic  agent,  allaying  laryngeal  spasm  and  preventing 
formation  of  membrane  (B.).  Alum,  one  of  the  best  emetics  in  this  disease,  a 
teasp.  in  honey  or  syrup,  repeated  every  10  or  15  minutes  until  it  operates  (M.  & 
P.);  a  very  useful  and  non-depressant  emetic  (B.).  Sanguinaria,  by  many 
considered  specific,  is  undoubtedly  the  best  emetic  for  this  disease  (P.) ;  is  too 
harsh  and  too  uncertain  in  action  (B.).  Tartar  Emetic,  as  an  emetic,  has 
established  value  in  croup  (Wa.).  Is  injurious;  too  depressant  (B.).  Potas¬ 
sium  Chlorate,  as  alkali,  after  emetics,  the  most  reliable  internal  remedy,  gr. 
ij-iij  every  2  hours  to  a  child  of  4  years  (M.  &  P.).  Chloride  of  Iron,  may  be 
combined  with  the  preceding,  in  doses  of  3-5  drops  of  the  tincture,  at  the  same 
age  (M.  &  P.).  Emetics,  besides  the  above  :  Copper  Sulphate,  in  small  frequent 
doses  (R.).  Ipecacuanha,  inferior  to  mercury  (B.).  In  severe  cases,  vomiting 
should  be  caused  3  or  4  times  a  day,  and  should  be  commenced  early  (R.). 
Apomorphine,  effective,  but  highly  dangerous  (B.).  Senega,  is  considered  a 
valuable  auxiliary  (P.),  has  been  employed  (R.).  Quinine,  in  full  doses  is  highly 
useful  (B.).  Sulphurous  Acid,  as  spray,  hourly  or  more  frequently  (R.).  Tannin, 
a  5  per  cent,  spray,  several  times  a  day  for  1 5  or  20  minutes  (R.).  Lactic  Acid, 
as  solvent  of  membrane  (B  ).  Iodine,  the  tincture,  externally,  affords  great 
relief,  and  tends  to  prevent  formation  of  false  membranes  (Wa.).  Water. — 
Warm  bath,  hot  fomentations  or  compress  to  throat.  Watery  vapor  in  room. 
Steam  inhalations,  with  a  few  drops  of  Iodine  or  Bromine.  Diet. — Water  only 
in  small  quantities  during  attack.  Supporting  diet  may  be  required  afterwards. 
Lime-water,  by  vaporization,  or  inhalations  of  the  vapor  of  slaking  lime  for  a 
few  minutes  in  every  hour,  or  some  other  alkaline  solution  during  the  whole 
treatment  (M.  &  P.).  Tracheotomy  fully  justifiable,  21  yz  per  cent.,  recovered, 
out  of  1024  operations  ;  should  be  done  when  paroxysms  become  very  frequent, 
and  dyspnoea  is  rather  persistent  than  paroxysmal  (M.  &  P.).  [Compare 
Laryngitis,  Diphtheria.] 


CYANOSIS — CYSTITIS. 


529 


Prescriptions. 

$  .  Acidi  Lactici, . 5  iijss. 

Aq.  Destillat., . 3  x. 

M.  Sig. — To  be  used  as  a  spray,  or  ap¬ 
plied  by  a  mop. 

(London  Throat  Hospital .) 

Cyanosis. 

Amyl  Nitrite,  by  inhalation,  often  gives  marked  relief  (P.).  Quebracho,  in 
that  from  asthmatic  attacks  of  consumptives,  lessened  the  cyanosis  or  entirely 
relieved  it  (Rohrer).  Leeching  is  of  service,  in  a  manner  not  easily  understood 
(P.).  Treatment  must  depend  on  the  nature  of  the  lesion  or  disease  giving 
rise  to  the  cyanotic  condition  (A.). 


R .  Pulv.  Sanguinarise,  .  .  .  gr.  xx. 

Pulv.  Ipecac., . gr.  v. 

Syr.  Ipecac., . 5  ij. 

M.  Sig. — A  teasp.  every  %  hour  until 
emesis,  then  G  teasp.  every  hour.  .  (P.) 


Cystitis,  Acute. 

Belladonna,  is  a  good  remedy  in  almost  every  form  of  vesical  irritation  (G.) ; 
when  the  vesical  mucous  membrane  is  irritable  (B.)  ;  very  useful  in  recent 
catarrh  from  chill,  with  pain  (P.).  Cantharis,  in  large  doses  causes  inflamma¬ 
tion  of  the  urinary  tract,  but  gtt.  j  of  the  tincture  every  hour  will  often  relieve 
vesical  catarrh  (A.  A.  Smith) ;  in  small  doses  continued,  very  efficient  (B.) ; 
gtt.  j-v  of  the  tincture  thrice  daily,  when  bladder  is  irritable,  its  sphincter  weak, 
and  pain  along  the  urethra  (P.) ;  may  be  employed  in  cystitis  with  benefit  (R.)  ; 
the  best  remedy  in  small  doses  for  acute  cystitis.  Aconite,  for  febrile  symptoms 
(R.,  P.).  Quinine,  often  useful  for  acute  symptoms  (B.).  Iodoform,  in  sup¬ 
pository  for  painful  cystitis  (R.).  Opium,  a  rectal  injection  of  starch  and  lau¬ 
danum  will  subdue  pain  and  prevent  the  frequent  micturition  (R.)  ;  opium  is 
dangerous  if  kidneys  are  diseased  (P.)  Alkalies,  the  citrates  and  bicarbonates 
if  urine  is  highly  acid  ;  stop  when  it  becomes  alkaline  (R.)  Liquor  Potassse  in 
barley-water  or  in  a  decoction  of  Triticum  repens,  preferred  to  all  other  alka¬ 
lies  ;  urine  must  be  maintained  at  a  neutral  or  very  slightly  acid  reaction 
(Thompson).  Cannabis  Indica,  an  excellent  anodyne  in  all  bladder  cases, 
having  specific  effect  on  that  organ.  Rest  in  horizontal  posture,  mucilaginous 
drinks,  hot  fomentations  arid  hip-baths,  from  ioo°  to  no0,  laxatives  for  the 
bowels,  light  food.  Milk-diet  often  necessary,  especially  in  children.  [  Com¬ 
pare  Bladder  Irritable,  Calculus,  Dysuria,  Enuresis,  Hematuria.] 


Prescriptions. 


R.  Atropinoe  Sulphatis,  .  .  .  gr.j. 

Acidi  Acetici, . gtt.  xx. 

Alcoholis, 

Aquae, . aa  5  ss. 

M.  Sig. — Four  drops  in  a  winegl.  of 
water  before  each  meal.  (G.) 


R.  Pulv.  Opii, . gr.  xij, 

Camphorae, . gr.  xxx. 


Ext.  Belladon., . gr.  iij. 

01.  Theobrom.,  q.  s. 

M.  et  div.  in  supposit.  no  vj. 

Sig. — One  at  bed-time. 


Cystitis,  Chronic. 

Benzoic  Acid,  and  the  benzoates,  in  chronic  cystitis,  from  any  cause,  when 
urine  is  alkaline  (B.) ;  has  some  balsamic  character,  and  is  useful  in  some  cases 
of  chronic  cystitis;  gr.  xxiv  at  least  in  the  day,  in  pills  made  with  glycerin 
(Thompson).  Sodii  Benzoas  3j  in  Tinct.  Gelsemii  5>j-iij  And  water  to  ^ vj 
makes  an  excellent  wash  for  painful  cystitis  of  old  men  with  enlarged  prostate. 
A  fluid  ounce  should  be  warmed  and  injected,  and  retained  20  to  30  minutes 
(Copeland).  Alkalies,  when  urine  is  acid  ;  the  liquor  potassse,  with  hyoscyamus 
as  an  anodyne,  preferred  notwithstanding  its  chemical  incompatibility,  to  con¬ 
trol  painful  and  frequent  micturition  (Thompson) ;  bicarbonates  or  citrates 
better,  as  the  strong  reaction  of  liq.  potassse  unfits  it  to  be  given  in  doses  suf¬ 
ficiently  large  to  affect  in  any  great  degree  the  reaction  of  the  urine  (R.). 

34 


530 


CYSTITIS,  CHRONIC. 


Triticum,  is  very  efficient  as  an  internal  remedy,  ^ij-iv  of  the  rhizome  boiled 
in  a  quart  of  water  until  reduced  to  a  pint,  this  strained  to  betaken  in  four  doses 
in  the  24  hours  (Thompson) ;  a  very  useful  remedy  (Pancoast).  Buchu,  is 
probably  the  most  efficient  of  the  urino-genital  remedies,  the  fluid  extract  in 
doses  of  TTx-3j  (B.) ;  the  best  drug  in  chronic  cystitis,  especially  when  the 
catarrh  implicates  the  ureters  or  the  kidneys  themselves,  producing  consider¬ 
able  muco-purulent  discharge  (P.)  Uva  Ursi,  is  decidedly  effective  (P.);  is  less 
so  than  Buchu  (B.).  Stigmata  Maydis,  an  infusion,  3 ij  ad  Oj,  wineglassful 
every  3  or  4  hours,  has  been  used  internally  with  considerable  success  (Des- 
sein).  Pareira,  considered  superior  to  Uva-Ursi  (Brodie) ;  often  very  successful 
(P.).  Chimaphila,  is  often  very  efficient,  but  is  more  actively  diuretic  than  the 
preceding  named  remedies  (B.) ;  by  many  practitioners  it  is  considered  the  best 
remedy  for  chronic  cystitis.  Copaiba,  is  very  useful  by  virtue  of  its  local  action 
on  the  mucous  membrane,  but  objectionable  for  its  nauseous  taste  and  resulting 
gastric  disturbance  (B.).  Cubeb,  is  often  useful  from  its  stimulating  effect  (P.). 
Turpentine,  has  been  useful  in  many  cases  (R.,  P.) ;  when  cystitis  due  to 
urethral  inflammation  or  prostatic  disease  (B.).  Juniper,  the  oil  is  indicated 
under  the  same  conditions  as  is  turpentine  (B.).  Eucalyptus,  there  is  no  more 
efficient  remedy  in  chronic  cystitis  than  this  (B.);  the  oxygenated  oil  of  Merck 
is  best  in  doses  of  3  drops  on  sugar  every  6  or  8  hours.  Salicylic  Acid,  in  large 
doses,  either  internally  or  by  injection  into  the  bladder,  is  most  efficient  (B.) ; 
the  acid  or  salicylates  often  useful  to  prevent  decomposition  (P.)  Carbolic  Acid, 
and  sulpho-carbolates  to  preserve  the  urine  sweet  (R.)  Sulphites  will  accom¬ 
plish  the  same  object  (B.).  Silver  Nitrate,  by  intra-vesical  injection,  gr.  j  ad 
5iv  to  begin  with,  increased  gradually  to  gr.  ^  ad  5j  at  most  (Thompson). 
Stronger  solutions  are  advocated  by  Professor  Richardson  of  New  Orleans,  and 
Prof.  Gardner  of  McGill  College,  Montreal.  In  the  writer’s  experience  a 
5  gr. to  SJ  solution,  used  as  a  vesical  wash,  has  been  promptly  efficient  in  curing 
many  cases  which  resisted  other  treatment  for  months.  It  sometimes  produces 
serious  symptoms,  and  it  is  therefore  well  to  have  a  neutralizing  solution  of 
sodium  chloride  on  hand  for  use  if  required.  Other  Injections  which  may  be 
used  to  wash  out  the  bladder,  are — Lead  Acetate,  gr.  j  to  ^iv  of  warm  water y 
once  daily  :  Nitric  Acid,  dilute,  j  -ij  to  the  of  water  :  Tannic  Acid,  gr.  j  to 
5j  :  Borax,  5j  in  3 ij  of  glycerin  and  3 ij  of  water,  of  which  £ss  to  £iv  of  warm 
water  for  one  injection  ;  Quinine,  gr.  j  -ij  to  the  5  of  water,  with  a  drop  of  acetic 
acid.  All  injections  must  be  used  with  great  care,  not  more  than  ^ij  forced  in 
at  once  and  that  very  slowly.  Use  flexible  catheter,  warm  solutions,  and  a 
rubber-injecting  bottle  with  a  long  nozzle  and  stop-cock  (Thompson).  Washing 
the  bladder  is  of  great  value  (R.).  Evacuation  of  the  urine,  some  of  which  is 
often  retained  in  the  bladder,  is  a  matter  of  great  importance.  Ergotin,  hypo¬ 
dermically,  increases  the  contractile  power  of  the  bladder,  and  enables  it  to 
empty  itself  more  perfectly  (Langenbeck).  Pichi,  the  fluid  extract,  rtpxx  to  xxx 
four  times  daily,  gave  excellent  results  in  bad  cases  of  long  standing,  urine 
being  alkaline,  ammoniacal,  ropy  and  purulent  (Delamere).  [Compare  Blad¬ 
der  Irritable,  Calculus,  Dysuria,  Enuresis,  Hematuria.] 

Prescriptions . 

R.  Uvae  Ursae  Fob,  R.  Quininae  Sulphatis,  .  .  .  .  >jss. 

Pareirae  Radicis,  .  .  .  aa  3  j— ij .  Acaciae, . £  \). 

Sig. — Boil  in  3  pints  of  water  until  re-  Morphinae  Sulphatis,  .  .  .  gr.  jss. 

duced  to  a  quart,  then  strain,  and  take  I  or  Aquae . s.  ad  £  \\). 

2  wineglassfuls  3  or  4  times  daily.  M.  Sig. — A  tablesp.  to  3j£  ounces  of 

(  Thompson .)  warm  water,  which  inject  in  3  parts,  daily. 


R.  Sodii  Boratis, . 5j. 

R.  Ext.  Tritici  Fluidi,  .  .  .  .  3  i j .  Glycerini, 

Syr.  Amygdalae, . 3  ij-  Aquae, . .  .  .  aa  3  ij. 


M.  Sig. — A  dessertsp.  in  water  5  or  6  M.  Sig. — Tablesp.  in  four  ounces  of 
times  daily.  (Pancoast.)  warm  water  as  an  injection. 


CYSTS - DEAFNESS - DELIRIUM  TREMENS. 


531 


R.  01.  Terebinth.,  .....  5  ss. 

Camphorae, . gr.  xv. 

Ext.  Hyoscyami,  ...  •  gr.  ss. 

Fiat  massa.  Sig. — Take  a  piece  the  size 
of  a  cherry-stone  morning  and  evening. 

( Chauvel .) 


R.  Argenti  Nitratis, . gr.  vij. 

Aquae  Destillat.,  ....  5  iijss. 

M.  Sig. — Injection  every  third  or  fourth 
day  after  washing  the  bladder  out  with 

warm  water.  ( Ricord .) 


Cysts. 

Iodine,  injection  very  effective  in  cysts  of  neck,  and  sometimes  in  unilocular 
ovarian  (B.)  ;  £x  after  tapping  (R.).  Silver  Nitrate,  gtt.  v-x  of  solution,  9j-ij 
as  injection,  will  cure  after  setting  up  inflammation  (B.).  Galvano-puncture, 
will  permanently  occlude  cysts  of  neck  (B.).  Aurum  Chloride,  may  sometimes 
cure  ovarian  dropsy  (B.).  Remedies  internally  have  all  been  proved  worth¬ 
less  (E.). 

Deafness. 

Quinine,  cures  some  forms,  and  often  causes  deafness  (Brown-Sequard). 
Glycerin,  for  dryness  of  meatus  ;  also  to  form  a  film  to  ruptured  tympanum 
(R.) ;  either  alone  or  in  combination  with  olive  oil  (P.) ;  effects  are  temporary 
(Wa.).  Tannin,  the  glycerite  as  application  for  throat  deafness  (R.,  Wa.). 
Colchicum,  when  from  gout  in  ear  (A.).  Cantharides,  as  ointment ;  gr.  xxx 
ad  5J  adipis,  below  and  behind  the  ear  bis  die,  with  alterative  mercurial  treat¬ 
ment,  in  deafness  from  thickened  tympanum  (Wa.).  Gargles,  in  throat-deaf¬ 
ness,  are  of  great  value  ;  potassium  nitrate,  borax,  etc.,  in  sthenic  ;  tincture  of 
capsicum  added  in  nervous  forms ;  hydrargyrum  perchloride,  when  from 
secondary  syphilis  (Wa.).  Water,  washing  in  warm  water,  in  deafness  from 
general  debility  (Toynbee).  Faradization,  of  the  ear  in  nervous  deafness,  in 
which  slight  results  only  to  be  expected  from  the  treatment  (R.).  Demands 
the  utmost  caution  (Wa.).  Collodion,  contractile,  applied  to  the  membrana 
tympani,  in  deafness  from  relaxation  of  the  membrane,  has  exerted  a  perma¬ 
nently  beneficial  influence,  even  in  cases  of  long  standing  (Wa.).  Turpentine, 
gtt.  xl  in  5SS  glycerin,  a  few  drops  into  the  meatus,  in  deafness  depending  on 
deficient  secretion  of  cerumen,  results  in  much  benefit  (Wa.).  Morphine, 
gr.  ss  sprinkled  on  surface  behind  the  ear  denuded  by  a  small  blister,  has 
proved  curative  in  chronic  deafness,  after  all  other  remedies  had  failed  (Wa.). 


Delirium. 

Belladonna,  delirium  of  typhus  and  other  fevers  (R.) ;  severe  forms  of  de¬ 
lirium  (P.).  Hyoscyamus,  delirium  of  typhus;  mild,  less  inflammatory  form, 
hallucinations,  nervous  excitement,  little  cerebral  congestion  (P.)  Stramo¬ 
nium,  in  wild  and  furious  delirium  of  puerperal  mania,  with  general  restless¬ 
ness  and  suicidal  or  destructive  tendency  (Wa.) ;  no  drug  deserving  of  more 
confidence  in  the  greater  number  of  maniacal  cases  (Cullen).  Opium,  in 
traumatic  delirium,  as  a  rectal  injection,  combined  with  tartar  emetic  in  fevers, 
or,  better  still,  morphine  hypoder.  Laudanum  in  low,  muttering  delirium  (R.). 
is  regarded  with  suspicion  (P.).  Cannabis  Indica,  the  extract  in  doses  of  gr. 
yi-yi  in  nocturnal  delirium  occurring  in  softening  of  the  brain  (Wa.).  Potas¬ 
sium  Bromide,  in  delirium  resembling  delirium  tremens  (R.).  Camphor  Mono¬ 
bromide,  useful  in  rambling  delirium  (Wa.).  Camphor,  in  20-gr.  doses,  every  2 
or  3  hours,  especially  in  low  muttering  delirium  (R.).  Chloral,  in  violent  deli¬ 
rium  of  fevers  (R.).  Antimony,  delirium  of  fevers  (R.).  [See  Fevers.] 
Water,  the  cold  douche  in  maniacal  delirium  ;  place  patient  in  warm  bath 
during  application  (R.).  [Compare  Cerebral  Congestion,  Fever,  Mania.] 


Delirium  Tremens. 

Belladonna,  of  proven  efficacy  when  congestion  of  the  brain  (P.);  useful 
for  the  insomnia  when  coma  vigil,  cold  surface,  cyanosis  (B.).  Stramonium 
can  do  all  that  Bell,  can  do,  and  is  more  powerful  (Tr.).  Hyoscyamus,  in 


532 


DEMENTIA  AND  INSANITY. 


some  forms  admirable  (P.).  Opium,  cautiously,  if  at  all  (B.) ;  as  rectal  injec¬ 
tion,  hypodermically,  or  with  spirits.  If  patient  strong,  delirium  boisterous, 
and  pulse  full,  add  Tartar  Emetic  or  Aconite  (R.).  Bromides  in  the  “hor¬ 
rors”  preceding  the  delirium,  £>j  every  4  to  6  hours.  Are  of  less  value  in  the 
delirium  and  in  subsequent  attacks  (B.,  R.).  Ammonium  Bromide  has  been 
used  with  very  good  results  (Wa.).  Chloral,  at  outset  (R.)  ;  very  successful, 
but  dangerous  to  old  drunkards,  or  when  heart  disease  exists  (B.).  If  long 
continued  to  produce  sleep  chloral  will  produce  a  condition  of  insomnia. 
Chloroform,  inhalations  to  procure  sleep  (R.).  Anaesthetics  dangerous  (B.). 
Cannabis  Indica,  gr.  ss-j  of  extract,  one  of  the  least  dangerous  and  most  use¬ 
ful  hypnotics  (P.).  Tartar  Emetic,  as  hypnotic  (B.) ;  combined  with  opium  to 
control  mania  and  insomnia  (R.).  Capsicum,  to  induce  sleep  in  early  stages, 
gr.  xx-xxx  in  a  bolus  with  honey,  repeated  after  three  hours  (R.).  In  20-30  gr. 
doses  has  remarkable  success  (P.).  The  tincture  in  £ss-doses  every  three 
hours  of  great  benefit  (YVa.).  Nux  Vomica,  or  Strychnine,  should  be  more 
freely  used  than  it  is  in  alcoholism,  and  in  delirium  tremens  may  be  used  hypo¬ 
dermically  almost  to  the  commencement  of  tetanic  action  (Luton).  Arnica, 
the  tincture  is  exceptionally  serviceable  in  cases  where  there  is  depression  (B.). 
Coffee,  often  exceedingly  useful  (P.).  Digitalis,  gss  of  tinct.  repeated  in  4  to  6 
hours  (R.) ;  a  tablesp.  of  the  infusion  every  4  hours  in  pale  subjects,  anaemia 
of  brain,  with  effusion  and  oedema  (B.)  has  cured  many  cases  promptly  with¬ 
out  producing  any  unfavorable  symptoms.  Its  safety  and  efficacy  are  alike 
questionable  (Wa.).  Cimicifuga,  an  excellent  tonic  for  the  nervous  system, 
very  successful  (P.).  Quinine,  with  a  mineral  acid  to  restore  digestion,  in  the 
“  horrors,”  and  in  adynamic  states  (B.) ;  gr.  j  two  or  three  times  daily  as  a 
tonic,  the  best  to  produce  nervous  tranquillity  (Anstie).  Sumbul,  very  efficient 
for  insomnia  (P.).  Zinc  Phosphide,  gr.  jss  daily,  in  divided  doses,  for  many 
weeks,  is  used  with  decided  benefit.  Zinc  Oxide,  is  of  essential  benefit  as  a 
nerve  tonic  and  sedative,  gr.  ij-viij,  twice  daily,  gradually  increased  to  the 
higher  dose  named  (Wa.).  Lupulin,  the  tinct.  or  oleo-resin,  useful  in  mild 
cases  as  stomachic  tonic  and  cerebral  sedative  (B.).  Ammonium  Carbonate, 
when  anaemia  of  brain  and  feeble  heart-action  (B.).  Conium,  combined  with 
opium,  useful  (P.).  Alcohol,  of  undoubted  use  where  failure  of  stomach  to  ap¬ 
propriate  food  (B.).  Water,  about  6o°  with  ice  to  head,  to  reduce  temperature 
in  the  hyperpyrexia  (B.,  R.).  Treatment,  should  tend  to  nourishment,  and 
establishing  of  digestion.  Concentrated  liquid  nourishment,  with  moderate 
use  of  stimulants  (H.).  Diet  and  Hygiene.  The  immediate  source  of  danger 
is  exhaustion,  hence  animalized  and  nutritious,  digestible  diet  in  fluid  form, 
small  quantities  frequently  repeated  ;  beef-tea,  soups,  yolk  of  eggs,  warm  milk, 
cocoa,  cayenne  pepper  or  stimulants  in  soups;  coffee,  to  still  nervous  excite¬ 
ment  ;  hot  baths  and  wet  pack  to  eliminate  the  poison.  A  quiet,  dark  room, 
sleep  a  necessity,  often  induced  by  Belladonna.  [Compare  Alcoholism.] 


Prescriptions. 


R .  Tinct.  Capsici, 

Ext.  Lupulini  FI.,  .  .  .  aa  Jj. 

Mucil.  Acaciae, . 5  ss. 

Aquae  Cinnamomi,  .  £  jss. 

M.  Sig.  —  Dessertsp.  as  required  for 
the  wakefulness  and  excitement  which  pre¬ 
cedes  an  attack. 


R.  Chi  oralis  Hydrat.,  .  .  .  .  gvj. 

Ext.  Conii  FI., . ,5  iij. 

Ext.  Hyoscyami  FL,  .  .  .  £iv. 
Mucil.  Acacke, . 3  ij. 


Aquae  Menth.  Virid., .  .  ad  ^ij. 

M.  Sig.  —  Teaspoonful  in  water  after 
each  meal. 


Dementia  and  Insanity. 

Moral  or  Mental  Treatment  in  recent  times,  is  confided  in  greatly.  With 
correct  management  from  the  start,  nearly  all  cases  of  insanity  unattended  by 
paralysis  or  physical  decay  may  be  cured  (Savage).  This  can  be  best  admin¬ 
istered  in  a  well-conducted  asylum  or  hospital  for  the  insane,  where  security 
and  the  prospect  of  recovery  will  be  better  than  in  the  best  home.  The  total 


DEMENTIA  PARALYTICA - DENGUE - DENTITION. 


533 


abolition  of  any  one  plan  of  treatment  in  favor  of  another  would  be  a  great 
mistake.  More  than  half  of  first  attacks  of  insanity  are  recovered  from  under 
good  management,  which  is  best  attained  under  the  direction  of  persons  trained 
in  this  specialty  (H.).  Recently,  efforts  have  been  made  at  the  improvement 
of  the  insane  condition  by  requiring  them  to  attend  school  daily,  with  remark¬ 
ably  good  results.  Tonics  and  Hypnotics,  should  be  used  in  cases  requiring 
them.  Food,  of  good  quality  is  at  the  basis  of  treatment.  Opium,  morphine, 
the  best  form,  especially  for  melancholics,  climacteric  and  senile  cases,  which 
improve  under  its  use;  is  hurtful  in  mania.  Chloral,  does  as  much  harm  as 
good,  is  best  suited  to  wildly  maniacal  and  erotic  patients.  Potassium  Bromide, 
is  almost  discarded,  except  for  epileptic  cases.  Conium,  is  useful,  sparingly, 
for  noisy  patients,  so  also  is  Hyoscyamine.  Colchicum,  for  gouty  cases,  which 
are  numerous.  Cure  the  gout,  and  you  may  cure  the  insanity.  Shower-bath, 
suitable  for  cases  due  to  self-abuse,  and  the  wet  pack  in  the  mania  of  hystero- 
epilepsy.  Stimulants  rank  high,  next  to  quiet  and  absence  from  home.  Kou¬ 
miss,  a  good  food  in  hysterical  dyspepsia  and  anorexia,  being  easily  digested 
and  preventing  waste  {Dr.  Savage,  Bethlehem  Asylum).  [Compare  Delirium, 
Hypochondriasis,  Mania,  Melancholia.] 


Dementia  Paralytica. 

Physostigma,  has  seemed  to  retard  the  progress  of  the  disease  in  some  few 
cases  (B.).  Paraldehyde,  in  one  or  two  drachm  doses  as  a  calmative  and  hyp¬ 
notic  is  as  efficient  as  chloral  and  without  danger  (B.).  Tonics,  may  be  used, 
though  treatment  is  only  palliative.  Lacto-phosphate  of  Calcium,  Cod-liver 
Oil,  etc.  No  remedies  have  hitherto  been  of  any  avail  (B.). 


Dengue. 

Emetics  and  Purgatives  are  indicated  at  the  outset,  also  free  diaphoresis. 
Treatment  is  entirely  symptomatic.  Quinine,  in  five-grain  doses  every  four  or 
five  hours  for  the  fever  (Da  Costa) ;  should  be  given  more  for  its  tonic  than 
for  its  antiperiodic  effects  (Fayrer).  Opium,  in  some  form  for  the  pains  and 
nocturnal  restlessness.  Salicylic  Acid  or  salicylates  for  the  pains  in  joints  and 
muscles.  Carbolic  Acid,  as  lotion,  a  5  per  cent,  solution,  for  the  itching,  or 
camphorated  oil.  Belladonna  confers  great  relief  in  this  disease,  tru  x-x v  of 
the  tincture  may  be  given  every  hour  for  two  or  three  doses  (Fayrer).  Aconite, 
with  saline  sand  nitric  ether,  during  the  pyrexia,  which  may  be  so  high  that 
cold  sponging  or  the  cold  bath  may  be  required.  Bitter  Tonics,  as  gentian  and 
calumba,  with  quinine  and  a  mineral  acid  or  strychnine  during  convalescence. 


Prescriptions. 


R .  Tinct.  Colchici  Sem.,  .  .  .  gij. 

Spt.  yEtheris  Nitrosi,  .  .  .  3  iv. 

Potassii  Nitratis, . gr.  xl. 

Aquae,  . ad  $  vj. 

M.  Sig. — Tablespoonful  well  diluted 
every  hour  or  two  until  profuse  dia¬ 
phoresis  occurs.  For  relief  of  the  violent 
pains. 


I£.  Tinct.  Aconiti, . npxyj. 

Morph.  Acetatis,  .  .  .  .  gr.  ij. 

Spt.  yEtheris  Nitrosi,  .  .  .  7,  iv. 

Liq.  Ammon.  Acetat.,  .  .  jjiij. 
Aquae  Camphorae,  .  .  .  ad  5  iv. 

M.  Sig. — Teasp.  to  dessertp.  according 
to  age,  every  hour  for  three  hours,  then 
every  two  hours. 


Dentition. 

Belladonna,  in  convulsions  of  dentition  rarely  fail  to  relieve  (P.).  Hyoscy- 
amus,  to  alleviate  pain  and  subdue  irritation  ;  better  than  opium  for  children 
(P.).  Chamomilla,  tt\J  of  the  tincture  every  ^  hour,  an  excellent  sedative  for 
children  (A.  A.  Smith).  Potassium  Bromide  for  irritability  and  convulsions  in 
teething  (R.)  Dulcamara,  the  infusion,  in  diarrhoea  of  dentition  quickly 
checks  symptoms  (P.).  Calumba,  excellent  for  the  accompanying  vomiting  and 


534 


DIABETES  INSIPIDUS - DIABETES  MELLITUS. 


diarrhoea  (P.).  Hypophosphites,  of  lime  or  sodium,  as  a  general  tonic,  are 
highly  recommended  (R.).  Rhubarb,  with  soda,  internally  for  the  aphthje,  with 
perfect  cleanliness  of  the  mouth  and  a  wash  of  Borax  or  Potassium  Chlorate 
in  glycerin,  gr.  x  ad  (E.  Smith).  Castor  Oil,  for  the  diarrhoea  of  dentition 
to  clear  out  the  bowels,  then  a  mixture  of  Chalk  and  Catechu,  or  Oxide  of 
Zinc,  gr.  j  to  the  dose,  with  gtt.  j  of  Laudanum  if  required  to  reduce  peristalsis 
(E.  Smith).  Lancing  the  Gums  to  relieve  tension  when  gum  is  actually 
swollen  :  should  not  be  indulged  in  indiscriminately. 


Prescriptions. 


R.  Potassii  Bromidi,  .  .  .  .  gj. 

Olei  Anisi, . rr^ij . 

Mucil.  Acacice, 

Aq.  Menth.  Pip.,  .  .  .  aa  ^j. 

M.  Sig. — Teasp.  every  half-hour  until 
relieved.  (B.) 


R  .  Sodii  Bromidi, 

Sodii  Bicarbonat., 

Chloralis, . aa  gr.  xx. 

Aq.  Menth.  Viridis,  .  .  .  j|jss. 

Syr.  Zingiberis, . 3  ss. 

M.  Sig. — Half-teasp.  to  dessertsp.  ac¬ 
cording  to  age. 


Diabetes  Insipidus. 

Opium,  large  doses  necessary,  gr.  vj-xij  a  day  (B.)  ;  combined  with  gallic 
acid  the  most  generally  useful  remedy  (W.).  Ergot  has  cured  many  cases,  the 
fluid  extract  in  doses  of  3ss-j  thrice  daily  (Da  Costa)  ;  one  of  the  most  efficient 
remedies  (B.) ;  is  the  most  useful  remedy  (R.).  Iron  and  Strychnine  are  very 
useful  for  tonic  effects  (Da  C.).  Valerian  restrains  the  flow  of  urine  but  does 
not  cure  (B.).  Muscarine  has  been  used  with  apparent  success  (R.).  Potassium 
Iodide  is  curative  in  many  cases  of  syphilitic  origin  (B.).  Alum  has  produced 
good  results  (B.).  Jaborandi,  used  successfully  to  reduce  the  quantity  of  urine 
(B.)  Valerian,  large,  increasing  doses  (R.).  Krameria  lessens  the  quantity  of 
urine  (P.).  Diet,  a  dry  diet  beneficial  (B.). 


Prescriptions. 


R.  Ext.  Ergotse  FL,  ....  ^  iij. 

Sig. — Half-teasp.  thrice  daily,  gradually 
increased  to  a  dessertspoonful. 


R .  Acidi  Gallici,  .  .  . 
Div.  in  chartulas  xij. 
Sig. — One  thrice  daily. 


5[[b 


Diabetes  Mellitus. 

Phosphoric  Acid,  largely  diluted,  assuages  the  inordinate  thirst.  In  one  case 
it  seemed  to  act  as  a  curative  agent  (Wa.).  Arsenic,  when  from  faulty  assimi¬ 
lation,  in  diabetes  of  hepatic  origin,  and  in  thin  subjects  (B.) ;  the  Bromide  of 
Arsenic  is  credited  with  several  cures.  The  Lithiated  Arsenical  Water,  used 
in  70  cases  with  cure  of  96  per  cent.  (Martineau).  See  infra  for  formulae. 
Morphine,  is  very  efficient  in  reducing  sugar  when  used  by  mouth,  but  is  of  no 
value  when  employed  sub-cutaneously,  even  in  the  same  case  (Bruce).  Opium 
in  large  doses  (gr.  vj-xij  a  day),  ameliorative.  Codeine,  is  especially  service¬ 
able  (B.).  Abates  thirst  and  controls  appetite  (R.)  Its  value  much  disputed 
(P.);  is  of  great  value  in  many  cases  (W.)  Codeine  gr.  ]i~Yz  one  of  the  best 
remedies  (Da  Costa).  Sodium  Salicylate  has  cured  when  all  other  drugs  have 
failed  (R.) ;  gr.  x-xv  in  compound  spirit  of  lavender,  and  water,  thrice  daily,  is 
my  favorite  remedy  (Da  Costa).  Ergot  is  one  of  the  useful  drugs  (Da  C.)  ; 
decreases  the  quantity  of  sugar  and  the  volume  of  urine.  Potassium  Bromide, 
gr.  xx  ter  die,  cured  two  cases  in  six  weeks  (Begbie,  R.)  ;  useless  (Da  C.). 
Krameria  lessens  the  quantity  of  urine  (P.).  Phosphates,  to  avert  failure  of  nutri¬ 
tion  (B.)  Glycerin  has  produced  good  results  (B.).  Used  in  place  of  sugar 
(W.).  Aurum  Chloride  is  one  of  the  promising  remedies  (B.).  Iodoform,  in 
doses  of  gr.  j-ij,  rapidly  reduced  the  sugar  and  caused  its  disappearance  in  4  or 
5  days,  in  five  cases,  without  any  change  in  diet  being  made  (Moleschott) ;  the 


DIARRHCEA. 


535 


amount  of  testimony  for  its  value  in  this  disease  is  quite  considerable  (B.). 
Iodol,  can  be  advantageously  substituted  for  Iodoform  in  all  the  diseases  to 
which  the  latter  is  applicable  (B.).  Oxygen,  as  oxygenated  water,  instead  of 
carbonated,  very  successfully  used  (Le  Blond).  Uranium  Nitrate,  gr.  i-iij, 
thrice  daily  has  caused  decided  improvement  in  several  cases  (Hughes).  Alka¬ 
lies  are  used  on  theoretical  grounds,  but  have  not  produced  much  benefit.  One 
case  apparently  cured  by  the  diligent  use  of  Ammonium  Carbonate  (B.)  ;  are 
serviceable  (Da  Costa).  Alkaline  mineral  waters  for  diabetes  of  hepatic  origin 
and  in  obese  subjects,  are  extremely  useful  (B.).  Salines,  a  warm  solution  of 
phosphate  and  chloride  of  sodium,  by  intravenous  injection,  in  diabetic  coma, 
produced  astonishing  results  in  one  case  (B.).  Aloin,  for  the  accompanying 
constipation  (Da  C.).  Nux  Vomica,  or  Strychnine,  is  generally  beneficial. 
Calcium  Lactophosphate  benefits  the  thin,  nervous  type  of  diabetes  remarkably 
(B.).  Aliment.  All  saccharine  and  farinaceous  foods  forbidden.  Use  fats, 
animal  food,  and  gluten  or  almond  bread.  Milk-cure,  buttermilk  best,  to  be 
the  only  food  until  cessation  of  symptoms.  Alkaline  Waters,  when  of  hepatic 
origin  and  in  obese  subjects.  Tepid  drinks  in  the  intense  thirst  (B.)  Diet  and 
Hygiene  are  of  the  utmost  importance.  Avoid  amylaceous  food,  and  everything 
containing  sugar,  especially  ordinary  bread.  Use  fresh,  nutritious  animal  food, 
with  bread  of  bran  or  almonds.  Warm  baths,  warm  climate,  flannel  under¬ 
clothing.  Milk-cure,  by  skimmed  milk,  very  successful,  6  to  io  pints  daily. 
No  other  food  for  six  weeks,  then  animal  food.  Caittion, — the  urine  of  patients 
taking  salicylic  acid  gives  the  reaction  of  sugar  with  Trommer’s  test  (R.). 


Prescriptions. 


R.  Liq.  Potassii  Arsenitis,  .  .  ^jss. 
Tinct.  Opii  Deodorat.,  .  .  %  v. 
Syrupi  Zingiberis,  .  .  .  .  %). 
Aquae  Cinnamomi,  .  .  ad  5  iv. 
M.  Sig. — Teasp.  thrice  daily. 


R .  Lithii  Carbonat., . gr.  xl. 

Sodii  Arseniat., . gr.  j. 

Ext.  Gentianae, . gr.  xx. 

Ft.  pil.  no.  xxv.  Sig. — One  night  and 
morning  until  sugar  disappears  from  urine. 

(  Vigier.)  More  convenient  than  Marti- 
neau’s  liquid. 


R.  Codeinae, . gr.  viij. 

Syrupi,  et  Aquae, . 3  ij. 

M.  Sig. — Half  teasp.  thrice  daily,  grad¬ 
ually  increased  up  to  two  teaspoonfuls. 

(Pavy.) 


R.  Sodii  Arseniat., . gr.  iij. 

Aquae, . Oj . 

A  tablesp.  of  this  with  Lithii  Carbonat. 
gr.  iij  into  a  quart  siphon  filled  with  car¬ 
bonated  water,  which  is  to  be  taken  freely, 
as  daily  beverage.  ( Martineau .) 


Diarrhoea. 

Aconite,  when  from  chill,  high  fever,  cutting  abdominal  pains  (P.).  Mercury : 
Calomel  for  infantile  diarrhoea  (ileo-colitis),  gr.  ^  to  y1^  every  half-hour  (B.). 
The  bichloride,  gr.  j  in  ^x  aquae,  a  teasp.  frequently  in  acute  or  chronic  diarrhoea 
of  adults  or  children  with  slimy,  bloody  stools,  pain  and  straining.  Gr.  ]/e  of 
gray  powder  hourly,  or  gr.  yi^  of  corrosive  sublimate  every  two  or  three  hours 
(R.) ;  gr.  j  of  the  bichloride  to  the  quart  of  water,  of  this  a  teasp.  every  hour 
in  mucous  diarrhoea  (A.  A.  Smith).  Camphor,  in  summer  diarrhoea  and  the 
preliminary  diarrhoea  of  Asiatic  Cholera  (B.) ;  when  from  effluvia  of  drains  or 
exposure  to  cold  (R.)  ;  useful  in  many  forms  (P.).  Ipecacuanha,  in  summer 
diarrhoea  and  dysentery  of  children  with  greenish  stools  (B.) ;  hourly  drop- 
closes  of  the  wine  especially  if  vomiting  (R.) ;  when  from  nervous  irritation, 
especially  young  children  (P.)  Dulcamara,  in  diarrhoea  of  children  from  damp, 
or  with  dentition  (P.).  Pulsatilla,  dyspeptic  diarrhoea,  mucous  discharges, 
active  piles  (P.).  Quinine,  in  periodic  diarrhoea,  with  dysentery  and  jaundice 
(B.).  Veratrum  Album,  in  the  vomiting  and  purging  of  summer  diarrhoea 
(R.).  Podophyllum,  in  chronic,  with  high-colored  motions  and  cutting  pains, 
also,  in  morning  diarrhoea  (R.).  Gr.  ^  to  y1^,  with  occasional  doses  of  aconite, 
for  vomiting  and  diarrhoea  of  gastro-enteritis  and  prolapse  of  rectum  (P.). 


DIARRHOEA, 


DO 


6 


Chamomile,  an  infusion  in  summer  diarrhoea  of  adults,  or  in  that  of  dentition 
(R.).  The  oil  in  diarrhoea  of  children,  especially  from  worms  (P.).  Arsenic, 
for  evacuation  of  undigested  food  (B.) ;  gtt.  j  of  liq.  arsen.  before  meals  when 
diarrhoea  excited  by  food;  also  in  chronic  and  membranous  forms  (R.).  Nux 
Vomica,  a  very  useful  adjunct  to  other  remedies  (B.)  ;  often  of  much  service  in 
epidemic  diarrhoea  (P.)  Sulphuric  Acid,  in  summer  and  choleraic  diarrhoea. 
Small  doses  in  chronic  form  and  in  the  straining  diarrhoea  of  children  (R.). 
Iron,  sol.  of  pernitrate  in  army  diarrhoea  (B.).  Lime  Carbonate,  in  later  stages, 
as  chalk  mixture  in  diarrhoea  of  typhoid  or  phthisis  (R.).  Zinc  Salts,  very  effi¬ 
cient  in  summer  diarrhoea  of  children  (B.).  Rhubarb,  in  early  stages  to  get  rid 
of  irritant,  afterward  to  check  the  diarrhoea  (R.) ;  when  torrefied  it  has  no  pur¬ 
gative  power,  but  its  astringency  is  retained.  Rumex,  in  morning  diarrhoea 
(R.).  Arnica  checks  exhausting  diarrhoea  with  great  certainty  (P.).  Silver 
Nitrate,  in  diarrhoea  of  children.  White,  pasty  and  offensive  stools.  Combined 
with  opium  the  most  effective  remedy  for  that  of  phthisis  and  typhoid  (B.).  Min¬ 
eral  Acids,  in  painless,  watery  stools,  light  color  and  alkaline  (B.).  Alkalies, 
mistura  cretse  in  sour-smelling  stools  (B.)  Sodium,  potassium  or  magnesium 
bicarbonates  when  acid  canal  (R.).  Lead  Acetate  is  excellent  in  all  forms  (B.) ; 
with  opium  as  an  injection  (R.).  Bismuth  is  effective,  requires  large  doses.  Gr. 
xxx-lx  every  three  or  four  hours  ;  is  especially  indicated  when  desire  for  stool 
is  felt  immediately  after  eating  (B.).  Gr.  j  hourly  with  milk,  sometimes  with  gr. 
lA>  gray  powder,  in  various  forms  of  infantile  diarrhoea  (R.).  Opium,  com¬ 
monly  used,  but  is  best  in  watery  evacuations,  combined  with  mineral  acids  or 
acetate  of  lead  (B.).  An  injection  with  starch  in  severe  cases  (R.).  Calumba, 
when  not  inflammatory  (B.).  Coto  Bark,  the  fluid  ext.  or  Cotoin  is  one  of  the 
new  remedies  for  atonic  diarrhoea.  Purgatives,  Saline,  a  teasp.  of  Epsom  salts 
(magnes.  sulph.)  in  a  wineglass  of  water  every  three  hours  when  intestinal 
inflam’n  (B.).  Copper  Sulphate,  the  most  effective  astringent  in  chronic  diar¬ 
rhoea  and  that  of  phthisis  (B.).  Ergot,  in  persistent  chronic  diarrhoea  (B.). 
Iodine,  one  or  two  drops  of  tinct.  in  diarrhoea  from  atony  of  mucous  membrane 
(B.).  Tannic  Acid,  very  useful  in  profuse  and  chronic  diarrhoea.  Stille  advises 
tannic  acid  and  milk  diet  for  chronic  diarrhoea  and  dysentery  (B.).  Thymol, 
gr.  xx  to  o\]  in  24  hours  in  divided  doses  for  adults,  is  a  very  efficient  internal 
antiseptic  in  all  cases  of  diarrhoea,  especially  that  of  phthisis,  teething  children, 
chronic  diarrhoea,  etc.  (Martini).  Carbolic  Acid,  very  useful  in  fermentative 
diarrhoeas,  especially  when  combined  with  bismuth  in  cholera  nostras  and 
cholera  infantum  (B.).  Diet.  Cool  or  cold,  light,  bland  food.  Gruel,  rice, 
arrow-root,  whey,  barley-water,  in  recent  cases.  In  chronic  cases  the  most 
digestible  but  nutritious  food,  as  fresh  fish,  game,  raw  eggs,  rice,  mucilaginous 
drinks.  Milk-and-lime-water  or  soda-water  very  useful.  Also  raw  meat  pulp. 
Avoid  beef,  pork,  veal,  and  much  starchy  food.  [Compare  Dysentery, 
Cholera.] 


Prescriptions. 


R.  Bismuthi  Subnit.,  ....  ^j-ij. 
Pepsini  Saccharat.,  .  .  .  .  ^ss. 

Zinci  Oxidi, . gr.  vj-xij. 

Trit.  et  div.  in  chartulas  xij. 

Sig. — One  every  four  hours  in  summer 
diarrhoea  of  children. 


R  .  Sodii  Bromidi, . 3  ss. 

Mucil.  Acaciae, 

Aquae  Purae,  .  .  aa  q.  s.  ad  5  ij. 

M.  Sig. — Teasp.  every  three  hours  in 
the  diarrhoea  of  dentition,  for  child  less  than 
a  year  old.  ( A .  A.  Smith.) 


R.  Tinct.  Opii  Deod.,  .  .  .  .  £j. 

Tinct.  Calumbae,  .  .  .  .  ad  £  ij. 

M.  Sig. — Teasp.  in  a  winegl.  of  water 
before  meals. 


R.  CupriSulphat., . gr.  j. 

Morph.  Sulph  at., . gr.  ij. 

Quininae  Sulph., . gr.  xxiv. 

Fiant  pil.  no.  xij.  Sig. — One  pill  thrice 
daily. 


R.  Zinc  Oxidi, . gr.  xvij. 

Sodii  Bicarb., . gr.  viij. 

M.  et  div.  in  chartulas  iv. 

Sig. — One  every  6  hours. 


DIPHTHERIA. 


537 


R .  Zinci  Sulphatis, 

Pulv.  Opii, 

Pulv.  Ipecac.,  .  .  .  .  aa  gr.  xij. 

M.  Fiant  pil.  no.  xij.  Sig. — One  3  or  4 
times  daily  in  chronic  diarrhoea  of  adults. 


R.  Tinct.  Opii  Camph., 

Tinct.  Catechu,  .  .  .  .  aa  £iij. 

Mist.  Cretae, . 5  x. 

M.  Sig. — A  teasp.  four  or  five  times 
daily  for  children. 


R  .  Spt.  /Etheris  Co., 

Tinct.  Opii  Camph.,  .  .  aa  ^j. 

Syr.  Simplicis, . sjij. 

M.  Sig. — Dessertsp.  after  each  move¬ 
ment. 


R.  Plumbi  Acetat., . gr.  xx. 

Pulv.  Opii, . gr.  x. 

Fiat  massa,  et  div.  in  pil.  x. 

Sig. — One  twice  daily. 


R.  Ac.  Nitrici  Diluti,  .  .  .  .  gij. 
Tinct.  Camphorce, 

Tinct.  Opii, . aa  3  j. 

Syr.  Zingiberis, . 3  iv. 

Aq.  Menthae  Pip.,  .  .  .ad  ^vj. 

M.  Sig. — Tablesp.  doses  to  be  used  after 
a  cathartic.  [Hope's  Mixture  modified  by 
Thompson.')  > 


R.  Tinct.  Opii  Camph., 

Syr.  Rhei  Aromat.,  .  .  aa  £  ss. 

Aquae  Calcis, . ad  5  ij. 

M.  Sig. — A  teasp.  for  children. 


Diphtheria. 

Belladonna,  an  excellent  remedy  ;  if  given  early  will  abort  the  exudation  and 
later  is  useful  to  sustain  the  heart  (B.)  ;  especially  when  throat  and  tonsils 
acutely  inflamed  and  much  swollen  (R.).  Corrosive  Sublimate,  gr.  210-1  every 

2  or  3  hours,  has  given  me  most  success,  with  Thymol  or  Boric  Acid  gargle  ; 

and  Potassium  Chlorate,  Iron  and  Quinine  together,  where  the  membrane  is 
not  spreading  (Da  Costa):  gr.  jss  in  5A  of  glycerin  and  water,  of  which 
every  y2  hour  for  6  doses,  then  every  hour  night  and  day,  to  a  child  of  4  years. 
(Grant-Bey) :  locally  very  efficient,  gr.  ij  to  Oj  of  water,  applied  on  a  cotton 
swab,  which  should  be  burned  after  one  using  ;  this  hourly  night  and  day  (Oat- 
man).  Hydrarg.  Cyanide,  in  solution  of  gr.  ^  to  the  5,  of  which  a  teasp.  every 
Yi  hour  day  and  night  to  older  children  and  adults,  with  a  gargle  of  the  same 
solution  (Sellden)  ;  gr.  according  to  age,  every  hour  or  two  (Erichsen). 

Calomel  is  next  in  importance  to  quinine  and  iron,  has  proved  successful  in 
cases  where  other  means  failed,  gr.  yi-]i  every  3  hours,  with  a  little  Dover’s 
powder  (Da  Costa),  checks  plastic  exudation  ;  its  use  limited  to  children  of  good 
constitution,  with  sthenic  symptoms.  Gr.  )/2  to  j  every  2  or  3  hours  with  or 
without  Dover’s  powder  (gr.  j)  or  ipecac,  (gr.  j)  till  bowels  become  relaxed,  with 
greenish  stools  (Wa.).  Gr.  v.  repeated  boldly  every  hour  to  £iv,  for  a  child  of 

3  years,  until  the  stools  appear  like  polyps  in  water-troughs,  gelatinous,  and  of 

a  bright,  dark-green  hue.  Then  a  dose  of  castor  oil  if  salivation  is  feared 
(Reiter’s  Monograph).  The  safest  and  most  efficient  germicide  with  which  we 
can  saturate  the  system  ;  nothing  like  it  in  diphtheria, —  gr.  every  hour, 

even  gr.  j  every  2  hours,  has  no  bad  effects,  no  salivation  (Fowler).  Calcium 
Chlorate,  solution  locally  as  lotion  for  the  mouth.  Considered  almost  specific 
by  some;  its  chief  utility  is  in  removing  fetor;  may  influence  germs  (R.,  B.). 
Potassium  Chlorate,  grain-doses  every  x/z  hour  (A.  A.  Smith) ;  is  more  largely 
used  than  any  remedy,  both  internally  and  locally  (B.)  ;  in  full  doses  with  Liq. 
Cinchome,  seems  to  be  of  service  in  some  cases  (Wa.).  Pilocarpine,  used  in  80 
cases  without  a  single  death  ;  produces  free  salivary  discharge  but  is  depressant 
to  the  heart  (Guttmann) ;  many  opinions  for  and  against  it.  Is  decidedly  inju¬ 
rious  in  adynamic  cases  (B.).  Quinine,  in  tonic  doses  recommended  from  my 
experience  (Da  C) ;  when  headache  with  high  temperature,  vomiting,  and 
symptoms  of  septic  poisoning,  then  in  full  doses  (Wa.) ;  is  most  useful  after 
serious  symptoms  have  abated,  then  with  Iron  and  a  mineral  acid  (Mackenzie). 
Carbolic  acid,  in  spray,  locally  to  the  fauces,  to  remove  fetor  and  destroy  disease- 
germs  (B.).  As  caustic,  the  concentrated  acid  in  glycerin  on  a  mop  or  brush 
(W.).  With  iodine  to  prevent  systemic  infection  (B.).  Arsenic,  in  medicinal 
doses,  when  sloughing  of  throat,  or  malignant  diph.  (R.).  Salicylic  Acid,  locally 


53§ 


DIPHTHERIA. 


and  internally  (gr.  x),  has  produced  g'ood  results  (B.).  Sulphurous  Acid  Gas, 
recommended  by  a  royal  commission  in  Victoria,  as  a  means  of  arresting  the 
disease.  Crude  sulphur  burned  in  the  room,  all  apertures  being  closed  (R.). 
Sulphurous  Acid,  in  full  and  frequent  doses,  causes  rapid  disappearance  of  the 
exudation,  and  improvement  in  the  general  condition.  3j  every  yz  hour  to  an 
adult  in  severe  cases,  in  ordinary  ones  every  two  hours.  An  8-ounce  mixture 
should  have  2  or  3  ounces  of  syrup,  and  should  be  given  in  milk  to  very  young 
children  (Snow).  Sodium  Sulphite,  3j~£j  aquae,  locally,  an  easily  managed 
application  (B.)  ;  an  injection  for  nares  in  nasal  diphtheria  (Da  C).  See  for¬ 
mula  below.  Sodium  Hyposulphite,  in  solution  of  5j  to^ij  of  water,  of  which 
hourly  doses  of  3j,  to  be  retained  in  throat  several  minutes  before  being  swal¬ 
lowed,  an  excellent  local  and  constitutional  remedy,  which  may  also  be  used 
by  a  brush  or  spray  to  the  throat,  and  by  a  syringe  to  the  nares  (Fruitnight). 
Sodium  Benzoate,  is  highly  efficient,  75  to  100  grains  daily,  according  to  age, 
also  used  locally  (B.).  Sodium  Sulpho-Carbolate,  has  been  found  useful  in  lieu 
of  carbolic  acid  (Wa.).  Lime  Water,  dissolves  false  membrane.  The  vapors 
of  slacking  lime  inhaled  ;  or  better,  lime  water  by  atomizer  to  back  of  fauces 
while  patient  respires  deeply  (W.).  Ferric  Chloride,  as  solution  painted  on  or 
applied  by  spray  to  the  throat  (R.).  Of  no  advantage  locally,  internally  may 
serve  by  supporting  the  organism  (B.) ;  the  tinct.  of  the  chloride,  gtt.  xx  every 
2  or  3  hours ;  or  better  the  perchloride,  gr.  ]/z  to  j  every  2  hours  in  syrup  and 
water,  is  easier  to  take  and  doesn’t  hurt  the  throat  (Da  C.).  Strychnine,  hypo¬ 
dermically,  for  the  subsequent  paralysis  (R.).  Tartaric  Acid,  locally,  converts 
membrane  into  a  gelatinous  mass,  easily  expelled  (Vidal).  Thymol,  gr.  xx  to 
the  5  of  water,  with  a  little  glycerin,  is  the  best  gargle  ;  may  need  weakening 
(Da  C  ).  Boracic  Acid  in  solution,  is  next  best  as  gargle  (Da  C.).  Alum  and 
Sulphur,  equal  parts,  powdered  and  blown  into  the  throat  at  moment  of  deep 
inspiration,  as  often  as  asphyxia  is  threatened,  has  been  found  efficient  (Jones). 
Trypsin,  is  a  good  solvent  of  the  false  membrane;  of  all  remedies  used  with 
the  spray-atomizer,  it  has  given  me  the  largest  percentage  of  recoveries  (Fruit- 
night).  Chinolin,  a  5  per  cent,  solution  painted  over  the  affected  parts  with 
great  advantage  (Seifert) ;  the  tartrate  in  10-grain  doses  internally  (B.).  Bro¬ 
mine,  the  vapor  by  inhalation,  is  useful  (Wa.) ;  a  solution  in  distilled  water, 
of  which  gtt.  j-iij  every  yz  hour  in  a  teasp.  of  sweetened  water,  using  a  glass 
spoon  ;  and  a  saucer  full  of  bromine  water  in  the  room,  renewed  every  12  hours, 
has  seemed  to  be  extremely  efficient  in  a  number  of  cases.  Iodine  as  inhala¬ 
tion  frequently  (see  formula  below) ;  with  use  the  solution  may  be  increased  to 
3SS  at  each  inhalation  (R.).  Potassium  Permanganate,  gr.  yz  in  distilled  water, 
internally,  and  also  used  locally,  is  of  undoubted  benefit  (B.) ;  is  credited  with 
brilliant  results  even  in  malignant  cases.  Sanguinaria,  the  best  emetic,  and  by 
many  is  considered  specific  in  this  disease  (P.).  See  formula  below.  Lactic 
Acid,  .^iijss  to  5X  of  distilled  water,  as  gargle,  on  mop  or  by  spray,  to  dissolve 
membrane  (B.).  Tannin,  a  5  per  cent,  solution,  as  spray  (R.).  Alcohol,  is 
probably  as  good  a  local  antiseptic  as  any ;  diluted  with  equal  parts  of  water, 
by  hand-ball  atomizer  every  yz  hour.  Is  the  prince  of  antiseptics,  and  the  most 
perfect  and  reliable  medicine  in  diphtheria  of  which  we  have  any  knowledge 
(Hills).  Stimulation,  freely,  the  essential  part  of  the  treatment ;  infants  are  not 
injuriously  affected  by  even  teasp.  doses  of  whiskey  every  yz  hour.  Stimulate 
for  effect  and  not  by  dose  ;  those  cases  do  best  which  are  stimulated  freely  and 
early  (Da  C.).  There  is  more  danger  from  giving  too  little  alcohol  than  from 
too  much.  A  three-year  old  child  can  comfortably  take  from  3j-5v  of  Cognac, 
or  gr.  xv  of  Musk  or  Camphor,  or  gr.  xv-oj  of  Ammonium  Carbonate  in  24 
hours.  In  the  septic  form  especially,  the  intoxicating  action  of  alcohol  is  out 
of  the  question.  Young  children  with  general  sepsis  began  to  improve  when 
their  ^iv  of  brandy  were  increased  to  ,§xvj  daily  (Jacobi).  Turpentine,  3j  of 
the  oil  thrice  daily,  with  rrpiv  of  Spiritus  /Etheris  as  a  corrective,  at  the  same 
time  using  ice-bags,  and  a  gargle  of  Potas.  Chlorate  solution,  and  internally  yz- 
ounce  doses  every  2  hours  of  a  2  per  cent,  solution  of  Sodium  Salicylate 
(Roesse,  Baruch).  Tar  and  Turpentine  vapor,  made  by  burning  in  the  room 
coal-tar  7  parts  to  01.  Terebinth.  3  (Delthil).  Chlorine- Water,  tablesp.  doses 


DIPHTHERIA. 


539 


internally  and  as  a  gargle,  highly  efficient.  Cubebs,  are  very  efficient  in  the 
catarrhal  forms  of  diphtheria  (B.  Robinson) :  the  freshly  ground  berries  in  large 
doses  in  early  stages  of  the  disease,  a  very  successful  treatment  (Trideau). 
Water.  Ice  in  the  mouth,  and  the  wet  pack  to  the  throat  are  extremely  service¬ 
able  (B.).  Ice  sucked,  especially  at  commencement,  and  continued  until  the 
disease  declines  (R.).  Ice  packed  in  bladders  or  thin  india-rubber  bags,  to  the 
throat  (W.).  Aliment.  Good  foods,  wines  or  brandy  necessary  from  the  start 
to  maintain  the  patient’s  strength  (R.).  A  teasp.  of  glycerin  every  3  or  4  hours, 
plenty  of  good  soup  and  wine,  nutritive  enemata,  are  necessary  to  sustain  sys¬ 
tem.  Moist  inhalations.  Temp,  of  room  68°  Fah.  Removal  from  the  house 
wherein  attacked  is  advisable.  Ice  very  grateful  to  the  patient.  Tracheotomy, 
only  in  extremis  (R.) :  is  not  successful  in  diphtheria,  though  very  much  so  in 
membranous  croup  (Da  C.).  Intubation  of  the  Larynx,  as  an  alternative  to 
tracheotomy,  is  enthusiastically  advocated  by  many  operators. 


Prescriptions. 


R.  Tinct.  Ferri  Chloridi,  .  .  .  5). 
Syrupi  Tolutani,  ....  ,3  ijss. 
Liq.  Potassii  Citratis,  .  .  .  3  ijss. 
M.  Sig. — Teasp.  to  dessertsp,  accord¬ 

ing  to  age,  every  3  hours,  gj  —  ft\x  °f  the 
tincture.  (Anderson.) 


R  .  Hydrarg.  Chlor.  Corros.,  gr.  j,  may 
be  added  to  the  above  formula,  which 
should  then  be  given  in  teasp.  doses. 


R .  Potassii  Chloratis,  .  .  .  .  gr.  xl. 
Syrupi  Simplicis,  calid.,  .  .  3  ijss. 
Solve,  et  adde — 

Ac.  Sulphur.  Aromat., 

Tinct.  Ferii  Chloridi,  .  .  aa  £j. 

M.  Sig. — Teasp.  doses  for  adults,  every 
2  to  4  hours,  reduced  as  improvement  ad¬ 
vances,  but  kept  up  throughout  disease. 


R  .  Hydrarg.  Bichlor.,  ....  gr.  jss. 


Glycerini, . ^j. 

Aquae  Destillat., . 3  iij. 


M.  Sig. — A  teasp.  every  j V2  hour  for  6 
doses,  then  every  hour  night  and  day  to  a 
child  of  4  years.  Also — 

R.  Ung.  Todoformi,  1  in  10,  rubbed  in 
over  swollen  glands  every  3  hours. 

( Grant-  Bey .) 


R.  Pulv.  Potass.  Chlorat.,  .  .  .  3  j. 

Ac.  Hydrochlor., . £ij. 

Mix  in  a  strong  pint  bottle,  cork  until 
effervescence  ceases.  Add  3  xvj  of  Water, 
3j  at  a  time,  shaking  at  each  time.  Cork 
tightly.  Paint  the  bottle. 

Sig.  Chlorine-water.  A  tablesp.  or  two 
to  be  taken  frequently,  according  to  age. 


R .  Acidi  Lactici, 

vel  Tartarici,  ....  5  ijss. 

Glycerini, . 5  iv. 

Aq.  Menth.  Pip.,  ....  3vij. 

M.  Sig. — Locally  to  patches  every  3 
hours. 


R.  Thymol, . 3j. 

Glycerini, . 3  j. 

Aquae, . J3  iij. 

M.  Sig. — Gargle.  (Da  Costa.) 


R  .  Sodii  Sulphit., . 3  iij. 

Glycerini, . 3  ij. 


M.  Sig. — Nasal  injection.  (Da  Costa.) 


R.  Tinct.  Ferri  Chloridi,  .  .  .  3  j. 

Potassii  Chloratis,  .  .  .  .  3  ss. 

Misce  et  adde — 

Aquae, . q.  s  .ad  3  viij. 

Sig. — Gargle.  (  J acobi .) 

For  the  chemistry  of  this  combination 
see  under  Chlorum,  ante ,  page  173.  Gly¬ 
cerin  should  not  be  added,  as  in  Dr.  Ja¬ 
cobi's  original  R ,  which  makes  an  explo¬ 
sive  mixture. 


R.  Bromi, . gr.  j 

Potass.  Iodidi, . 3). 

Aquae, . J-j. 


M.  Sig. — Inhale  from  a  cone,  as  solvent 
of  membrane. 


R .  Acidi  Carbolici,  . ttbxv. 

Aquae  Calcis, . 3  vj, 

M.  Sig. — Spray.  To  be  used  with  a 
hand-ball  atomizer  several  times  daily,  for 
5  minutes  each  time. 


DROPSY. 


540 

R.  Pilocarpinae  Muriatis,  .  .  gr. 

Pepsini,  . gr.  x-xx. 

Acidi  Hydrochlor.,  .  .  .  gtt.  ij. 

Aquae  Destill., . 3viij. 

M.  Sig.  Teasp.  every  hour  for  a  child. 


R .  Pulv.  Sanguinariee,  .  .  .  gr.  xx. 

Pulv.  Ipecac., . gr.  v. 

Syrupi  Ipecac.,  .  .  .  .  3  ij. 

M.  Sig. — Teasp.  every  *4  hour  until 
vomiting;  afterwards,  y2  teasp.  every  hour, 

(. Phillips .) 


R.  Liq.  Ferri  Subsulph.,  .  .  £ij. 
Glycerini,  .  .  .  .  q.  s.  ad  3  ij. 

M.  Sig. — Apply  with  brush  to  throat  2 
or  3  times  a  day. 


R.  Ac.  Tartarici, . Jfj. 

Glycerini, . ojss- 


Aquae  Menth.  Pip.,  .  ad  5  iv. 

M.  Sig. — Gargle  frequently.  (  Vidal.) 


R .  Ac.  Salicylici, 
Sodii  Boratis,  . 

.  .  .  aa  £ij. 

Ac.  Carbolici,  . 

....  zi- 

Aquae,  .... 

.  .  .  .  3  iv. 

M.  Sig. — Use  as  a 

gargle  or  wash. 

R.  Iodi, . 

.  .  .  .  gr.  iv. 

Potassii  Iodidi,  . 

,  .  .  .  .  gr.  iv. 

Alcoholis,  .  .  . 

.  ...  ziv- 

Aquae, . 

,  .  .  ad  3  iv. 

M.  Sig. — Teasp.  in  boiling  water  as  in¬ 
halation.  (Waring-  Curran.^ 


Dropsy. 

Arsenic,  in  dropsy  from  feebleness  of  heart,  and  in  old  age  (B.) ;  swelled 
feet  from  debility  (R.).  Digitalis,  one  of  the  best  remedies,  esp.  in  renal  dropsy 
from  acute  desquamative  nephritis.  The  infusion  in  doses  of  3ss(B.).  The 
fresh  infusion  best  for  heart  disease,  esp.  when  tricuspid  regurgitation  (R.).  In¬ 
duces  striking  effects  in  cardiac  dropsy,  when  scanty  urine  and  venous  engorge¬ 
ment.  Has  high  rank  as  a  diuretic  (P.).  Apocynum  Cannabinum,  actively 
diuretic  (P.).  Caffeine,  the  citrate  in  5-grain  doses  is  eminently  diuretic.  Hy¬ 
drargyrum,  a  classical  pill  in  dropsy  with  dyspnoea  from  cardiac  disease  is  the 
combination  of  Dr.  Baillie,  containing  Mercury,  Digitalis  and  Squill  (see  for¬ 
mula  below).  Calomel  in  doses  of  gr.  ss-ij  is  eminently  diuretic,  especially  in 
cardiac  dropsy  :  but  by  many  it  is  thought  to  act  by  aiding  the  action  of  other 
diuretics.  Bryonia,  as  a  drastic  purgative  and  diuretic ;  care  necessary  as  it 
depresses  the  heart.  The  infusion  best  (P.).  Hellebore,  the  tinct.  in  doses  of 
gtt.  v-xv,  every  2  or  3  hours,  very  successful  in  dropsical  effusions,  especially 
in  general  anasarca  after  scarlatina  (P.).  Senega,  as  a  diuretic  when  depend¬ 
ent  on  kidney  disease;  has  been  praised  (P.).  Chimaphila,  is  useful  as  a  diu¬ 
retic  in  renal  dropsy  esp.  when  with  loss  of  appetite  and  debility  (P.) ;  may  be 
substituted  for  Scoparius  (B.).  Juniper,  largely  used  as  a  diuretic  in  cardiac 
and  renal  dropsy  (B.) ;  esteemed  in  post-scarlatinal  dropsy  (R.).  Iron,  purga¬ 
tive  chalybeate  waters  (B.)  :  the  Mistura  Ferri  et  Ammonii  Acetatis  (Basham’s 
Mixture),  in  anaemic  dropsy  (Da  C.).  Pilocarpus,  very  valuable  in  renal  dropsy 
when  secretion  of  urine  is  much  reduced  or  suppressed  (B.).  Jalap,  the  com¬ 
pound  jalap  powder,  gr.  xv-xx,  with  3hj  of  potas.  bitart,  and  a  little  ginger,  early 
in  the  morning,  2  or  3  times  a  week;  no  hydragogue  superior,  in  dropsy  from 
Bright’s  disease  (Wa.).  Turpentine,  controls  dropsy  with  albuminous  urine, 
from  non-desq.  renal  disease.  Gtt.  ss.  every  2  to  4  hours  (P.).  Colchicum,  as 
a  hydragogue  in  hepatic  and  cardiac  dropsy  when  patient  is  vigorous,  also  in 
post-scarlatinal  dropsy  (B.).  Scoparius,  esteemed  by  English  physicians  (B.)  ; 
is  most  useful  in  cardiac  dropsy.  Cullen  found  it  the  most  certain  diuretic. 
Diluents  should  be  freely  used  with  it  (P.).  Squill,  in  cardiac  dropsy  ;  cautiously 
if  from  kidney  disease.  If  anaemic  add  iron  (B.,  R.).  Taraxacum,  is  occa¬ 
sionally  used  as  a  diuretic,  with  limited  utility  (B.).  Copaiba,  gives  good  results, 
especially  in  Ascites,  which  see  for  formula  (B.).  Potassium  Bitartrate  and 
Acetate,  are  very  certain  as  diuretics  when  largely  diluted  with  water.  “  Cream- 
of-tartar  lemonade.”  Indicated  in  desquamative  nephritis,  and  general  dropsy 
from  valvular  disease  of  the  heart  (B.,  R.).  Elaterium,  of  unquestionable  value 
as  a  derivative  in  many  passive  forms  of  dropsy;  though  many  fear  it  (P.)  Acu¬ 
puncture,  or  better  still,  incisions  from  y  to  an  inch  long,  one  over  each  exter- 


DUODENAL  CATARRH - DYSENTERY. 


541 


nal  malleolus  generally  sufficient.  A  hot  sponge,  moist  with  weak  carbolic 
acid  solution  kept  to  incisions  (R.).  Aliment:  dry  diet  is  of  advantage  in  dropsy 
of  serous  cavities  (B.).  Diet.  Should  be  light  in  acute  dropsies  ;  in  chronic, 
nourishing.  Water  not  injurious  but  beneficial  as  drink.  Warm  baths,  Hol¬ 
lands  gin  in  small  doses,  tapping,  for  alleviation  in  incurable  cases.  A  moder¬ 
ately  warm,  dry  atmosphere.  Skim-milk  diet  said  to  be  of  very  great  value  in 
renal  dropsy.  [Compare  Ascites,  Hydrocele,  Hydrocephalus,  Hydro¬ 
thorax,  etc.] 

Prescriptions. 


R .  Yini  Colchici  Seminis,  .  .  5  ss. 

Liq.  Ammonii  Acetat.,  .  .  5  ijss. 
Infusi  Petroselini,  .  .  .  .  5  V. 

M.  .  Sig. — Teasp.  every  4  hours.  An 
excellent  diuretic,  esp.  adapted  to  dropsy 
of  scarlatina.  (B.) 


Elaterini, . 

•  •  gr-  j 

Spt.  Etheris  Nitrosi,  . 

•  •  5  ’J* 

Tinct.  Scillae, 

Tinct.  Colchici,  .  .  . 

.  aa  g  ss. 

Syr.  Simplicis,  .... 

M.  .Sig. — Teasp.  3  or  4  times  daily,  in 
hepatic  and  cardiac  dropsy  in  sthenic  sub¬ 
jects. 


R  .  Pulv.  Digitalis, . gr.  j-jss. 

Pulv.  Scilke, . gr.  j. 


Hydrarg.  c.  creta  vel 

Pil.  Hydrargyri, . gr.  j-iij. 

Ft.  pil  no.  j.  Sig. — One  thrice  daily. 


R .  Pulv.  Scillae, 

Pulv.  Digitalis,  .  .  .  .  aa  3  ss. 
Potassii  Nitratis,  .  .  .  .  .  %). 
M.  Fiat  massa,  et  div.  in  pil.  xxx. 
Sig. — One  pill  thrice  daily. 


R  .  Aceti  Scillae, . ^  ss. 

Infusi  Digitalis,  .  .  .  .  ad  3  iv. 

M.  Sig. — A  tablesp.  2  or  3  times  daily. 


R .  Potassii  Acetatis,  .  ...  g  vss. 
Spt.  Etheris  Nitrosi,  .  .  .  £ij. 

Aquae, . q.  s.  ad  5  viij. 

M.  Sig. — Tablesp.  every  3  or  4  hours. 


R.  Potassii  Bitartrat.,  .  .  .  .  3  j. 

Ext.  Taraxaci, . g  ss. 

Decocti  Taraxaci,  ....  ,3  viij. 

M.  Sig. — winegl.  twice  or  thrice 
daily. 


R.  Tinct.  Digitalis,  .....  3; j— ij . 

Tinct.  Scillae, . g  ij. 

Spt.  Juniperi  Comp.,  .  .  .  giv-vj. 
Potassii  Acetatis,  .  .  .  .  £iv. 

Yini  Albi,  .  .  .  .  q.  s.  ad  g  vj. 

M.  Sig. — A  tablesp.  3  or  4  times  daily. 


R.  Mist.  Ferri  et  Ammonii  Ace¬ 
tatis  (U.  S.  P.), . g  vj. 

Sig. — Dessertsp.  or  two  three  or  four 
times  daily.  (. Basham's  Mixt.) 


Duodenal  Catarrh. 

Sodium  Phosphate,  oj  four  times  daily,  extremely  efficient  in  catarrhal  con¬ 
ditions  of  the  duodenum  and  bile-ducts,  resulting  in  jaundice,  hepatic  colic, 
etc.  (B.).  Vichy  Water,  in  similar  conditions,  probably  owes  its  efficacy  to 
the  phosphate  of  sodium  contained  in  it  (B.).  Potassium  Bichromate,  in  doses 
of  gr.  tV-?’  tw0  or  three  times  a  day,  is  an  excellent  remedy  in  so-called  duo¬ 
denal  dyspepsia,  manifested  by  a  bitter  taste,  coated  tongue,  pale  stools,  vom¬ 
iting  of  glairy  fluid  and  dull  pain  in  right  hypochondrium.  Arsenic,  has  been 
used  with  success  in  jaundice  from  catarrh  of  bile-ducts  after  duodenal 
catarrh  (B.).  Podophyllum,  in  catarrhal  and  malarial  duodenitis.  Nitro- 
muriatic  Acid,  in  mucous  duodenitis  ;  also  as  bath  to  right  hypochondrium 
(^iij-gall.  j),  temp,  of  bath  96°  (B.).  Aliment.  No  starches  or  fats;  milk,  eggs, 
oysters,  beef-broth,  broiled  or  raw  beefsteak,  whitefish  (B.).  Diet  should  be 
exclusively  animal,  in  order  to  let  the  stomach  deal  with  it.  [Compare  Jaun¬ 
dice,  Biliousness.] 


Dysentery. 

Aconite,  fever  and  cutting  pains  (P.).  Mercury,  in  minute  doses  for  the  ileo¬ 
colitis  of  children,  Gr.  to  Tb  of  calomel  or  hydrargyrum  cum  creta  every 
half  hour  (B.).  Gr.  of  the  bichloride  hourly  or  every  2  hours,  in  acute  or 


542 


DYSENTERY. 


chronic  dysentery  if  stools  are  slimy  or  bloody  (R.)  Ipecacuanha,  is  par  excel- 
letice  the  remedy  for  acute  dysentery  of  the  ordinary  type ;  large  doses.  Gr. 
xxv-xxx  (P.) ;  gr.  xv  in  milk  (B.).  Valuable  in  acute  or  epidemic,  also  in 
summer  dysentery  of  children,  with  greenish  stools,  mucus  and  blood,  gr. 
ii-v  every  2  hours  in  milk  (B.).  Dysenteric  diarrhoea  of  children,  especially 
with  vomiting,  will  often  yield  to  hourly  drop  doses  of  ipecacuanha  wine  (R.). 
Hamamelis,  when  the  discharges  contain  much  blood  (R.)  Nux  Vomica,  in 
epidemic  dysentery  (P.) ;  prune-juice  stools,  much  gas,  vital  depression  (B.). 
Arsenic,  Fowler’s  solution  gtt.  ij  with  gtt.  v  of  opium  often  benefits  (B.). 
Quinine,  when  periodic  (B.) ;  in  malarial  subjects  is  as  successful  as  ipecacu¬ 
anha  in  dysentery  of  the  ordinary  type  (P.).  Gamboge,  gr.  ^  in  24  hours, 
exceedingly  valuable,  especially  in  young  persons  ( P. ) .  Castor  Oil,  as  a  mild 
cathartic,  is  very  valuable  in  appropriate  cases  (YVa.) ;  gtt.  v  every  hour,  in 
water  with  sugar  and  gum,  is  excellent  for  dysenteric  diarrhoea  of  children 
(A.  A.  Smith).  Arnica,  when  vital  powers  are  greatly  depressed,  is  highly 
extolled  (Wa.).  Saline  Purgatives,  Epsom  salts  the  best  treatment  for  acute 
dysentery,  especially  when  fever,  pain,  tenesmus  and  stools  of  mucus  and 
blood  (B.).  Silver  Nitrate,  in  pill,  gr.  ]i~ j,  with  opium,  in  acute  dysentery 
after  subsidence  of  acute  symptoms.  Also  as  enema  beyond  the  sigmoid  flexure 
(gr.  x-xx  ad  Oj  aquae).  Also  as  escharotic  through  speculum  to  ulcer  of  rectum 
(B.).  Opium,  as  enema,  with  starch  and  milk,  after  canal  is  emptied  by  salines. 
Indispensable  in  chronic  dysentery  (B.).  For  the  purging  (R.).  A  remedy  of 
great  value,  and  applicable  to  every  stage  and  every  form  of  the  disease,  allaying 
pain  and  vascular  excitement,  moderating  peristalsis,  promoting  the  cutaneous 
secretion.  Is  inferior  to  ipecac,  in  acute  dysentery,  and  is  most  valuable  in  the 
.chronic  form  (Wa.).  Glycerin,  with  infusion  of  flaxseed  (1  to  4),  to  allay 
tenesmus  (B.).  Lead  Acetate,  as  enemata  in  acute  and  chronic  dysentery, 
to  allay  tenesmus  (B.) ;  with  ipecac,  and  opium  in  pill,  for  acute  form.  See 
formula  (Da  C.).  Sulphuric  Acid,  with  saline  purgatives  (B.).  Copper  Sul¬ 
phate,  useful  in  acute  dysentery  ;  in  chronic  the  most  valuable  astringent  (B.). 
Gr.  x-xx  ad  Oj  aquae  (R.).  Ergot,  in  chronic,  after  acute  ;  and  also  in  the 
acute  form  (R.).  Grape-cure,  is  used  successfully  in  the  chronic  form  (P.). 
Iron  Pernitrate,  sometimes  in  chronic  (army)  dysentery  (B.).  Calumba,  is 
of  great  value  in  chronic,  with  ulceration  of  colon  (P.).  Injections  of  muci¬ 
laginous  enemata  (as  flaxseed)  are  of  great  value  (R.).  Diet  is  of  prime 
importance  (B.).  Avoid  animal  food  and  stimulants.  Liquid  foods  best;  all 
cold  (R.).  [Compare  Diarrhcea,  Enteritis.] 


Prescriptions. 


R  .  Plumbi  Acetat., . gr.  xxiv. 

Ipecacuanha, . gr.  iij. 

Pulv.  Opii, . gr.  iij. 

Fiant  pil.  no.  xij.  Sig. — One  every  2 

hours  until  blood  ceases,  then  at  longer 
intervals.  (Da  Costa.)  1 


R.  Plumbi  Acetat., . gr.  iv. 

Morph.  Acetat., . gr.  ss. 

Aq.  Fervid., . ^j. 

M.  Sig. — Enema  to  allay  tenesmus. 


R.  Morphinae  Sulph.,  .  .  .  .  gr.  ij. 
Strychninae  Sulph.,  .  .  .  gr. 

Ac.  Sulphurici  Dil.,  .  .  .  :jss. 

Aquae  Camphorae,  ....  5  iijss. 

M.  Sig. — Teasp.  well  diluted,  every 

hour  or  two.  In  epidemic  dysentery  with 
prune-juice  stools  and  marked  depression.  | 


R.  Magnesii  Sulph.,.  .  .  .  ^viij. 

Ac.  Sulph,  Dil.,  .  .  .  .  gss. 

Aquae, . 5  viij 

M.  Sig. — Tablesp.  in  a  winegl.  of  water 
every  hour  or  two  until  it  operates.  (B.) 


R  .  Ergotini, . gr.  xx. 

Ext.  Nucis  Vom.,  .  .  .  .  gr.  v. 

Ext.  Opii, . gr.  x. 

Fiant  pil.  no.  xx.  Sig. — One  every  6 
hours.  (King.) 


R.  Liq.  Ferri  Nitratis, 

Ac.  Nitrici  Dil.,  .  .  .  aa  3  ss. 

Syr.  Zingiberis, . j^j. 

Aquae, . q.  s.  ad  5  iij. 

M.  Sig. — teasp.  thrice  daily  for  a  child 
of  2  years.  Tonic  to  follow  palliative  treat¬ 
ment.  (Starr.) 


DYSMENORRHCEA. 


543 


R.  Bismuthi  Subnit.,  . 


Spt.  Ammon.  Aromat. 

Tinct.  Opii . 

Syrupi  Simplicis, 
Misturse  Cretae,  .  . 


R.  Ext.  Ergotas  FI.,  .  .  .  . 

Tinct.  Opii  Deodor.,  .  .  . 

M.  Sig. — Teasp.  thrice  daily. 

(Andrew.') 


M.  Sig. — Dessertsp.  to  child  over  one 
year ;  tablesp.  or  more  to  an  adult,  every  2 
or  3  hours,  after  emptying  bowels  by  a 
laxative. 


R.  Ferri  Subsulphatis,  .  .  .  .  gr.  xl. 


Pulv.  Opii, . gr.  xx. 


Fiant  pil.  no.  xx.  Sig. — One  thrice  daily. 
Chronic  dysentery. 


Dysmenorrhcea. 


Pulsatilla,  in  the  functional  form,  is  of  much  benefit  when  discharge  is 
scanty  or  profuse,  black  and  clotted;  should  be  persevered  in  for  2  months  or 
more  (P.) ;  gtt.  ij  every  hour  is  most  effective  when  the  affection  is  not  of  mem¬ 
branous,  obstructive  or  neuralgic  character  (A.  A.  Smith).  Belladonna,  in 
neuralgic  or  spasmodic  forms,  dark  and  fetid  discharge,  crampy  pains  and 
cold  chills,  a  suppository  or  mild  injection,  together  with  internal  administra¬ 
tion,  will  relieve  (P.);  in  neuralgic  dysmenorrhoea  it  will  permanently  relieve 
(B.).  Aconite,  a  valuable  remedy  when  commenced  early  (P.) ;  for  the  con¬ 
gestive  form  in  plethoric  subjects  (B.).  Cimicifuga,  relieves  the  pain  in  con¬ 
gestive  variety,  and  is  decidedly  useful  (P.) ;  is  said  to  be  very  efficient  (R.) ;  is 
valuable  (Wa.).  Opium,  necessary  when  pain  is  very  severe  ;  one  hypodermic 
of  morphine  at  each  period  is  often  sufficient  (Wa.).  Codeine,  when  morphine 
is  not  well  borne,  has  given  very  complete  satisfaction  in  several  cases  ;  gr.  y 
morning  and  evening  (Oliver).  Gelsemium,  relieves  pain  in  the  neuralgic  form, 
npv-x  of  the  fluid  extract  every  2  hours  (B.).  Chloroform,  as  the  liniment  on  a 
flannel  wrung  out  of  hot  water,  or  by  inhalation  as  anaesthetic  when  pains  very 
severe  ;  sometimes  exerts  a  permanent  influence  (Wa.).  Ergot,  given  when 
the  molimen  begins,  is  useful  in  the  congestive  form  (B.).  Amyl  Nitrite,  may 
be  inhaled  with  benefit  in  the  neuralgic  variety,  especially  in  chlorotic  girls 
(Wa.).  Sodium  Borate,  in  the  membranous  form,  has  been  used  with  great 
benefit  combined  with  ext.  belladonnae  (Wa.).  Ammonium  Acetate,  has 
remarkable  power  over  many  forms  of  dysmenorrhoea.  The  liq.  ammonii 
acetatis,  in  ^ss  doses,  with  gr.  y  of  ipecac.,  every  2  or  3  hours,  to  keep  up  the 
action  of  the  skin  until  the  flow  is  well  established  (E.).  Camphor,  is  my 
favorite  remedy,  gr.  x  in  mucilage  and  cinnamon-water ;  repeat  the  dose  in 
an  hour  or  two  if  necessary  (Dewees).  Guaiacum,  is  very  useful  (P.)  ;  drachm 
doses  of  the  ammoniated  tincture  in  the  neuralgic  or  rheumatic  forms  (B.). 
Caulophyllum,  is  by  many  considered  the  best  curative  remedy  for  spasmodic 
dysmenorrhoea,  if  given  in  the  intervals.  Viburnum  Opulus,  the  fluid  extract, 
in  half-drachm  doses,  has  considerable  reputation  in  some  sections  for  uterine 
pains  of  various  kinds,  and  is  useful  in  the  spasmodic  variety  of  this  affection ; 
may  be  used  in  combination  with  cannabis  indica  (Thomas).  Arsenic,  gtt.  iij-x 
of  Fowler’s  sol.  with  gtt.  x  of  tinct.  digitalis,  ter  die  between  the  periods,  gives 
excellent  results  (Athill) ;  indicated  when  copious  membranous  discharge  from 
bowels  and  uterus  (R.).  Cannabis  Indica,  is  very  useful  as  a  palliative  in 
painful  menstruation  (B.);  gr.  ss-j  thrice  daily  to  relieve  the  pain  (R.).  Nux 
Vomica,  in  neuralgic  form.  Syrup  or  elixir  of  iron,  quinine,  and  strychnine 
(B.).  Apiol,  neuralgic  form  (B.) ;  as  emmenagogue,  night  and  morning,  for 
several  clays  near  the  period  (Wa.).  Electricity:  in  neuralgic,  a  galvanic  cur¬ 
rent ;  in  congestive,  inverse  current  (B.)  Croton-Chloral,  in  neuralgic  form 
(R.).  Iron,  if  depending  on  anaemia  (B.).  [See  Amenorrhcea  for  formula.] 
Cajuput  Oil,  said  to  relieve  the  pains  (R.).  Rue  and  Sumbul,  are  reported 
useful  (P.).  Emetic  of  ipecac,  with  warm  covering  in  bed,  feet  in  hot  water, 
hot  ginger  tea,  liquor  ammonii  acetat.  If  pain  very  severe,  a  suppository  of 
morphine  and  belladonna  per  rectum  ;  best  to  avoid  anodynes  (E.).  Acces¬ 
sories,  spinal  ice-bag,  when  scanty  discharge  ;  when  menorrhagic,  hot  water 
spinal-bag.  Sitz  baths,  either  hot  or  cold,  or  cold  alone,  during  intervals. 


544 


DYSPEPSIA. 


Prescriptions. 


R .  Ext.  Cimicifugae  FI.,  .  .  .  %  iv. 

Ext.  Pulsatillae  FI.,  ...  £jss. 

Ext.  Eriodyctii  FI.,  .  .  .  %  j. 

Syr.  Aurantii,  .  .  q.  s.  ad  ^  iv. 

M.  Sig. — One  or  two  teasp.  every  2 
hours  to  six  doses. 


R .  Ext.  Belladonnas,  .  .  .  .  gr.  iv. 

Ext.  Straraonii, 

Ext.  Hyoscyami,  .  .  .  aa  gr.  v. 
Quininae  Sulphatis,  .  .  .  gr.  xl. 
Fiant  pil.  no.  xx.  Sig. — One  pill  thrice 
daily.  Neuralgic  dysmenorrhcea. 


R  .  Ext.  Opii, . gr.  v. 

Ext.  Cannabis  Ind., 

Ext.  Hyoscyami,  .  .  .  aa  gr.  x. 

Camphorae, . gr.  xxv. 

M.  Fiant  pil.  no  x.  Sig. — One  pill  2 
or  3  times  daily.  ( McLane .)  j 


R.  Ext.  Viburni  Prunifol.  FI.,  5  ij. 

Ext.  Senec.  Aurei,  .  .  .  ^ij. 
Tinct.  Guaiaci  Volat., 

(Dewees.)  See  U.  S.  Disp., 

P-  HS6, . 3xiJ-  . 

Sig. — A  teasp.  in  new  milk,  thrice  daily, 
between  attacks,  every  hour  during  at¬ 
tack,  and  a  hot  sitz-bath. 


R.  Ext.  Ergotae  Fluidi,  .  .  .  3  vij. 
Tinct.  Gelsemii,  .  .  .  .  3]. 

Tinct.  Aconiti, . Ppxvj. 

M.  Sig. — Teasp.  every  2,  3  or  4  hours. 
In  congestive  dysmenorrhoea. 


R.  Ext.  Cannabis  Ind.  FI.,  .  .  ^jss. 
Ext.  Viburni  Op.  FI.,  .  .  .  3  vj. 
Mucil.  Acaciae,  .....  .^  iij. 

Aq.  Cinnamomi,  .  .  .  ad  g  iv. 

M.  Sig. — Dessertsp.  every  4  to  6  hours. 


Dyspepsia. 

Nux  Vomica,  gtt.  v-x  ter  in  die  before  meals  as  stomachic  tonic  (B.) ;  when 
flatulence,  weight  on  head  and  heartburn  (R.).  Often  of  the  highest  possible 
value  in  simple  atonic  form,  or  in  the  dyspepsia  of  drunkards  (P.).  Arsenic, 
drop  doses  of  Fowler’s  solution  before  meals  in  irritative  dyspepsia  (B.);  also 
when  diarrhoea  is  excited  by  food  (R.).  Bryonia,  in  dyspepsia  of  liver  origin, 
“bilious”  headache  with  vomiting  (P.).  Charcoal,  when  flatulence;  nux 
vomica  in  5-TTp  doses,  before  meals,  better  (R.).  Mercury,  gray  powder  gr.  j, 
3  or  4  times  a  day,  when  dyspepsia  during  chronic  disease  or  convalescence. 
If  constipated,  calomel,  gr.  ss  with  extract  hyoscy.  gr.  iij  in  pill  for  3  nights  (R.). 
The  yellow  oxide,  in  doses  of  gr.  f°r  dyspepsia  septica  and  kindred 

disorders  of  the  alimentary  canal ;  remarkably  efficient  in  Austrian  navy 
(Schaffer).  Ipecacuanha,  rrpv-x  of  the  wine  most  valuable  in  atonic  and 
chronic  catarrhal  dyspepsia  (P.) ;  constipation,  depression,  food  “  like  a  heavy 
weight”  (R.).  Hydrastis,  gtt.  v-xv  of  the  tincture  before  meals,  a  good  stom¬ 
achic  tonic  (B.) ;  in  chronic  dyspepsia,  sluggish  liver  (P.).  Pulsatilla,  a  good 
remedy  when  depression  with  fear  of  death,  white-coated  tongue,  little  or  greasy 
taste,  nausea,  flatulency,  heartburn;  gtt.  v  in  water  every  4  hours  (P.).  Cin¬ 
chona,  with  mineral  acids  in  atonic  dyspepsia  (P.).  Quinine,  especially  for 
town-dwellers  and  elderly  people ;  checks  excessive  fermentation  in  aliment¬ 
ary  canal  (R.,  P.).  Chamomile,  hQ)  of  oil,  very  useful  in  atonic  dyspepsia  (P.) 
Ignatia,  useful  in  nervous  dyspepsia  (P.).  Taraxacum,  certainly  does  good  in 
simple  atonic  dyspepsia  (P.).  Belladonna,  gr.  £  to  %  of  the  extract,  once  a 
day  when  there  is  constipation  (R.).  Bismuth,  mixed  with  vegetable  charcoal 
in  flatulent  dyspepsia  (R.) ;  gr.  x  with,  same  quantity  of  calcined  magnesia,  in 
chronic  gastric  catarrh,  where  diet  cannot  be  regulated  (Rose).  Manganese, 
gr.  x-xv  of  the  black  oxide  in  gastrodynia  and  pyrosis  (B.).  Sanguinaria, 
gtt.  ij-v  of  tincture  or  gr.  ^  of  alkaloid,  in  atonic  dyspepsia  promotes  secretion 
and  increases  the  appetite  (B.).  Silver  Oxide,  '/> -grain  doses  with  same  quan¬ 
tity  of  ext.  hyoscyami  before  meals  in  nervous  dyspepsia  (B.).  Xanthoxylum, 
as  stomachic  tonic,  3j  A-  ext.  in  atonic  dyspepsia  (B.).  Simple  Bitters,  calumba 
best,  quassia  or  gentian  or  infusions  of  them  as  vehicles  for  acids  and  alkalies 
(B.).  Calumba  easily  tolerated  when  stomach  weak  (R.).  Gentian  as  stom¬ 
achic  and  tonic  very  useful  in  atonic  dyspepsia,  and  that  of  gouty  subjects. 
The  tinct.  in  some  aromatic  water,  or  in  combination  with  alkalies  and  seda¬ 
tives  (Wa.).  Pepsin,  very  beneficial.  Scheffer’s  or  Beale’s  saccharated  pepsirr 


DYSPEPSIA. 


545 


with  hydrochloric  acid.  Ingluvin  also  promotes  digestion  (B.).  Mineral 
Acids.  Hydrochloric  or  lactic  with  pepsin  after  meals  in  atonic  dyspepsia. 
Hydrochloric  after  meals  for  acid  pyrosis.  Nitro-muriatic  for  dyspepsia  with 
mental  despondency,  oxalate  of  lime  in  urine,  offensive  gas,  sallow  complexion 
(B.,  R.) ;  Phosphoric,  dilute,  very  efficient  before  meals  (Da  C.).  Sulphurous 
Acid,  rrpv-3 j  well  diluted,  for  acid  pyrosis  (B.).  Alkaline  Mineral  Waters, 
before  meals  in  atonic  dyspepsia,  and  highly  useful  in  the  dyspepsia  of  obese 
subjects  (B.).  Alkalies,  shortly  before  a  meal  increase  the  gastric  juice,  and 
are  usually  better  than  acids  in  atonic  dyspepsia.  Sodium  bicarbonate  is  the 
best  (R.) ;  a  full  dose  (gr.  xl-lx),  in  dyspeptic  attacks,  with  flatulence,  etc., 
usually  affords  speedy  relief  (Wa.).  Cascara  Sagrada,  in  all  cases  of  dys¬ 
pepsia,  associated  with  a  torpid  liver  and  constipation  ;  small  doses  at  first, 
gradually  increased  (Wa.).  Chloroform,  gtt.  xv-xx  in  sweetened  water,  when 
rapid  fermentation  of  food  and  evolution  of  gas  soon  after  eating  ;  is  promptly 
efficient  in  giving  relief  (Willis).  Aloes,  combined  with  other  agents,  where 
habitual  constipation  accompanies  dyspepsia  (R.) ;  especially  indicated  in 
duodenal  dyspepsia,  gr.  ij-iv  with  ipecac,  gr.  j-ii,  two  or  three  times  a  week 
(Wa.).  Water.  A  dry  diet  will  entirely  relieve  the  ice-water  dyspepsia,  or 
that  due  to  excessive  beer-drinking  (B.)  ;  half  a  tumbler  of  cold  water  y2  hour 
before  breakfast  acts  to  some  people  as  a  purgative  and  removes  many  dys¬ 
peptic  symptoms,  but  flatulent  dyspepsia  is  often  traceable  to  excessive  water 
drinking  at  meals,  especially  that  of  iced  beverages  (R.).  Hot  Water,  ]/2  a 
pint  to  a  pint  at  uo°-i5o°  F.  an  hour  before  each  meal  and  y2  an  hour  before 
going  to  bed,  each  draught  sipped  slowly  during  15-30  minutes.  As  a  cure 
for  dyspepsia  this  is  an  old  and  efficient  practice  (Wa.).  Milk-cure,  has  suc¬ 
ceeded  admirably  (B.) ;  fresh  buttermilk  a  most  excellent  article  for  dyspep¬ 
tics,  as  also  is  koomis.  Alcohol,  in  any  form,  especially  good  wines,  is  useful 
in  the  atonic  dyspepsia  of  sedentary  livers  (B.) ;  when  loss  of  appetite  and  of 
digestive  power  from  fatigue,  a  glass  of  wine  or  brandy-and-water  before  eating 
is  very  appropriate ;  useful  also  in  indigestion  of  town  dwellers,  or  during  con¬ 
valescence  from  acute  disease  (R.).  Diet.  Avoid  tea  and  hot  beverages, 
over-cooked  food,  over-feeding  and  iced-water  ;  masticate  all  food  well,  eat 
slowly,  small  quantities  and  frequently.  Active  out-of-door  habits  should  be 
cultivated,  and  all  articles  of  food  known  to  disagree  should  be  strictly  avoided. 
[Compare  Acidity,  Biliousness,  Flatulence,  Gastralgia,  Pyrosis.] 


Prescriptions . 


R .  Acidi  Hydroch.  Diluti,  .  .  gjss. 

Glycerini, . 3  ij. 

Syr.  Rubi  Idaei, . jjjss. 

Liq.  Pepsini  (Fairchild),  .  3  lij. 
Spt.  Chloroformi,  . 

Vini  Albi  vel  Xerici, 


ss. 


‘  '  •  Q  . 

q.  s.  ad  3  xij. 

M.  Sig. — A  tablesp.  thrice  daily  after 
meals. 


R.  Tinct.  Nucis  Vom.,  .  .  .  ^jss. 

Ac.  Hydrochlorici  Dil .,  .  .  gijss. 

Glycerini, . Sjj. 

Aquae  Lauro-cerasi,  ...  3  iv. 

M.  Sig. — Dessertsp.  before  meals,  to 
improve  appetite  and  digestion. 


R.  Tinct.  Capsici, . TTLxvj. 

Tinct.  Nucis  Vom.,  .  .  .  %  ij. 

Tinct.  Gentianae  Co.,  .  ad  q  ij. 

M.  Sig. — Ateasp.  in  water  thrice  daily, 
with  gr.  i  Aloin  at  bedtime,  avoiding  a 
starchy  diet.  For  aggravated  dyspepsia 
with  constipation.  ( Da  Costa.) 


R.  Sodii  Bicarb., . _qij. 

Spt.  Ammon.  Aromat.,  .  .  75  ij. 

Tinct.  Zingib., . gj. 

Infusi  Gentianae  Co., 

U.  S.  P.  1870.  q.  s.  ad  %  viij. 

M.  Sig. — Teasp.  or  two  thrice  daily. 
For  acid  dyspepsia. 


R.  Bismuthi  Subnit.,  ....  ."jss. 

Pepsini, . £j. 

Strych.  Sulph., . gr.  j. 

Tinct.  Cardam.  Co.,  .  .  ad  3  iv. 

M.  Sig. — Teasp.  thrice  daily  in  water. 
For  bilious  dyspepsia. 

35 


R.  Pepsini  (Jensen),  ....  %  iijss. 

Ac.  Tartarici, . gr.  v. 

Glycerini, . ,5  jss;  / 

Vini  Xerici, . ad  3  viij. 

M.  Sig. — Teasp.  after  meals. 


DYSPHAGIA - DYSPXCEA. 


546 


R.  Creasoti, . rr^viij . 

Bism.  Subcarb., . £ij. 

Glycerini, 


Aq.  Menth.  Pip.,  .  .  .  aa  ^j. 

M.  Sig. — To  be  well  shaken.  A  teasp. 
every  3,  4  or  6  hours,  for  pain  in  stomach 
and  wind.  (B.) 

R.  Ac.  Hydrochlorici  Dil.,  .  .  gj. 

Tinct.  Capsici, . ss. 

Tinct.  Calumbae,  ....  5  jss. 

Vini  Pepsini, . ad  5  iv. 

M.  Sig. — Dessertsp.  after  meals.  In 
atonic  dyspepsia.  ( Pancoas /.) 


R.  Rhei,  Gentiance,  et  Carda- 

momi,  contus.,  .  .  .  aa^ij. 

Spt.  Vini  Gallici,  .... 

Aquse, . g  vj. 

Macera  per  horas  48,  cola,  et  adde — 
Tinct.  Nucis  Vom.,  .  .  .  ^j. 
Potassii  Carbonat.,  .  .  .  .  zj. 

M.  Sig. — Tablesp.  in  water  thrice  daily,, 
before  meals. 


R.  Tinct.  Gentianae  Co.,  .  .  .  5ij. 
Sig. — Teasp.  in  water  thrice  daily. 


Dysphagia. 

Cocaine,  the  hydrochlorate  in  solution,  20  per  cent.,  as  spray  or  by  swab,  re¬ 
lieves  the  dysphagia  of  phthisical  laryngitis  (P.).  Cajuput  Oil,  in  nervous  dys¬ 
phagia,  used  in  India  with  considerable  success  (P.).  Potassium  Bromide,  for 
congenital  dysphagia  of  liquids  in  children,  when  no  diphtheria  or  malforma¬ 
tion  (R.)  ;  in  hysterical  dysphagia  (Wa.);  benefits  a  curious  affection  sometimes 
seen  in  children,  who  from  their  birth  can  swallow  solids  with  ease  but  choke 
at  liquids  (R.).  Sprays  of  ammonium  bromide,  chlorine  water,  or  other  sedative 
agents  in  warm  solution,  for  the  dysphagia  depending  on  specific  disease  of  the 
larynx  (Muirhead).  Galvanism,  in  the  vicinity  of  the  oesophagus  will  speedily 
remove  hysterical  dysphagia  (Muirhead).  Tonics,  as  strychnine,  iron  and  qui¬ 
nine,  for  post-diphtheritic  dysphagia.  Iced  Fluids,  slowly  swallowed,  will  often 
remove  spasmodic  dysphagia  (Wa.). 


Dyspnoea. 

Morphine,  hypodermically,  the  most  efficient  agent  in  relieving  dyspnoea 
from  cardiac  disease,  or  any  other  form  ;  but  if  albumen  in  the  urine  it  must  be 
withheld  (Allbutt) ;  controls  dyspnoea  from  any  cause,  more  energetically  than 
any  other  agent,  giving  the  very  power  to  breathe  (Huchard).  Grindelia,  of 
great  service  in  dyspnoea  with  cough,  occurring  in  emphysema  (W.).  Cimici- 
fuga,  has  often  relieved  most  distressing  cases  from  cardiac  disease  (P.).  Spigelia 
Anthelmia,  produces  and  often  relieves  it  when  with  palpitations  (P.).  Valerian, 
proved  useful  when  nervous  (P.).  Prunus  Virginiana,  has  proved  very  effica¬ 
cious  in  cardiac  dvspnoea  (P.).  Amyl  Nitrite,  serviceable  in  cardiac  dyspnoea 
and  other  forms  (Wa.).  Asafcetida,  in  combination  with  other  antispasmodics, 
often  very  beneficial  in  the  dyspnoea  of  chronic  bronchitis  (Wa.).  Chloroform, 
a  few  whiffs  give  temporary  relief  in  the  cough  and  dyspnoea  of  phthisis  and 
bronchitis  (Wa.).  Iodide  of  Ethyl,  by  inhalation,  is  very  serviceable  in  many 
forms  (See).  Terpine  Hydrate,  of  especial  value  in  asthmatic  dyspnoea,  gr.  ij 
every  hour  until  gr.  x  are  taken  (Boyland).  Terebene,  for  the  dyspnoea 
of  chronic  emphysema  of  the  lungs;  efficient  in  combating  this  symptom 
of  various  pulmonary  affections.  Arsenic,  for  the  dyspnoea  of  weak  heart. 
Dyspnoea  is  a  symptom,  and  may  be  referable  to  cardiac,  pulmonary,  pharyn¬ 
geal,  laryngeal  or  tracheal  disease  (T.).  [Compare  Asthma,  Bronchitis, 
Croup,  Emphysema,  Phthisis,  etc.] 


Prescriptions. 


R.  Potassii  Iodidi, . gj. 

Tinct.  Lobeliie, . iv 

Syr.  Sanguinarice,  .  .  .  .  ^j. 
M.  Sig. — Teasp.  every  hour. 


R.  Liq.  Morph.  (Magendie),  .  ^j. 
Spt.  Etheris  Compos.,  .  .  gij. 

Syr.  et  Aquee, . ad  5  ij. 

M.  Sig. —  ^ss-j  thrice  daily. 


DYSURIA - ECZEMA. 


547 


Dysuria. 

Cantharis,  gtt.  j  (sometimes  v)  of  tinct.  ter  die,  for  frequent  micturition  with 
pain  (R.).  Irritable  bladder,  vesical  tenesmus  (B.).  Cannabis  Indica,  relieves 
dysuria  (R.)  ;  when  bloody  urine  (P.)  ;  an  excellent  anodyne  in  painful  affec¬ 
tions  of  the  bladder,  having  specific  action  on  that  organ.  Belladonna  and 
Hyoscyamus  have  similar  sedative  effects  in  vesical  and  urethral  irritation  (P.). 
Linseed,  as  infusion,  is  often  a  valuable  adjunct  (P.).  Opium,  in  suppository, 
combined  with  hyoscyamus,  gr.  ij  with  gr.  x,  an  excellent  palliative  (P.)  ;  an 
enema  of  laudanum  or  morphine  hypodermically  to  relieve  the  strangury  caused 
by  blisters  (B.).  Camphor,  is  said  to  relieve  strangury  (R.).  Chimaphila,  has 
undoubted  power  (P.).  Squill  often  produces  the  best  effects,  especially  a  com¬ 
bination  of  the  acetum  with  spt.  etheris  nitrosi,  equal  parts,  of  which  5ss  in  5ij 
anise  water,  every  hour  or  oftener  (Wa.).  Gelsemium,  a  useful  remedy  (B.). 
Ergot,  in  paralytic  dysuria,  with  sensation  of  bladder  being  imperfectly  emptied 
(P.).  Alkalies,  the  citrates,  when  dysuria  from  uric  acid  crystals  in  young  male 
children  (R.).  Nitrous  Ether.  Spt.  etheris  nitrosi  5j-jss  in  any  convenient 
vehicle,  a  popular  and  efficacious  remedy  (Wa.).  Diluent  Drinks,  freely, 
especially  a  decoction  of  uva  ursi,  or  of  cotton-root  (P.).  [Compare  Vesical 
Sedatives,  page  45,  also,  Bladder,  Irritable,  page  496,  and  Cystitis, 
page  529.] 

Ecchymosis. 

Arnica,  rapidly  disperses,  if  administered  shortly  after  injury,  npv-x  in  water 
every  two  or  three  hours  (P.).  Alcohol,  diluted  more  or  less,  according  to  the 
amount  of  irritation  present,  is  a  good  lotion  (P.).  Hamamelis,  the  tincture 
diluted  with  5  to  8  parts  of  water,  as  lotion  when  much  discoloration.  Ammo¬ 
nium  Chloride,  in  solution,  as  lotion  on  lint,  or  with  bread  or  linseed  to  form  a 
poultice,  in  ecchymosis  of  the  eyelids  (Wa.).  [Compare  Bruises,  Purpura.] 

Ecthyma. 

Quinine,  cures,  though  in  many  subjects  will  cause  it  (B.) ;  malnutrition  (R.). 
Lead,  the  liquor  plumbi  subacet.,  £j  ad  Oj  aquae,  a  soothing  application  (Wa.). 
Zinc  Oxide,  the  glycerite,  with  a  little  camphor,  an  excellent  application  (Wa.). 
Cod-liver  Oil,  internally  and  locally  (B.).  Grape-cure,  often  happily  modifies 
(P.).  Borax,  a  solution  in  rose  or  elder-flower  water  (Wa.).  Chlorinated  Lime, 
a  solution  as  a  lotion  (Wilson).  Chrysarobin,  internally,  half-grain  doses,  in 
water  or  pill,  given  with  good  results  (Stocquart). 

Ectropium  and  Entropium. 

Silver  Nitrate,  freely  to  the  exposed  surface,  in  ectropium  of  lower  lid  due  to 
hypertrophy  of  conjunctiva  after  inflammation  (C.).  Collodion,  successfully 
used  in  entropium  to  restore  position  of  the  lid  by  its  contraction.  Should  be 
concentrated  (Wa.).  Faradization,  in  paralytic  ectropium  (C.).  Operative 
Measures,  of  great  variety,  are  in  use,  Arlt’s  being  the  best  for  bad  cases  in  the 
upper  lid  (Roosa).  Epilation  of  lashes  gives  temporary  relief  in  entropium. 

Eczema. 

Mercury,  as  black  and  yellow  wash  in  early  vesicular  and  pustular  conditions. 
Mercurial  ointments  are  the  most  efficient  of  the  local  applications,  especially 
those  of  white  precipitate,  nitrate,  mild  chloride,  and  black  oxide.  Ointments 
of  the  biniodide  or  bichloride  as  irritating  application  in  chronic  indolent  form 
(Pf.).  Brown  citrine  ointment  nightly  in  eczema  of  the  margin  of  the  eyelids 
after  detaching  scales  (B.) ;  very  useful  when  eczema  on  hairy  parts  of  face, 
often  is  best  mixed  with  a  tar  oint.  (R.).  Arsenic,  rr^v  of  Fowler’s  solution  thrice 
daily  on  a  full  stomach,  gradually  diminishing  the  dose  for  chronic  type  (B.)  ; 


548 


ECZEMA. 


especially  in  eczema  of  vulva,  anus  and  scrotum  (R.).  Small  doses  for  acute, 
full  doses  for  chronic  form  ;  the  urine  to  be  closely  watched  and  the  drug  dis¬ 
continued  on  the  least  sign  of  renal  irritation  (Pf.).  Arseniate  of  Sodium, 
hypodermically  into  an  eczematous  patch,  to  change  the  indolent  form  into  an 
active  one  (Pf.).  Rhus  Tox.,  externally  and  internally,  when  burning  and 
itching,  quickly  subdues  in  some  cases  (P.) ;  in  chronic  form  with  rheumatism, 
worse  at  night-time  ;  also  in  acute  cases  if  given  at  the  very  beginning,  rt\/rir_. 
of  a  good  tincture  enough  dose  to  begin  with  (Pf.).  Phosphorus,  of  undoubted 
service  in  eczema  of  long  standing,  probably  acts  as  a  hepatic  stimulant,  gr. 
Tiro  t0  ws  in  °il»  or  reliable  pill  (Pf.).  Viola  Tricolor,  an  infusion  the  best  form, 
with  purgative  doses  of  senna  for  a  few  days,  then  alone,  in  eczema  of  the  head 
and  face;  gives  prompt  results  (good  or  bad),  often  aggravating,  which,  though 
good  in  chronic  forms,  must  be  avoided  in  acute  types  (Pf.).  Calcium  Sulphide, 
gr.  to  in  acute  and  chronic  cases  of  pustular  character,  the  impetigo  of 
old  writers  ;  small  doses  in  acute  form,  larger  ones  in  chronic  cases  (Pf.).  Sul¬ 
phur,  internally  and  sulphides  as  baths,  but  not  in  the  acute  stage  (R.) ;  solution 
of  potassium  sulphide  in  water  locally  (B.).  Liquor  Potassse,  or  a  stronger 
solution  of  potash,  to  infiltrated  patch  of  chronic  eczema,  before  attempting  to 
heal  it  (Pf.).  Croton  Tiglium,  the  seeds  bruised  in  alcohol,  as  liniment  (Wa.); 
the  oil  as  basis  of  stimulating  applications  in  the  chronic  form  (Pf.).  Glycerite 
of  Tannin,  locally  (R.).  Potassium  Iodide,  is  often  efficient  where  a  syphilitic 
history  or  inheritance  can  be  traced.  Salicylic  Acid,  locally,  in  eczema  of  hands 
and  feet  has  been  very  successful  (B.) ;  in  plaster  is  of  very  great  value,  and 
becoming  more  recognized  every  day,  especially  by  Unna,  Pick,  etc.  The  best 
form  is  a  salicylated  soap-plaster  (see  formula  below).  Belladonna,  gr.  %  of 
extract  with  gr.  iij  of  quinine  sulphate  thrice  daily  in  eczema  of  the  hand,  with 
bismuth  subcarbonate  as  a  dusting  powder  (B.).  Zinc  Salts,  the  oxide  and 
carbonate  as  dusting  powder,  or  the  sulphate,  etc.,  in  astringent  ointments 
(Bulkley).  Buckwheat  Flour,  one  of  the  best  dressings;  a  limb  may  be  envel¬ 
oped  in  a  bag  filled  with  the  flour  (Bulkley).  Tar,  internally,  the  pix  liquida  in 
doses  of  gr.  ij-v  thrice  daily,  when  arsenic  fails  to  relieve  or  is  contraindicated  ; 
locally  in  third  stage  when  redness,  dryness  and  scaling.  Oleum  Cadini,  when 
genuine,  is  the  best  form  of  tar,  mixed  with  simple  ointment  (3ss-j  ad  5).  01. 

Rusci  or  Pix  Liquida  may  be  used  (Pf.).  Conium,  the  tincture  may  be  added 
to  one  of  the  ointments  for  the  pruritus,  which  is  usually  very  obstinate.  So 
also  Stramonium  or  crude  Petroleum  (Pf.).  Hamamelis,  locally  as  antipruritic, 
and  in  chronic  eczema  marked  by  decided  venous  retardation  (Pf.).  Benzoin, 
to  allay  itching,  the  compound  tincture  painted  on  the  skin  (R.).  Lead,  soluble 
salts  as  lotions  when  much  inflammation  and  discharge  (R.) ;  also  in  early  vesicu¬ 
lar  and  pustular  conditions.  Diachylon  ointment  comes  next  in  efficiency  to  mer¬ 
curial  ointments  (Pf.).  Zinc,  the  oxide  and  carbonate  as  dusting  powders  (R.) ; 
the  sulphate  with  alum,  glycerin  and  rose-water,  an  excellent  lotion  (B.);  the 
oxide  is  not  curative,  but  as  a  protective  is  the  best  ointment  when  freshly  and 
well  made,  for  use  over  a  large  surface  (Pf.).  Lime-water,  as  sedative  applica¬ 
tion  and  to  check  discharge;  after  inflammation  is  subdued,  lime-water  and 
glycerin  (R.).  Carbolic  Acid,  externally  and  internally  in  chronic  forms  (B.)  ; 
is  analogous  to  tar,  and  suitable  to  the  same  types  of  the  affection  as  the  latter 
is  given  for  (Pf.).  Phytolacca  has  cured  obstinate  cases  (B.).  Graphite,  in 
ointment,  1  to  10,  or  with  some  inert  powder,  as  lycopodium  or  precipitated 
phosphate  of  calcium,  in  fissured  eczema,  especially  that  of  the  hands  and 
behind  ears  (Pf.).  Bismuth,  the  subnitrate  or  subcarbonate  locally  (R.). 
Anacardium  Orientale  (oil  of  Cashew),  as  ointment  in  patches  of  indolent 
chronic  eczema  (Pf.).  Iris  Versicolor,  in  chronic  eczema  of  gouty  patients 
invaluable  as  a  hepatic  stimulant,  rr^v-x  of  tincture  from  the  fresh  root  twice 
daily  (P.).  Glycerin,  locally  at  night  when  caustic  lotions  have  been  used 
(R.).  Electricity  has  cured  obstinate  cases  (B.).  Milk-cure,  when  acid  indi¬ 
gestion  present  (B.).  Water,  locally  is  injurious,  unless  its  sp.  gr.  approaches 
that  of  the  blood  serum.  Rose-water  with  a  little  glycerin  and  sodium  chloride 
when  ablution  necessary  in  second  stage,  that  of  exudation  and  crusting  (Pf.). 
Soaps,  petroleum,  cade  or  carbolic  (R.) ;  sapo  viridis,  to  soften  up  infiltrated 


EMACIATION. 


549 


patches  of  chronic  form,  instead  of  the  potash  solutions  mentioned  above  (Pf.). 
Diet  should  be  largely  vegetable,  especially  those  which  are  eaten  raw.  Cod- 
liver  oil  as  a  supplemental  article  of  diet.  Chaulmoogra  Oil,  in  old  cases  is 
often  of  great  benefit,  as  an  ointment.  The  oil  i  part  to  2  or  more  of  vaseline 
(Wa.).  Oil  of  Cajuput,  put  up  by  mistake  of  druggist  for  oil  of  cade  made  a 
remarkable  cure  in  a  case  which  had  resisted  treatment  for  some  time. 
(Claiborne.) 

Prescriptions. 


Internal. 


R.  Violse  Tricolor, . 5  j. 

Sennoe, . 5  ss* 


M.  Fiant  chartulae  no.  iv. 

Sig. — Make  an  infusion  with  hot  water 
from  each  paper,  and  take  every  night. 

(. Piffard .) 


R .  Emplas.  Diachyli  Simplicis, 

Emplas.  Saponat.,  .  .  aa  p.  xl. 

Petrolati, . p.  xv. 

Acidi  Salicylici, . p.  v. 

Sig. — Emplas.  Salicyl.  Compos.  ( Pick. ) 


R .  Picis  Liquidae, 

Pulv.  Sem.  Anisi,  .  .  .  aa  5  ijss. 
Magnesias  Calcin.,  q.  s. 

M.  Ft.  pil.  no.  c.  Sig. — Two  to  ten 
pills  daily.  ( Miguet .) 


R  .  Vini  Ferri  Amari,  ....  l$jss. 

Syrupi  Tolutani, . g  iij. 

Liq.  Potass.  Arsenit.,  .  .  j. 

Aquae  Anethi, . ^ij. 

M.  Sig.  —  Teasp.  to  dessertsp.  thrice 
daily.  ( Wilson .) 


R.  Ferri  et  Ammon.  Citrat.,  . 

Potassii  Citratis . ^ij. 

Liq.  Potassii  Arsenit.,  .  .  ^j-ij. 
Tinct.  Nucis  Vom.,  .  .  .  ^ij. 
Tinct.  Cinchon.  Comp.,  ad  5  iv. 

M.  Sig  — Teasp.  in  water,  after  meals, 
as  tonic  and  alterative.  ( Bulkley .) 


Local. 

R.  Ung.  Zinci  Oxidi,  •  .  .  .  J|ss. 

Ung.  Plumbi  Subacet  ,  .  .  5  ss. 
Chloralis,  Camphorae,  .  aa  gr.  xv. 

M.  Sig.  —  Use  as  oint.  2  or  3  times 
daily  after  bathing  with  warm  water.  For 
local  use  in  general  eczema.  [Gross.) 


R.  Olei  Cadini, . £ss-j. 

Zinci  Oxidi, . g  ss-j. 

Ung.  Aquae  Rosae,  .  .  .  3  j. 

M.  Sig.  —  Ointment,  antipruritic  and 
mildly  astringent.  [Bulkley.) 


R.  Aluminis, . gr.  xx. 

Zinci  Sulphat., . gr.  x. 

Glycerini, . ^j. 

Aquae  Rosae, . 3  iv. 

M.  Sig. — Lotion.  (B.) 


R.  Liq.  Plumbi  Subacet.,  .  .  $). 

Glycerini, . 3  ss. 

Aq.  Laurocerasi,  ....  5  ijss. 

M.  Sig. — Lotion,  when  there  is  much 
weeping.  (B.) 


R.  01.  Cadini, . ^ss. 

Glycerini . %). 

Ung.  Diachylon,  ....  5  ijss. 

M.  Ft.  unguentum.  In  squamous  ec¬ 
zema  with  thickened  skin.  [Pox.) 


R  .  Hydrarg.  Ammoniat.,  .  .  gr.  xv. 

Glyceriti  Amyli, . y)). 

M.  Ft.  unguentum.  [Muller.) 


Emaciation. 

Calcium  Phosphate,  is  especially  useful  in  chronic  wasting  disease  (R.). 
Arsenic,  is  used  by  cattle-breeders  to  fatten  oxen,  etc.,  quickly  (Tr.).  Iodine, 
improves  the  appetite  and  digestion,  and  gives  strength  and  plumpness  to  the 
body  (Wa.).  Cinchona,  in  small  doses  improves  the  appetite,  and  the  general 
tone  (Wa.).  Iron  Salts,  cause  marked  gain  in  flesh  and  color  (Wa.) ;  remark¬ 
ably  promote  the  appetite  and  digestion  (B.).  Cod-liver  Oil,  internally  and 
externally  with  friction,  often  very  effective  in  the  mal-nutrition  and  marasmus 
of  children  (P.).  Olive  Oil,  by  friction,  daily  inunctions  are  of  value  in  many 
wasting  diseases  (P.).  Pepsin,  to  promote  digestion  of  food  (P.).  [Compare 
Tabes  Mesenterica.] 


550 


EMISSIONS - EMPHYSEMA - EMPYEMA. 


Emissions  and  Erections. 

Belladonna,  when  emissions,  genitalia  relaxed,  atonic  state  (B.) :  in  gradu¬ 
ally  increasing  doses  produces  good  results,  even  in  extreme  cases  of  emis¬ 
sions  (Wa.).  Camphor,  fails  as  often  as  it  succeeds  (P.).  Potassium  Bromide, 
exercises  special  influence  as  a  sedative  in  irritable  states  of  the  genito-urinary 
organs  (Wa.).  Cimicifuga,  as  tonic  to  the  nervous  system,  removes  irritation 
and  melancholy,  procures  sound  and  refreshing  sleep  (Wa.,  P.).  Lupulin, 
useful  to  check  emissions  (P.) ;  gr.  v-x,  or  xv,  to  keep  penis  at  rest  (Wa.). 
Ruta,  in  small  doses  to  limit  discharge  (P.).  Chloral,  at  bed-time,  repeated 
every  night  until  the  habit  is  broken  off  (Wa.).  Iron,  the  tincture  of  the  chlo¬ 
ride  in  5  doses  at  bed-time,  sometimes  conquers  nocturnal  emissions  (Wa.). 
Cocaine,  a  few  drops  of  a  4  per  cent,  solution  upon  the  glans  penis,  promptly 
controls  an  erection.  [Compare  Anaphrodisiacs,  page  47,  also  Chordee, 
Spermatorrhoea.] 


Emphysema  of  the  Lungs. 


Morphine,  gr.  l/e,  and  Atropine,  gr.  t^-q,  hypodermically  for  the  asthmatic 
attacks  :  no  remedy  so  efficient.  The  disease  being  incurable,  treatment  must 
be  chiefly  palliative  (B.).  Potassium  Iodide,  in  full  doses  alone,  or  combined 
with  the  bromide,  affords  most  relief  next  to  morphine  (B.).  Strychnine,  is 
a  valuable  respiratory  stimulant;  useful  where  there  is  constant  dyspnoea  with 
prolonged  expiration  (Wa.).  Stramonium,  the  leaves  smoked  for  the  asthma 
and  dyspnoea  before  retiring,  will  often  give  a  good  night’s  rest  (Wa.).  Am¬ 
monium  Iodide,  with  arsenic,  for  the  bronchitis,  with  copaiba,  turpentine  or 
eucalyptol,  continued  for  some  time  (B.).  Digitalis,  or  hydragogue  cathartics 
as  pulvis  jalapas  comp,  for  the  dropsy  (Da  C.).  Arsenic,  when  connected  with 
recession  of  a  rash  is  esp.  useful  (R.).  Long-continued  it  ameliorates  (B.). 
Terebene,  gives  good  results  upon  the  dyspnoea.  Lobelia,  allays  the  dyspnoea 
which  accompanies  capillary  bronchitis  in  emphysema  (R.).  Senega,  often 
acts  beneficially  (P.).  Cod-liver  Oil,  continued  for  a  long  time  (R.).  Hypo- 
phosphites,  are  useful  (B.).  Chalybeates,  the  phosphate  of  iron,  quinine  and 
strychnine  (B.).  Grindelia,  for  asthmatic  breathing  and  bronchitis  (B.)  ;  of 
great  service  (Wa.).  Chloral,  for  the  short  breath  of  such  patients  brought  on 
by  catching  cold.  If  obstructed  circulation,  caution  required  (R.).  Bleeding 
and  Purging,  have  been  used  with  great  success  in  many  emphysematous  con¬ 
ditions  (R.).  Compressed  Air,  the  only  scientific  remedy  yet  brought  forward 
for  this  disease;  affords  much  relief  which  is  sometimes  permanent  (B.) ;  the 
apparatus  of  Waldenberg  is  the  best  for  this  purpose.  [Compare  Asthma, 
Bronchitis,  Dyspncea.] 

•  Prescriptions . 


R.  Potassii  Iodidi, . £iij. 

Strychnin®  Sulph.,  .  .  .  gr.  j. 

Liq.  Potassii  Arsenit.,  .  .  3  ijss. 

Aquse  Laurocerasi,  .  ad  3  iv. 

M.  Sig. — Teasp.  4  times  daily.  For 
relief  of  dyspnoea,  toning  the  cardiac  action, 
removing  the  bronchial  catarrh,  and  pre 
venting  the  progress  of  the  affection. 

{Hughes  f) 


R.  Potassii  Chlorat.,  ....  3jss. 
Tinct.  Belladon.,  ....  ^jss. 

Ext.  Pruni  Virgin.  Fluidi, 

Tinct.  Cinchon®  Comp.,  aa  5  ij. 

M.  Sig. — A  dessertsp.  4  times  a  day. 
Where  chronic  bronchitis  and  anorexia. 
Dry  cups  also  to  chest  night  and  morning. 

( Da  Costa.) 


Empyema. 

Carbolic  Acid,  a  weak  solution  to  be  injected  after  evacuating  the  pus  (R.). 
Carbolate  of  Iodine,  has  been  injected  with  benefit  (B  ).  Iodine,  in  solution  to 
be  injected  after  tapping  (R.) ;  the  undiluted  tincture  may  be  thrown  in  without 
risk  and  with  great  benefit ;  or  the  compound  solution  ^j  to  3.W  aquas,  as  wash 
for  the  cavity  to  prevent  reformation  of  pus  (B.).  Chlorine- Water,  or  solution 
of  Quinine,  to  wash  out  the  cavity  *(R.).  Salicylic  Acid,  in  solution,  answers 


ENDOCARDITIS - ENDOMETRITIS. 


551 


well  for  the  same  purpose  (P.).  Ammonium  Acetate.  The  official  mistura 
ferri  et  ammonii  acetatis,  with  quinine  and  stimulants,  if  the  affection  shows  a 
tendency  to  linger  (Da  Costa). 


Endocarditis. 


Aconite,  should  be  given  early  in  all  inflammations  of  serous  membranes 
(Wa.) ;  gtt.  or  less,  frequently  (R.);  it  is  rare  to  meet  with  permanent  organic 
heart  disease  as  a  result  of  rheumatic  fever  when  the  disorder  is  treated  with 
aconite  from  its  commencement  (P.).  Spigelia  Anthelmia,  is  very  useful  in 
rheumatic  endocarditis  (P.).  Opium,  in  inflammation  of  serous  membranes 
(B.).  Digitalis,  to  control  the  circulation,  especially  where  irregular  heart 
action  (Da  C.).  Veratrum  Viride,  has  been  used  with  remarkable  effect  on  the 
pulse  (Wa.).  Alkalies,  as  potassium  or  ammonium  carbonate,  freely  until  urine 
is  alkaline,  to  prevent  permanent  changes  about  the  valves  or  orifices  (Da  C.). 
Potassium  Iodide,  to  promote  absorption  of  the  exuded  lymph.  Quinine,  at 
the  onset,  may  check  the  inflammation  (B.).  Salicylic  Acid,  is  useful  in  the 
rheumatic  form  (P.).  Rest  for  some  days  after  active  signs  have  abated,  with 
agents  to  lower  the  blood-pressure  within  the  heart  and  vessels  (Fothergill). 
Leeching,  in  the  acute  inflammation  is  to  be  recommended  if  done  early,  later 
is  useless.  Use  cups  if  no  leeches  are  at  hand  (Da  Costa).  Poultices,  give  great 
relief  and  are  of  decided  benefit  (Da  C.).  Stimulants,  as  ammonium  carbonate, 
etc.,  freely,  if  signs  of  oppressed  circulation  appear  (Da  C.).  Iron,  the  tincture 
of  the  chloride  with  alkalies,  if  pyaemic  symptoms  are  manifested  (Da  C.). 
[Compare  Pericarditis.] 


Endometritis. 


Carbolic  Acid,  undiluted,  on  cotton-wrapped  probe ;  no  better  method  of 
treating  uterine  catarrh  (B.).  Iodine,  the  most  valuable  of  all  local  remedies 
(E.) ;  Churchill’s  tincture  (Iod.  gr.  75,  Pot.  Iod.  gr.  90,  Alcohol  $)),  one  of  the 
most  useful  applications  to  the  endometrium  (Munde).  Iodized  Phenol  (Iod.  j, 
Ac.  Carbol.  iv),  on  cotton-wound  probes,  applied  to  the  uterine  cavity,  has  given 
the  best  results  of  any  agent  used  for  8  years  past  (Battey).  Chromic  Acid,  as 
caustic,  when  slough  is  required;  should  only  be  used  after  dilatation  of  cervi¬ 
cal  canal,  and  at  the  patient’s  house  (Munde);  a  solution  of  gr.  xv  to  3j  of  hot 
water  applied  with  success  to  the  uterine  cavity  for  catarrh  (Wooster).  Nitric 
Acid,  fuming,  to  uterine  cavity  through  intra-uterine  speculum  (Atthill) ;  is  con¬ 
sidered  by  many  the  one  agent  for  all  forms  of  intra-uterine  medication.  Is 
efficient  and  comparatively  safe,  but  produces  too  much  cicatricial  tissue 
(Munde).  Iodoform,  as  suppository  in  rectum  (B.);  in  pencils  to  uterine  canal. 
Iodo-tannin,  locally  in  chronic  cases  (B.).  Ergot,  or  better  Ergotine,  gr.  j,  sub¬ 
cutaneously,  for  the  train  of  uterine  disorders  depending  on  passive  congestion 
of  the  organ  (P.).  See  Hysteria  for  formula.  Glycerin,  as  a  local  application 
introduced  by  Sims,  is  of  great  value  ;  esp.  as  vehicle  for  impure  carbolic  acid, 
iodine,  on  cotton,  or  oakum  (E.).  Hot  Water  injections  in  large  quantity  about 
the  os  uteri,  are  of  great  value  (E.) ;  as  usually  made  are  of  no  value,  must  be 
applied  by  special  syringe,  in  the  dorsal  recumbent  posture  with  elevated  hips, 
at  a  temperature  of  ioo°  to  120°  F.  twice  daily  for  at  least  20  minutes  each  time, 
and  persevered  in  for  months  and  years  (Munde).  [Compare  Uterine  Con¬ 
gestion  and  Hypertrophy.] 


Prescriptions. 


R.  Potassii  Iodidi, 


R.  Ergotini,  . 


.  gr.  xx. 


Potassii  P>romidi,  . 
Tinct.  Iodi,  .  . 
Aquae,  .... 


.  .  aa  gr.  xx. 


Tinct.  Iodi, 
Glycerini,  . 


M.  For  hypodermic  injection  into  cer¬ 
vix,  in  chronic  cervical  metritis. 

{Bennett.') 


M.  For 


M.  Sig. — Apply  twice  daily  with  cam¬ 
el’s  hair  brush,  in  cervical  metritis. 

(Dabney.) 


552 


ENEMATA - ENURESIS. 


Enemata. 


Enemata,  for  an  infant,  3ss-j  ;  child  2  to  5  years,  ^ij-vj  ;  5  to  15  years, 
5vj-0j  ;  adult,  Oj-i  quart.  A  simple  domestic  enema  consists  of  soapsuds  with 
a  little  common  salt,  or  a  pint  of  cold  water  (B.).  Simple  warm  water  or  gruel 
sometimes  ;  or,  to  one  or  the  other  of  these  add  soap,  turpentine  or  castor  oil, 
with  soap  or  gruel  to  suspend  the  two  latter.  Very  cold  water  may  be  used 
without  inconvenience.  Starch,  boiled  or  raw,  of  cream  consistence,  tempera¬ 
ture  ioo°,  with  a  few  drops  of  tinct.  opii,  in  extreme  cases  of  choleraic  diar¬ 
rhoea,  or  that  of  phthisis,  or  typhoid  fever  (R.).  Nutrient  Enemata,  should 
contain  materials  for  artificial  digestion,  as  the  rectum  is  not  an  organ  of  diges¬ 
tion,  and  to  secure  rapid  osmosis  should  have  an  acid  reaction.  A  suitable 
formula  is  appended  below.  Inject  slowly  and  not  frequently ;  five  times  in 
twenty-four  hours  should  be  the  maximum.  Defibrinated  blood  has  also  been 
used  as  a  rectal  injection  with  good  results,  being  completely  absorbed  (B.). 
Should  not  exceed  three  or  four  ounces  of  bland  material,  injected  slowly,  after 
ascertaining  that  the  rectum  is  not  filled  with  faeces  (R.).  [Compare  Enemata, 
ante ,  page  462.] 

Prescriptions. 


Nutrient  Enema. 

BA  Infusi  Carnis  (Beef-tea),  .  3  iv. 
Acidi  Hydrochlorici,  .  .  .  nyx. 
Glyceriti  Pepsini  (Scheffer),  3  ij. 

If  rectum  irritable  add  10  to  20  drops  of 
Laudanum. 


Enema  Ricini  et  Terebinth. 


BA  01.  Ricini, . 3jss- 

01.  Terebinth., . 3  ss. 

Ovum, . no.  j. 

Decocti  Hordei,  vet 

Aq.  Fervid., . 3  xiv. 


Enteritis. 

Opium,  to  the  point  of  tolerance,  is  the  remedy,  the  deodorized  tincture  in 
io-drop  doses  every  second  or  third  hour,  according  to  age  (Da  Costa) ;  of 
great  value  to  control  inflammation  and  quiet  the  intestines  (B.) ;  proves  of 
signal  use  (Wa.).  Aconite,  of  great  utility  in  acute  inflammation  with  high 
temperature,  sthenic  condition,  resisting  pulse  (R.,  P.).  Arsenic,  surprisingly 
curative;  small  doses,  with  opium  (B.).  Podophyllum,  with  occasional  doses 
of  aconite,  will  often  allay  the  vomiting  and  diarrhoea  (P.).  Ricinus  Communis, 
is  employed  with  great  advantage  (P.).  Turpentine,  stupes,  hot,  over  seat  of 
disease,  are  of  manifest  advantage  (Wa.).  Skim-milk,  is  of  the  highest  value 
as  sole  diet  in  acute  inflammation  of  digestive  organs  (B.).  Water,  cold  and 
hot,  principally  cold,  or  ice,  of  unquestionable  advantage  (B.).  Poultices, 
linseed,  large  and  hot  (Wa.) ;  may  be  used  or  not,  as  the  patient  feels  benefit 
from  them  or  otherwise  (Da  C.).  Water,  hot  fomentations  constantly,  fol¬ 
lowed  by  a  wet  compress.  Perfect  quiet  in  bed.  Ice  or  cold  water  freely 
swallowed.  No  food  until  inflammation  subsides,  then  beef-tea,  milk,  gum- 
water,  etc.,  the  very  mildest  and  most  bland  diet  for  four  or  five  days  (Da  C.). 
[Compare  Diarrhcea,  Dysentery,  Cholera,  Peritonitis,  Typhlitis.] 

Enuresis. 

Belladonna,  no  single  remedy  so  uniformly  successful.  Children  require 
large  doses.  A  solution  of  atropine,  best,  gr.  to  (B.).  The  best 
remedy  for  children,  gtt.  x-xx  of  the  tinct.  three  times  a  day.  If  unsuccess¬ 
ful,  and  no  worms  or  other  irritation  exist  try  strychnine,  cantharides,  turpen¬ 
tine,  santonin  or  galvanism  (R.).  Small  doses  are  useless  (P.).  Santonin, 
in  over  doses  produces  incontinence  of  urine  in  children,  but  curiously  will 
sometimes  stay  the  habit,  even  when  not  dependent  on  worms,  and  in  cases 
where  belladonna  fails  (R.);  in  the  enuresis  from  worms  (P.).  Cantharides, 
one  or  two  drops  of  the  tinct.  three  or  four  times  a  day  in  middle-aged  women 
or  the  aged,  even  when  due  to  paralysis  ;  sometimes  also  in  children,  but  for 
them  belladonna  is  generally  better  (R.).  Chloral  Hydrate,  enuresis  in  chil- 


EPIDIDYMITIS - EPILEPSY. 


553 


dren  (R.);  three-grain  doses  thrice  daily  for  infantile  incontinence  (Da  C.). 
Strychnine,  may  succeed  when  above  remedies  fail  (B.) ;  sometimes  useful 
for  old  people  with  paralysis  of  bladder,  also  for  children  (R.,  P.).  Buchu, 
often  successful  in  chronic  enuresis  (P.).  Turpentine,  small  doses  sometimes 
remove  the  trouble  (B.).  Lupulin,  said  to  be  useful ;  Herzfelder  used  it  with 
advantage.  Rhus  Aromatica,  has  proven  curative  in  75  per  cent,  of  cases 
treated  with  it,  and  of  great  benefit  in  the  other  25  per  cent.  The  fluid  ex¬ 
tract,  rr^x-xv  four  times  daily  in  glycerin  and  water  (Stein).  Scutellaria,  re¬ 
markably  efficient  in  many  instances,  3  doses  of  the  fluid  extract  thrice  daily 
for  a  child  of  12  years  old.  Potassium  Nitrate,  has  been  recommended  for 
children  (R.).  Potassium  Bromide,  succeeds  in  some  cases  (Wa.).  Collodion, 
painted  to  form  a  cap  over  end  of  prepuce  (R.).  Ergot,  when  from  paralytic 
state  of  sphincter  (B.);  said  to  be  useful  (R.).  Iron  Iodide,  the  syrup  nbxv-xx, 
well  diluted  with  water,  ter  die,  in  pale,  delicate,  strumous  children  (B.) ;  some¬ 
times  useful  even  when  no  worms  (R.).  Habits.  Children  to  be  taught  to 
retain  water  as  long  as  possible  during  the  day  ;  little  salt  to  be  eaten  ;  absti¬ 
nence  from  fluids  not  necessary ;  bland  fluids  diminish  acridity  of  the  urine. 
Stopping  meat  from  the  diet  has  cured  several  cases  permanently,  after  all 
remedies  had  been  tried  without  success. 


Prescriptions. 


fie.  Strychnime  Sulph.,  .  .  .  gr.  j. 
Pulv.  Cantharidis,  .  .  .  .  gr.  ij. 
Morphinae  Sulph.,  .  .  .  .  gr.  jss. 

Ferri  Reducti, . gr.  xx. 

Ft.  pil.  no.  xl.  Sig. — One  thrice  daily 

to  a  child  of  10  years.  (Gross.) 


R.  Tinct.  Ferri  Chloridi,  .  .  3  ij. 

Ext.  Ergotae  Fluidi,  .  .  .  3  v. 

Spt.  Chloroformi,  .  .  .  .  3  ij. 
Tinct.  Quassiae,  ...  ad  3  iv. 

M.  Sig. — A  teasp.  in  a  winegl.  of  water 
thrice  daily  for  children. 


Epididymitis. 

Aconite,  alternately  with  Pulsatilla,  the  latter  in  very  small  doses,  a  few 
drops  of  tinct.  in  a  glass  of  water,  a  teasp.  every  2  or  3  hours  produces  the 
happiest  effects  (Pf.,  St.).  Belladonna,  the  extract,  3j-ij  ad  gj  of  glycerin  and 
water,  on  lint,  applied  to  the  inflamed  testicle  (Bumstead).  Tobacco,  with  lin¬ 
seed  meal,  as  poultice,  cautiously  (P.).  Mercury  and  Morphine,  locally,  a  20 
per  cent,  oleate  by  inunction,  in  cases  of  syphilitic  origin  (R  ).  Silver  Nitrate, 
^iv  ad  3iv.  aq.  destil.  freely  applied  to  the  scrotum  will  sometimes  abort  an 
epididymitis  (Wa.).  Strapping  and  suspensory  bandage  to  support  the  testi¬ 
cle,  and  rest  it  in  the  recumbent  posture  from  the  beginning,  with  a  saline 
cathartic  to  clear  the  bowels,  are  all  measures  of  great  importance  (Bum- 
stead).  [Compare  Orchitis.] 


Epilepsy. 

Amyl  Nitrite,  inhaled  at  the  beginning  of  the  aura  will  prevent  an  attack 
(B.);  or  n\jj-v  in  mucilage,  when  fits  are  very  frequent  (R.).  Nitro-glycerin, 
TTr hj<  slower  in  action  than  amyl  nitrite,  but  more  enduring  (Pf.).  Ignatia, 
convulsions  unattended  with  cerebral  congestion  (P.).  Par  excellence  the 
controller  of  functional  phenomena  of  the  cerebro-spinal  axis  (Pf.).  Bella¬ 
donna,  in  petit  mal  and  nocturnal  epilepsy,  in  pale  anaemic  subjects,  should 
be  given  for  a  year  or  more  (B.,  Tr.) ;  extr.  and  leaves  i  of  each  in  pill,  every 
day  at  same  hour,  one  additional  pill  every  month  (Tr.).  Useful,  especially 
when  from  fright  (P.).  Atropine  better,  drop-doses  of  a  1  per  cent,  solution 
of  the  neutral  sulphate  in  white  brandy  (Tr.).  Arsenic,  in  epileptiform  ver¬ 
tigo  from  stomach  disorder  (B.) ;  sometimes  useful  (R.).  Chloroform,  by 
inhalation  during  paroxysm  and  also  in  interval  (Wa.) ;  is  of  high  value 
especially  in  cases  of  an  hysterical  character  (Brown-Sequard).  Chloral,  the 
most  suitable  remedy  for  the  nocturnal  variety,  in  full  doses  at  bed-time  (B.). 


554 


EPILEPSY. 


Cannabis  Indica,  has  given  good  results ;  is  suitable  for  petit  mal,  the  nocturnal 
variety,  and  with  strychnine,  belladonna,  or  picrotoxin,  for  cases  characterized 
by  anaemia  and  depression  (B.).  Quinine,  when  of  malarial  origin  (P.)  ;  often 
useful  in  intermittent  epilepsy  (Ros.).  Silver  Nitrate  is  not  without  efficacy,  and 
was  formerly  much  used,  but  the  danger  of  staining  the  skin  has  caused  its 
disuse,  especially  as  better  agents  have  been  found  (\Va.).  Picrotoxin,  anaemic 
subjects,  attacks  occurring  at  night,  to  ^  of  a  grain  hypoderm.,  or  to  yC 
by  stomach  (B.).  Benefits  cases  resulting  from  onanism  (P.).  Copper  Salts, 
may  be  useful  in  cases  originating  from  stomach,  formerly  much  used  (B.)  ; 
the  nitrate  or  oxide  often  given  with  benefit  (R.).  Strychnine,  idiopathic 
epilepsy,  injurious  in  symptomatic.  Benefits  when  bromide  of  potassium  fails. 
Cerebral  anaemia;  nocturnal  epilepsy  (S.,  Pf.) ;  if  bromides  fail  and  case  is 
anaemic,  give  Strychnine,  gr.  ter  die,  and  push  it  (B.).  Sodium  Bromide, 
gr.  xx  ter  die,  will  arrest  epilepsy  without  producing  the  cerebral  symptoms  of 
bromism  (Clymer).  Potassium  Bromide,  gr.  xl  ter  die  before  meals,  double 
dose  at  bed-time,  for  two  or  more  years  after  all  epileptic  indications  have 
ceased.  Is  generally  useful,  especially  in  daytime  seizures  and  grand  mal  of 
sexual  origin  ;  also  for  infantile  convulsions  (B.) ;  especially  in  convulsive 
form,  but  often  powerless  (R.).  Digitalis,  trpx  of  the  tincture,  with  gr.  xx  of 
potas.  brom.  thrice  daily,  in  cases  complicated  with  cardiac  dilatation  (Gowers). 
Lithium  Bromide,  Ass  daily,  acts  in  some  cases  after  pot.  brom.  has  failed, 
and  is  generally  efficient  in  about  one-half  the  dose  of  the  latter  salt  (S.  Weir 
Mitchell).  Nickel  Bromide,  gr.  v  thrice  daily,  is  remarkably  efficient  in  the 
epilepsy  occurring  at  the  menstrual  epoch,  and  those  which  have  withstood 
the  action  of  the  other  bromides  (Da  Costa).  Ferrum  Bromide  will  often  cure 
cases  in  weak  and  anaemic  subjects;  also  with  potassium  bromide  to  combat 
the  anaemia  and  depression  produced  by  the  latter  (B.).  Zinc  Oxide,  probably 
useful  only  in  cases  originating  from  the  stomach.  Much  said  for  and  against 
it  (B.,  R.).  Turpentine,  has  long  been  used,  when  due  to  reflex  impression  of 
intestinal  parasites  (B.).  Conium,  not  equal  to  the  bromides  (B.)  ;  not  of  much 
value  (P.).  Valerian,  has  been  used  with  some  advantage  (R.).  Bryonia,  has 
an  ancient  reputation  (P.).  Rue,  may  benefit  when  seminal  emissions  (P.). 
Anaesthetics,  are  rarely  called  for  (W.).  Fats  and  Oils,  especially  cod-liver 
oil  when  faulty  assimilation  exists  (B.).  Galvanism,  only  in  idiopathic  epilepsy 
(B.).  Meat  Diet,  in  many  cases  must  be  prohibited  entirely  (B.).  [Compare 
Convulsions.] 


Prescriptions. 


R .  Potassii  Bromidi,  .  .  .  .  5  ss. 

Sodii  Bromidi, . a  ss. 

Liq.  Potas.  Arsenitis,  ...  5  ss. 

Ext.  Conii  FI., . rt\L 

Aquae  Cinnamomi,  .  .  .  .  A  ij. 


Infus.  Gentian.  Co.,  .  .  ad  j|viij. 

M.  Sig. — Tablesp.  two  hours  after  each 
meal. 


R. 

Potassii  Bromidi,  .  .  . 

•  oJ- 

Ferri  Bromidi,  .... 

.  ST  iv. 

Aquae, . 

•  Sd- 

Syrupi  Simplicis,  .  .  . 

•  ,5  VJ- 

M 

t.  Sig. — Tablesp.  twice  d 

aily. 

R. 

Strychninae  Sulphatis, 

•  gr-j- 

Acidi  Sulph.  Dil.,  .  .  . 

Aquae  Destill.,  .... 

.  A  tv. 

M.  Sig. — Teasp.  after  each  meal,  gradu¬ 
ally  increased  to  a  dessertsp. 


R .  Potassii  Bromidi, 

Sodii  Bromidi, 

Ammonii  Bromidi,  .  .  aa  ^iij. 
Potassii  Iodidi, 

Ammonii  Iodidi,  .  .  .  aa  Ajss. 
Ammonii  Carbonat.,  .  .  .  A  j. 

Tinct.  Calumbae,  ....  Ajss. 

Aqute, . q.  s.  ad  g  viij. 

M.  Sig. — A  teasp.  and  a  haif  before 
each  meal,  and  three  teasp.  at  bed  time. 

(. Brou'n-Sequard .) 


R .  Potassii  Bromidi, 

Ammonii  Brom.,  .  .  .  aa  A  ij . 

Ext.  Ergotae  FI.,  .  .  .  .  Sj. 

Aq.  Cinnamomi,  .  .  .  ad  5  viij. 

M.  Sig. —  Dessertsp.  in  water  thrice 
daily.  When  maniacal  excitement  and 
danger  of  cerebral  hemorrhage.  [Smith i) 


EPISTAXIS - ERUPTIONS - ERYSIPELAS. 


555 


Epistaxis. 

Aconite,  has  been  used  with  the  best  results  (P.) ;  small  frequent  doses 
quickly  check  epistaxis  in  children  and  plethoric  people  (R.).  Arnica,  is  of 
great  service  when  from  mechanical  violence  (P.).  Belladonna,  when  of  con¬ 
gestive  origin  (P.).  Ipecacuanha,  has  been  highly  praised  (R.)  ;  acts  upon  the 
vessels  (B.) ;  gr.  j-ij  every  quarter  hour  until  nausea  is  felt,  but  vomiting  need 
not  be  excited  (Wa.).  Hamamelis,  venous  hemorrhage  (Pf.,  R.).  Ergot, 
5ss-3j  of  fresh  powdered  ergot,  or  £j-3ij  of  flu.  ext.  every  half  hour  or  hour, 
necessary  in  urgent  cases  (B.).  Alum,  injected  or  snuffed  up  in  powder  (R.). 
Iron  Spray,  in  obstinate  cases  liq.  ferri  subsulph.  ^j-^viij  aquae  by  spray  or 
injection.  The  tinct.  of  the  chloride  also  useful  (B.) ;  diluted  3(j  in  3vj  injected 
into  the  nostrils  is  often  effectual  (Wa.).  Tannin,  finely  powdered,  blown  into 
the  nostrils  through  a  quill  (Wa.);  a  strong  solution,  £ij  ad  ^iv,  by  nasal 
syringe  (B.).  Turpentine,  may  be  given  internally  with  advantage  (Wa.)  ; 
especially  in  debilitated  conditions  (B.).  Lead  Acetate,  gr.  ij-iv  with  opium 
gr.  ss-j,  proves  signally  useful  (Wa.).  Vinegar,  on  lint  introduced  into  the 
nostrils,  sometimes  highly  efficient  (Wa.).  Digitalis,  is  of  undoubted  benefit 
(B)  ;  the  infusion  best  (R.).  Transfusion,  when  death  from  exhaustion  is  ap¬ 
parently  imminent  (B.).  Facial  Artery,  compression  of  (R.).  Sundry.  Keep 
head  elevated  and  cool ;  warm  the  feet  and  hands  by  plunging  into  hot  water  ; 
apply  ice  over  the  nose;  resort  at  once  to  the  tampon,  if  bleeding  becomes 
alarming.  [Compare  Hemorrhage,  for  formulae.] 

Eruptions. 

The  following-named  Drugs  produce  the  eruptions  indicated  respectively 
after  each,  viz. — Aconite — vesicular  exanthemata.  Arsenic,  erythema  and 
papules,  vesicles  and  pustules.  Belladonna — as  Quinine.  Bromide  of  Potas¬ 
sium — papules,  pustules,  deep  tubercles  with  ecchymoses,  ulcers,  pemphigus. 
Cinchona — as  Quinine.  Carbolic  Acid — erythema.  Chloral — erythema,  itch¬ 
ing,  desquamation,  eczema,  purpura  and  petechia.  Copaiba  and  Cubebs — 
pemphigus,  erythema,  eczema.  Cod-liver  Oil — acne.  Digitalis — erythema 
after  long  usage.  Iodide  of  Potassium — papules,  vesicles,  pustules,  eczema, 
ecthyma,  ecchymoses  and  purpura.  Mercury — erythema,  eczema.  Opium 
and  Morphine — erythema,  papular  eruption  with  marked  desquamation  and 
itching.  Phosphorus — purpura.  Quinine — erythema,  scarlatina,  papular  ery¬ 
thema,  hemorrhagic  purpura,  pemphigus  and  prurigo.  Rhus  Toxicodendron 
(and  other  varieties  of  Sumach) — vesicles,  perhaps  pustules,  with  redness, 
swelling  and  intolerable  itching.  Salicylic  Acid — purpura,  pemphigus,  vesi¬ 
cular  angina.  Santonin — pemphigus,  vesicles.  Stramonium — as  Quinine. 
Strychnine — as  Quinine.  Turpentine — as  Copaiba. 

Articles  of  Food  producing  eruptions  are — Acid  Fruits — may  cause  acute 
eczema.  Strawberries — urticaria.  Apples — acneform  efflorescence  about  the 
mouth.  Walnuts — inflammation  of  buccal  mucous  membrane.  Shell-fish — 
urticaria.  Roast  Turkey — in  one  case  caused  great  urticaria.  Lager  Beer — 
acne  in  some.  Alcohol — aggravates  cutaneous  inflammations.  Butter,  Oat¬ 
meal,  Buck-wheat,  Fish — are  popularly  credited  with  causing  eruptions,  but 
there  is  no  evidence  therefor. 


Erysipelas. 

Pilocarpine,  to  abort  the  disease,  very  efficient  if  used  early,  gr.  x/e  hypoder¬ 
mically,  or  fluid  extract  of  Jaborandi  internally  :  when  free  diaphoresis  occurs, 
the  temperature  and  pulse  fall  to  normal,  and  the  disease  is  checked.  Not 
suitable  to  debilitated  cases,  or  those  with  a  weak  heart  (Da  Costa).  Aconite, 
a  favorite  remedy  with  Liston,  if  used  at  beginning,  when  fever  high  (Wa.)  ; 
no  more  useful  agent  in  idiopathic  erysipelas,  especially  facial,  and  cases  of 
sthenic  type  (B.) ;  at  onset,  often  cuts  the  attack  short;  is  very  useful  in  the 
erysipelas  following  vaccination  (R.) ;  very  valuable  in  sthenic  cases  (P.) ;  espe¬ 
cially  so  in  traumatic  erysipelas  (Tr.).  Belladonna,  r^v  of  tincture  in  water 


556 


ERYSIPELAS. 


every  hour  for  five  or  six  doses,  also  locally ;  has  astonishing  power  in  super¬ 
ficial  and  non-vesicular  forms,  also  when  erysipelas  attacks  the  brain,  and  in 
the  phlegmonous  type  (P.) ;  for  similar  indications  as  noted  under  Aconite,  also 
when  adynamia  ;  if  much  fever,  combine  it  with  digitalis  or  aconite  ;  when  much 
depression,  give  it  with  quinine  ;  gr.  %  of  the  extract  with  gr.  ij  of  quininae 
sulph.  every  3  or  4  hours  (B.) ;  the  extract  with  glycerin,  equal  parts,  spread 
thickly  over  the  surface  (Ouain) ;  should  be  used  both  internally  and  externally, 
and  may  be  combined  with  aconite  (R.).  Iron,  Tincture  of  the  Chloride,  the 
nearest  to  a  specific  yet  discovered ;  the  remedy  of  most  service,  any  man 
being  decidedly  to  blame  who  neglects  its  use  ;  requires  decided  doses,  gtt.  xl 
every  4  hours  (Da  Costa) ;  treatment  by  it  very  general,  but  questionable  (B.) ; 
should  be  given  with  shorter  intervals  than  4  hours  (R.)  ;  is  very  successful  in 
this  disease  (P.) ;  ten-drops  doses  every  hour,  or  rr^xl  every  4  hours  (Ouain).  Is 
also  used  locally  with  much  success,  being  painted  over  the  surface  in  full 
strength.  Quinine,  may  be  given  with  the  iron  ;  also  alone  if  thoracic  compli¬ 
cations,  wherein  iron  might  be  contra-indicated  (Da  Costa) ;  if  pulse  soft  and 
tremulous,  or  very  rapid,  low  muttering  delirium  (D.) ;  a  combination  of  qui¬ 
nine  and  tincture  of  the  chloride  of  iron  offers  special  advantages  (Wa.) ;  in 
the  more  severe  cases  to  sustain  the  vital  powers,  and  prevent  cerebral  embol¬ 
ism  ;  but  large  doses,  gr.  v-xx  every  4  hours,  are  alone  of  any  use  (B.).  Am¬ 
monium  Carbonate,  when  feeble  circulation,  cyanosis  and  delirium  ;  also  when 
any  signs  of  embolism  appear  (B.) ;  highly  useful  in  debilitated  subjects  (Wa.) ; 
after  free  purgation  the  continued  use  of  this  salt  is  all  that  is  needed  in  most 
cases  (Sir  T.  Watson).  Potassium  Iodide,  with  agents  to  secure  free  action  of 
the  bowels,  skin  and  kidneys,  the  only  efficient  treatment  in  erysipelas  ambu- 
lans,  in  which  iron  and  quinine  are  useless  (Da  C.).  Antipyrin,  is  particularly 
efficient  when  hyperpyrexia  (Ernst).  Rhus  Tox.,  a  very  useful  remedy  in  the 
vesicular  form  (P.).  Tartar  Emetic,  in  doses  of  gr.  y1^  frequently  repeated, 
renders  incontestable  service  (B.).  Calomel  and  Jalap,  as  purgative  at  onset, 
followed  in  4  or  5  hours  by  magnesium  sulphate,  gss  (Da  C.).  Chloral,  is  an 
admirable  adjunct  to  give  sleep  at  night  (Da  C.).  Turpentine,  as  a  stimulant 
in  traumatic  erysipelas,  more  generally  serviceable  than  alcohol  (B.). 

Local  Applications.  Silver  Nitrate,  by  Higginbotham’s  method  in  trau¬ 
matic  form  ;  gr.  lxxx  of  the  brittle  stick  dissolved  in  giv  of  water  and  painted 
2  or  3  times  over  inflamed  surface  and  beyond,  after  careful  washing  and  drying 
(R.)  ;  no  agent  more  useful  in  subduing  external  inflammation.  Iodine,  painted 
over  affected  and  neighboring  surface,  to  prevent  spreading  (R.).  Iodized 
Collodion,  very  successful  as  a  local  application,  see  formula  below.  Collo¬ 
dion,  a  thick  coating  relieves  (B.).  Digitalis,  an  infusion  locally  is  of  much 
service  applied  as  a  lotion  (R.).  Sulphurous  Acid,  and  glycerin,  equal  parts, 
or  a  solution  of  Sodium  Bisulphite  (Dewar).  Zinc,  Benzoated,  as  ointment,  or 
the  unguentum  zinci  oxidi,  anything  to  exclude  the  air,  and  whichever  one  is 
most  agreeable  to  the  patient  (Da  C.).  Bismuth,  the  ointment  of  the  oleate,  a 
very  certain  application  to  allay  itching  and  burning,  lessen  pain,  etc.  (Shoe¬ 
maker).  Oil,  by  inunction,  is  very  grateful  in  simple  erysipelas  (B.).  Oil  of 
Turpentine,  painted  over  surface  is  said  to  be  remarkably  efficient.  Vaseline, 
lard,  or  mercurial  ointment,  diluted,  gj  to  gj  of  vaseline;  the  simplest  applica¬ 
tions  are  the  best  (B.).  Carbolic  Acid,  one  part,  with  8  to  14  parts  of  oleic  acid, 
locally  by  inunction  for  3  or  4  minutes  every  ^  hour,  all  around  the  edge  of 
the  diseased  part  until  it  ceases  to  spread  (Jacobi).  Cotton  Wool,  sprinkled 
with  flour  or  a  mixture  of  starch  and  zinc  oxide,  is  a  good  application  (B.). 
Earth,  clean  yellow  clay,  free  from  grit  or  sand,  and  powdered,  applied  directly 
to  the  skin  in  the  form  of  a  smooth  paste,  made  by  mixing  it  with  water,  the 
best  of  all  applications,  having  properties  of  antiseptic,  antiphlogistic,  anti¬ 
pyretic  and  antimorbific  nature  (Hewson). 

Tracheotomy,  promptly  if  oedema  of  glottis  occurs,  the  operation  giving  time 
for  inflammation  to  subside  (Da  C.).  incisions,  may  be  necessary  in  traumatic 
erysipelas,  when  limb  is  greatly  swollen  andinflamed;  also  in  the  phlegmonous 
variety  (Da  C.).  Diet,  a  milk-diet  is  generally  suitable  ;  should  be  light  but 
nutritious  (R.)  ;  feed  the  patient  well  (Da  Costa).  [Compare  Phlegmon.] 


ERYTHEMA - EXHAUSTION. 


557 


Prescriptions. 


; .  Quininae  Sulphatis,  .  .  . 

5SS. 

Ext.  Belladonnas,  .... 

gr.  ijss. 

Ft.  pil.  no.  xx.  Sig. — Two  pills  every 

hours,  where  much  depression. 

(B.) 

; .  Quininae  Sulphatis,  .  .  . 

El 

Ac.  Sulphurici  Dil.,  q.  s. 

Aquae, . 

.ru- 

Tincturae  Ferri  Chlor.,  .  . 

0 ss* 

Spt.  Chloroformi,  .... 

E  v j  • 

Glycerini,  .  .  .  .  q.  s.  ad 

5 1V* 

M.  Sig. — A  teasp.  in  water  every  two 
hours.  ( Loomis .) 


R.  Tinct.  Ferri  Chloridi,  .  .  ^j. 

Syrupi  Tolutani,  .  .  .  .  ,|j. 

Liq.  Potassii  Citratis,  .  .  .  5  iv. 

M.  Sig. — Teasp.  to  tablesp.,  according 
to  age,jsvery  3  hours.  ajj  =  rr\x,  gij  =  | 
rtpxx,  5  ss  =  11^x1.  {Anderson.) 


R.  Tinct.  Ferri  Chlor.,  .  .  .  3  ij— iij. 
Glycerini,  Aquae,  .  .  .  aa  %  j. 

M.  Sig. — Teasp.  every  2  hours  for  chil¬ 
dren.  ( Gibney .) 


For  Local  Use. 

R .  Aitheris, 

Alcoholis, . aa  5  v. 

Pyroxylini, . gj. 

Solve,  et  adde — 

Ammonii  Iod., . gr.  xl. 

Cadmii  Iod., 

Cadmii  Brom.,  .  .  .  .  aa  gr.  xx. 

M.  Sig. — For  local  use  with  a  camel’s- 
hair  pencil.  If  the  cadmium  salts  are  not 
to  be  had  use  3  j  Amm.  Iod.,  and  gr.  xx 
Pot.  or  Amm.  Bromide.  ( Humphreys .) 


R .  Plumbi  Acetatis, 

Ammonii  Carb.,  .  .  .  aa  gj. 


Aquae  Rosas, . ~  viij. 

Ft.  lotio.  Sig. — Apply  on  lint,  to  allay 
irritation.  (Pearl.) 


R  .  Acid.  Carbol., 

Alcoholis, . aa  ^ij. 

01.  Terebinth., . ^iv. 

Tinct.  Iodi, . £  ij. 

Glycerini,  .  .* . g  x. 


M.  Sig. — Brush  over  surface  every  2 
hours,  and  cover  with  a  thin  layer  of  wad¬ 
ding. 


Erythema. 

Belladonna,  useful  in  cases  resisting  ordinary  treatment  (B.).  Quinine,  the 
most  valued  remedy  in  erythema  nodosum  (B.).  Rhus  Toxicodendron,  a  valu¬ 
able  remedy  (P.).  Zinc  Sulphate,  as  lotion,  with  alum  and  glycerin.  See 
Eczema,  for  formula;  or  the  Acetate,  in  ointment,  see  below.  Bismuth,  dusted 
over  erythema  about  genitals  of  infants  soothes  pain  and  promotes  healing  (B.). 
Mineral  Acids,  nitric  and  nitro-hydrochloric,  have  been  advantageously  used 
when  from  imperfect  digestion  (B.).  Dusting  Powders,  of  starch,  lycopodium 
or  buckwheat  Hour  are  very  useful. 


Prescriptions. 


R .  Plumbi  Carbonatis, 

Bismuthi  Subnit.,  .  .  .  aa  3 j. 
Sodii  Bicarbonat.,  .  .  .  .  3  ss. 
Ung.  Zinci  Oxidi  Benz.,  .  5  ij. 
Ft.  unguentum.  Sig. —  Local  use. 


R  .  Zinci  Acetatis, . gr.  ij. 

Aquae  Rosae . 3 j. 

Ung.  Aquae  Rosae,  ....  Jj. 
M.  Sig. — Ointment. 


Exhaustion. 

Arnica,  a  few  drops  internally  for  aching  of  the  muscles  (R.) ;  in  nerve  pros¬ 
tration  with  general  aching  from  over-fatigue  (P.).  Phosphorus,  for  physical  or 
mental  exhaustion  ;  also  in  depression  from  over-work  (R.).  Calcium  Phosphate, 
combined  with  Calcium  Carbonate  and  Phosphate  of  Iron,  gr.  j  of  each  for  a 
dose  (R.).  Potassium  Bromide,  when  insomnia,  bad  dreams  and  irritability 
(R.).  Opium,  gtt.  j  of  laudanum  with  2  or  3  of  the  tinctura  nucis  vomicae,  3  or 
4  times  a  day,  for  symptoms  of  exhaustion  with  headaches,  flushing  and  dys¬ 
pepsia  (R.).  Ammonia,  internally  ;  its  influence  is  but  brief  (R.).  Coffee  or  Tea, 
in  hot  or  cold  climates  (R.).  Castor,  is  serviceable,  but  seldom  used  (P.).  Musk, 


553 


EXOPHTHALMOS — EXOSTOSIS - EYE-DISEASES. 


benefits  all  forms  of  nerve-exhaustion  (P.).  Cimicifuga,  for  headache  from 
over-study  or  excessive  fatigue  (R.).  Alcohol,  of  value  in  all  conditions  of 
fatigue  (P.).  Coca,  lessens  the  sense  of  fatigue  under  exertion,  relieves  thirst, 
and  obviates  the  effects  of  a  too  rarefied  atmosphere  ;  is  suitable  for  weakly 
subjects  easily  fatigued,  and  to  convalescents  (P.).  Cocaine,  has  been  used 
successfully  in  exhaustion  from  sunstroke,  loss  of  blood,  and  diarrhoea  (P.). 
Wet  Sheet,  dripping,  cold,  as  a  restorative,  and  to  prevent  aching  of  muscles 
(R.).  Sea  Bathing,  is  also  valuable  (R.).  Habits,  change  of  occupation 
better  than  absolute  rest.  [Compare  Adynamia,  Convalescence,  Insomnia, 
Myalgia.] 

Exophthalmos. 

Belladonna,  rrpv  of  tincture  hourly,  of  great  service  (R.) ;  results  recorded  from 
its  use  are  very  remarkable,  but  Digitalis  will  usually  answer  better  (P.).  Duboi¬ 
sine,  gr.  of  the  sulphate  2  or  3  times  daily,  has  produced  remarkable  results 
in  one  case  (Hunt).  Opium,  may  be  of  use  in  some  cases  (P.).  Digitalis,  to 
raise  the  arterial  tension  and  slow  the  heart,  decidedly  ameliorative  in  young 
subjects  (B.).  To  tranquillize  the  heart  is  the  main  indication.  Iron,  with  Digi¬ 
talis,  seems  to  do  more  good  than  any  other  medicines  (Da  Costa).  Chalybeate 
Waters,  are  beneficial  (B.).  Convallaria,  ameliorates  the  painful  palpitation 
(YVa.).  Galvanism,  of  the  cervical  sympathetic  and  pneumogastric,  and  eyes 
and  thyroid  gland,  is  decidedly  curative  in  uncomplicated  cases  (B.). 

Exostosis. 

Potassium  Iodide,  may  promote  absorption  when  recent ;  also  friction  with 
ointment  of  Mercury  or  Iodine  (D.).  Aconite,  was  used  by  Storck  (P.).  Mer¬ 
cury,  a  moderate  course  of  mercurials  may  be  effectual,  when  exostoses  due  to 
a  blow  or  from  syphilis  (D.).  Exostoses  of  clavicles  in  children  almost  always 
disappear  themselves  (D.).  Excision  if  required  (MacCormac). 

Eye-Diseases. 

Belladonna,  locally  and  internally  in  iritis,  conjunctivitis  and  other  inflam¬ 
mations.  Atropine,  in  iritis,  locally;  hypodermically,  in  glaucoma  (R.)  ;  the 
best  application  in  inflammatory  conditions  generally.  Euphrasia,  had  an 
extended  reputation  in  Germany,  is  a  mild  astringent,  and  of  service  in  catar¬ 
rhal  conjunctivitis  (P.).  Pulsatilla,  as  lotion  in  inflammations  and  ophthalmic 
cases  (P.).  Santonin,  gives  good  results  in  inflammatory  and  atrophic  condi¬ 
tions  of  the  retina  and  optic  nerve,  and  the  stage  of  effusion  of  many  other 
inflammations  (Wa.).  Ruta,  minim  doses,  night  and  morning,  in  dimness  of 
vision  depending  on  functional  amaurotic  condition,  produces  good  results  (P.). 
Physostigma,  topically,  to  contract  pupils;  to  reduce  excessive  atropinization. 
Stimulates  the  third  nerve  (P.).  Strychnine,  hypodermically  in  muscular 
asthenopia,  amblyopia,  amaurosis,  and  in  progressive  nerve-atrophy  not  de¬ 
pendent  on  intercranial  diseases  (R.).  Increases  the  sensibility  of  the  eye,  the 
field  of  vision  becoming  extended,  and  the  vision  more  acute  (Br.).  Ergot, 
useful  in  many  eye  affections,  especially  disturbances  of  accommodation,  acute 
and  chronic  inflammations,  and  the  blepharitis  and  pustular  conjunctivitis  of 
children  (Wa.).  Is  myotic.  Pilocarpus,  is  used  with  great  benefit  in  many  eye- 
affections,  particularly  amblyopia  from  alcohol  and  tobacco,  detachment  of  the 
retina,  chronic  iritis,  keratitis,  hemorrhage  into  the  vitreous,  glaucoma,  muscse, 
atrophic  choroiditis,  hemorrhages  of  the  retina,  white  atrophy  of  the  optic 
nerves,  and  inflammatory  affections  with  effusion  and  exudation  to  promote 
resolution  and  absorption  (Wecker).  Cocaine,  as  a  local  anaesthetic  in  oph¬ 
thalmic  surgery,  a  4  per  cent,  solution,  by  instillation,  sometimes  injection 
required,  as  into  the  muscles  for  squint  operation.  Is  mydriatic,  and  in  rare 
cases  panophthalmitis  has  resulted  after  operations  under  cocaine  (R.).  Chlo¬ 
roform,  vapor,  close  to  a  photophobic  eye,  relieves  (R.).  Oleate  of  Mercury 


EYELIDS - FEET. 


559 


and  Morphine,  outside  the  eye  in  palpebral  conjunctivitis,  and  stye;  also  in 
syphilitic  iritis  (R.).  Silver  Nitrate,  Copper  and  Zinc  Salts,  are  much  used 
(B.).  [See  Conjunctivitis,  etc.  Compare  Mydriatics,  Myotics,  pages  28,  29 ; 
also  in  this  section  the  titles  Amaurosis,  Asthenopia,  Cataract,  Conjuncti¬ 
vitis,  Corneal  Opacities,  Glaucoma,  Iritis,  Keratitis,  Myopia,  Ophthal¬ 
mia,  Photophobia,  Retina,  Strabismus,  etc.] 

Eyelids. 

Calomel,  locally,  or  brown  citrine  ointment,  as  application  in  many  diseases 
(B.).  Mercury  and  Morphine,  the  20  per  cent,  ointment  with  lard,  outside  lid, 
for  stye  (R.).  Pulsatilla,  internally,  and  externally  as  wash,  in  ophthalmic 
cases  and  inflammations;  the  so-called  “  stye  ”  may  often  be  aborted  by  this 
treatment  (P.).  Cadmium,  much  esteemed  as  collyrium,  gr.  ij  of  sulphate  to 
5j  aquae  rosae  (R.).  -Zinc  and  Copper  Sulphates,  are  esteemed  applications 
(B.).  [See  Conjunctivitis  for  formulae.]  Ergot,  an  aqueous  infusion,  as  a 
collyrium,  in  ptosis  and  paralysis  of  the  eyelids  (Wa.).  Tannin,  a  strong 
solution  (1  to  3  aquae),  locally  ;  or  a  weaker  solution  (1  to  20,  30  or  50  aquae), 
is  much  employed.  Also  used  in  pomade,  or  as  fine  powder  (Wa.).  Veratrine, 
in  solution,  brushed  over  lids  once  daily  in  painful  spasmodic  contraction  of  the 
orbicularis  (Wa.).  Ammonium  Chloride,  in  solution  as  lotion,  for  ecchymosis 
of  eyelids,  vulgarly  known  as  “black  eye.”  [See  Ecchymosis,  Blepharitis, 
Conjunctivitis,  Ptosis,  Ectropium,  etc.] 

Face. 

Amyl  Nitrite,  tAtu  to  in  30  times  its  volume  of  spirits,  for  flushing  of  face, 
or  sensation  of  flushing,  with  cold  feet  and  hands,  and  great  prostration,  chiefly 
in  women  at  change  of  life  (R.).  Curare,  effective  in  facial  spasm,  when  other 
remedies  failed  (P.).  Blisters,  behind  the  ear,  in  facial  palsy,  followed  by  warm 
covering  to  part  (H.).  Strychnine,  has  improved  some  cases  of  facial  palsy 
(P.).  [Compare  Neuralgia,  Odontalgia,  Tic-Douloureux.] 

False  Pains. 

Tartar  Emetic,  combined  with  small  doses  of  opium,  together  with  external 
fomentations,  where  evidence  of  congestion  (L.).  Opiates,  to  allay  uterine 
irritation,  after  rectifying  any  derangement  of  bowels  (L.).  Opium,  is  valuable, 
having  specific  action  on  uterine  muscular  fibres,  relaxing  some,  stimulating 
others  (Wa.). 

Feet. 

Arsenic,  swelled  feet  of  old  or  weak  persons  (R.) ;  oedema  of  feet  and  ankles 
in  the  old,  from  feebleness  of  the  heart  (B.).  Lead,  as  ointment  of  equal  parts 
of  emplastrum  plumbi  and  linseed  oil  spread  on  linen,  and  wrapped  round  the 
feet  when  they  sweat — to  be  renewed  every  third  day  for  nine  days  (R.). 
Potassium  Permanganate,  gr.  j— 3 j ,  as  wash,  will  remove  fetor  of  feet  (B.)  ;  tem¬ 
porarily  discolors  the  skin.  Boracic  Acid,  in  strong  solution,  is  used  with  good 
results.  Chloral,  1  in  50  of  water,  as  bath,  efficient.  Sodium  Bicarbonate,  a 
solution  freely  applied  will  remove  fetor  (B.).  Belladonna,  will  check  fetid 
secretions  (R.).  Salicylic  Acid,  in  solution  with  borax,  the  most  agreeable  and 
efficient  deodorant  for  fetid  perspirations  (B.).  3jss— iij  with  3 iij  of  dried  alum, 
in  powder,  applied  freely  to  foot  after  washing  and  drying.  Acid,  salicylic.  3, 
magnesium  silicate  87,  is  the  composition  of  the  powder  used  in  the  German 
army  for  sweating  of  the  feet.  Ice,  to  the  spine,  or  heat  and  cold  alternately, 
to  equalize  the  circulation,  has  been  strongly  advocated  (Wa.)  Stockings, 
should  be  changed  every  day,  and  if  dipped  in  a  strong  solution  of  boracic  acid 
and  dried  will  effectually  check  fetid  perspirations.  Cold  Foot-Bath,  and  dry¬ 
ing  with  friction,  for  cold  feet  (R.). 


FEVER. 


560 

R. 

Ac.  Salicylici,  . 

.  .  .  .  gr.  xv. 

Amyli,  .... 

.  .  .  .  gr.  cl. 

Talci,  .  .  .  . 

....  |iij. 

M. 

feet. 


et  trit. 


Sig. — Locally  for  sweating 
( Kohnhorn ). 


Prescriptions. 

R.  Ac.  Borici  (pulv.),  .  .  .  5jss. 

Vaselini, . ^j. 

M.  Sig. — Ointment  for  bromidrosis. 

(  Champion  n  iere. ) 


Fevers. 

[See  also  the  titles  of  the  various  fevers,  in  their  respective  alphabetical 

order.] 

Aconite,  has  the  highest  value  in  the  eruptive  fevers,  also  in  all  hyperpyrexiae 
(B.).  Always  indicated  in  early  stage  of  simple  inflammatory  fevers,  pneu¬ 
monia,  and  in  most  acute  congestions  (P.).  Has  marvellous  power  over  sthenic 
fevers.  Thermometer  should  go  hand  in  hand  with  Aconite  (R.).  Veratrum 
Viride,  possesses  considerable  power  as  an  antipyretic ;  useful  in  rheumatism, 
pneumonia  (P.) ;  in  delirium  ferox  of  fevers  it  is  of  value  (B.).  Strongly  recom¬ 
mended  in  both  sthenic  and  asthenic  fevers  (R.).  Belladonna,  in  the  eruptive 
fevers,  especially  scarlatina  (B.).  In  typhus,  with  delirium,  insomnia,  painful 
sensitiveness  to  light  and  sound.  In  all  hyperaemic  states  of  brain  and  spinal 
cord  (P.).  Is  prophylactic  often  against  scarlet  fever  (P.,  Pf.).  In  delirium ; 
also  excellent  in  typhus  (R.).  Gelsemium,  in  remittent  and  typho-malarial,  of 
real  benefit.  Is  antipyretic  (B.).  In  bilious  remittent,  of  value  (Pf.).  Arsenic, 
in  prostrating  acute  fevers  to  strengthen  pulse  and  invigorate  patient.  Except 
quinine,  no  drug  subdues  intermittents  so  well  (R.).  In  malarial,  especially 
typho-malarial,  it  is  of  great  value  (B.).  Cinchona.  Quinine  in  the  eruptive, 
and  all  malarial,  remittent,  and  intermittent ;  as  apyretic,  less  effective  and 
more  dangerous  than  cold  baths.  Useless  in  typhus  and  typhoid,  except  for 
hyperpyrexia  (B.).  It  is  anti-miasmatic,  antiseptic,  and  antiphlogistic  ;  of  great 
value  in  intermittent,  septicaemic,  and  hectic  fevers  (P.).  Large  doses  at  night 
to  reduce  temperature  in  typhoid  and  other  fevers  strongly  urged  in  Germany. 
Cinchonine  best  as  prophylactic  against  ague  (R.).  Antipyrine,  the  type  and 
the  best  of  the  new  series  of  synthetical  antipyretics,  which  includes  kairine, 
chinoline,  thallin,  etc.  (see  pp  56,  105,  179) ;  is  antipyretic  and  diaphoretic,  mod¬ 
erates  the  intensity  of  the  febrile  movement,  and  is  especially  indicated  in  self¬ 
limited  diseases  with  persistant  hyperpyrexia,  especially  pneumonia,  typhoid, 
etc.  Kairine,  is  an  efficient  antipyretic,  but  profusely  diaphoretic,  also  a  cardiac 
and  nerve  depressant  of  great  power,  and  highly  dangerous  in  pneumonia,  and 
other  fevers  where  the  heart  is  weak.  It  often  produces  nausea  and  vomiting 
with  headache  and  tinnitus  aurium  (P.).  Resorcin,  has  been  given  in  acute 
rheumatism,  typhoid,  typhus,  pneumonia,  erysipelas,  etc.,  as  an  antipyretic  ; 
like  Kairine,  however,  its  action  in  lowering  temperature  is  transient  as  com¬ 
pared  with  quinine  or  salicylic  acid  (P.) ;  may  be  used  hypodermically  as  it  is 
not  irritant  (B.).  Salicylic  Acid,  or  salicylate  of  sodium,  nearly  equal  to  quinine 
as  antipyretic.  Very  useful  in  all  forms  with  high  temperature  and  in  intermit¬ 
tents.  Especially  in  septicaemia,  pyaemia,  erysipelas,  and  surgical  fevers  (B., 
R.).  Digitalis,  the  German  antipyretic.  Very  useful  in  scarlet  fever,  rheu¬ 
matic,  and  pneumonia  (B.) ;  especially  in  typhoid  (R.).  Cimicifuga,  as  substi¬ 
tute  for  digitalis,  but  less  effective;  good  in  hectic  (B.).  Hydrastine,  intermit¬ 
tents,  typhoid  with  copious  sweats  (P.).  Arnica,  is  antipyretic,  full  doses  in 
sthenic  cases,  small  (tt\,v  of  tincture)  in  asthenic.  Large  and  small  doses  pro¬ 
duce  different  results  (B.).  In  rheumatic  and  typhoid  is  highly  extolled  (P.). 
Camphor,  subdues  reflex  excitability  ;  praised  as  stimulant  in  adynamic  fevers 
(P.).  In  adynamic  fevers  and  where  there  is  delirium  (R.).  Mercury,  large 
closes  of  calomel,  the  German  “  specific  ”  treatment  of  typhoid  (B.).  Small 
doses  in  typhoid  at  commencement;  has  marked  effect  on  tonsils  in  scarlatina 
(R.).  Rhus  Tox.,  in  rheumatic  fever  after  aconite,  and  in  scarlatina  with  typhoid 
symptoms,  is  invaluable  (P.).  Opium,  much  less  used  than  formerly.  Useful 
in  delirium,  and  with  quinine  in  remittents  and  intermittents  (B.).  For  fevers 


FEVER,  SIMPLE. 


56l 


characterized  by  prostration,  insomnia  and  delirium,  noisy  or  muttering,  with 
picking  of  bed-clothes  and  twitching  of  the  muscles  ;  in  such  cases  opium,  judi¬ 
ciously  given,  may  save  an  almost  hopeless  case  (R.).  Morphine,  hypodermi¬ 
cally,  the  best  form  in  febrile  diseases,  being  less  disturbing  to  the  stomach  and 
digestive  power  (P.).  Turpentine,  in  typhoid,  puerperal,  and  yellow,  as  a  stimu¬ 
lant  to  vaso-motor  nervous  system  0Ax-5ss)  (B.) ;  as  enema  (np3o-6oin  starch 
mucilage  with  rtpx  of  liq.  opii  if  pain)  invaluable  when  in  typhoid  hemorrhage 
occurs  with  tympanitis  (P.,  R.).  Tartar  Emetic,  minute  doses  (gr.  y1^)  frequently 
repeated,  and  with  opium,  are  of  great  value  in  many  acute  febrile  diseases 
(B.) ;  as  a  diaphoretic  ;  in  ague  ;  in  large  doses  to  abort  specific  fevers  (R.). 
Muriatic  Acid,  very  useful  in  all  forms,  especially  in  typhoid  and  the  exanthe¬ 
mata;  relieving  dryness  of  the  mouth  and  fauces,  increases  digestion,  and  re¬ 
strains  the  diarrhoea  (B.).  Acid  Drinks,  such  as  raspberry  vinegar,  citric  acid, 
etc.,  very  grateful  and  useful  (R.,  B.) ;  two  sliced  limes  or  lemons,  with  3 ij  of 
sugar,  in  Oj  of  boiling  water,  cooled  and  strained,  make  an  agreeable  refriger¬ 
ant  beverage  (Wa.).  Baptisia,  useful  in  common  continued  fever,  or  in  the  first 
stage  of  typhoid  ;  drop  doses  of  a  fresh  tincture  every  hour.  Eucalyptus,  has 
given  varied  results  in  malarial  fevers,  some  observers  praising  it  very  highly 
(P.).  Valerian,  has  done  much  good  in  fevers  of  a  nervous  character  (P.). 
Sumbul,  is  used  in  Russia  for  low  fevers  of  a  typhoid  type  (P.).  Cocculus,  for 
tympanitis  of  typhoid  (P.).  Ammonium  Acetate,  as  a  diaphoretic,  and  in  simple 
forms,  as  catarrhal  ;  the  Carbonate  in  scarlet  fever  and  measles  (R.).  Purga¬ 
tion,  by  castor  oil,  sulphate  of  magnesium,  etc.,  before  exhaustion  (R.).  Mus¬ 
tard  Bath,  on  recession  of  rash  in  eruptive  fevers  (R.).  Aliment,  milk  and 
beef-tea  alternately,  every  3  hours.  Milk  only,  in  fevers  and  inflammations  of 
the  digestive  tract  (B.).  Alcohol,  in  low  conditions  is  useful  when  causes  im¬ 
provement  in  symptoms,  which  may  become  worse  (B.,  R.).  Coffee  better  than 
alcohol  (P.).  Water,  is  a  valuable  adjunct  to  remedies  in  the  treatment  of 
fevers.  Warm  baths,  the  wet  pack,  hot  and  cold  compresses,  fomentations, 
moist  inhalations,  etc.,  have  great  value  [see  various  fever  titles]  :  a  most  im¬ 
portant  agent.  Cold  baths  or  cold  wet  pack  to  reduce  temperature  (B.) ;  cold 
affusion,  baths,  packing,  ice,  and  ice-bag;  hot  affusion  and  sponging,  all  of 
great  value  in  every  form  (R.). 


Prescriptions. 


R  .  Ext.  Aconiti  FI.,  ....  rrpxvj. 

Spt.  Etheris  Nitros.,  .  .  .  ."ij. 
Glycerini,  .  .  .  .  q.  s.  ad  3  ij. 

M.  Sig. — A  teasp.  every  hour  to  an 
adult,  as  a  febrifuge. 


R.  Antipyrini, . gr.  xlv. 

Aquae  Cinnam.,  .  .  .  .  25  ij. 

M.  Sig. — A  teasp.  every  2  hours  for 
children,  to  control  pyrexia. 


Fever,  Simple. 

Aconite,  in  small  repeated  doses,  the  best  remedy  for  febricula,  etc.  (B.) 
in  ordinary  febrile  conditions,  if  given  early,  will  abate  fever  and  induce  free 
perspiration  ;  may  be  administered  in  conjunction  with  any  other  remedy  indi¬ 
cated  (R-).  Veratrum  Viride,  in  small  doses,  as  antipyretic  (P.,  R.).  Hyoscya- 
mus  or  Belladonna,  very  useful  in  febricula,  especially  for  head  symptoms  and 
constipation  (P.).  Gelsemium,  with  remittent  or  bilious  symptoms  (P.,  B.). 
Arsenic,  if  typho-malarial  symptoms  (B.).  Antipyrine,  in  hourly  doses  of 
gr.  iv  or  less,  in  the  simple  continued  fever  of  children,  as  antipyretic.  Even 
infants  bear  it  well  (Penzoldt).  Hydrochloric  Acid,  in  the  continued  fever  of 
childhood,  has  a  beneficial  influence  (West).  Valerian,  when  nervous  excita¬ 
bility  (P.).  Lemon-juice,  as  “lemonade,”  or  with  bicarbonate  of  potass.,  as 
mild  diaphoretic  and  diuretic  (P.).  Pomegranate-juice  is  very  grateful  if  mixed 
with  sugar  or  honey  (P.).  Bromides,  gr.  ss-j  every  quarter-hour  are  excellent 
for  the  febrile  disturbances  of  children  (A.  A.  Smith).  Baths,  warm,  in  simple 
fevers  of  children  (R.).  Aliment,  milk  and  beef-tea  alternately  every  3  hours,, 
the  most  useful  (B.).  . 

36 


I 


562  FISTULA - FLATULENCE. 

v 

Prescriptions. 


R.  Ac.  Hydrochlor.  Dil.,  .  .  3SS. 

Spt.  FEtheris  Co.,  ....  3jss. 

Syr.  Rosae, . 3  ss. 

Aquae  Camph.,  .  .  .  cd  5  iv. 

M.  Sig. — Teasp.  to  tablesp.,  according 
to  age,  every  6  hours. 

(Modified  from  West.) 


R .  Potassii  Acetatis,  .  .  .  .  3  ij . 

Spt.  /Etheris  Nitrosi,  .  .  .  giv. 

Syr.  Simplicis, . ^j. 

Liq.  Ammonii  Acetatis,  .  3?  lj. 
Aquae  Camphorae,  .  .  ad  5  viij. 

M.  Sig. — Teasp.  to  tablesp.  doses,  ac¬ 
cording  to  age.  Diaphoretic  and  anti¬ 
febrile. 


Fistula. 

Piper  Nigrum,  the  confection,  as  a  gentle  stimulant  in  anal  fistula  (P.). 
Iodine,  by  injection,  sometimes  curative,  but  generally  fails  (Wa.).  Sanguinaria, 
as  injection,  has  cured  (P.).  Capsicum,  the  weak  infusion,  a  useful  stimulant 
in  fistulous  ulcerations  (P.).  Surgical.  Division  of  sphincter  in  anal  fistula,  by 
knife  or  ligature,  the  best  treatment  (D.).  In  fistula  lachrymalis,  dilatation  of 
passage  by  probing  the  canaliculus,  or  slitting  the  canaliculus  up  (D.).  In 
vesico-vaginal,  or  recto-vaginal,  surgical  methods  best.  Diet  should  be  nour¬ 
ishing  and  digestible  ;  fresh  air  and  general  hygienic  conditions  are  neces¬ 
sary  (R.). 

Flatulence. 

Nux  Vomica  will  remove  flatulence  and  intestinal  indigestion  (B.)  ;  when  ' 
constipation,  heart-burn,  weight  on  head  (R.).  Charcoal,  gr.  v.  or  x,  soon 
after  or  just  before  meals  (R.) ;  mixed  with  bismuth  (R.).  Chloroform,  pure, 
in  drop  doses,  benefits  (R.).  Carbolic  Acid,  when  no  acidity  present  (R.). 
Turpentine,  gtt.  iij-v  on  sugar,  will  quickly  relieve  (B.).  Asafcetida  or  Vale¬ 
rian,  quickly  relieves  the  flatulence  of  hypochondriasis  (B.,  P.).  Asaf.  3j  of 
tinct.  to  O y2  water,  give  3j  ;  useful  for  children  (R.).  Sodium  Sulpho-carbo- 
late,  gr.  xxx  after  eating,  will  be  found  very  serviceable  (R.).  Phosphoric 
Acid,  dilute,  is  often  promptly  alleviative.  Anise,  the  oil,  also  Ether,  or  any 
other  member  of  the  Carminative  group  (see  page  37),  will  promote  the  expul¬ 
sion  of  gas  from  the  stomach  and  intestines.  Mercury,  when  with  clayey 
stools  (R.).  Calumba,  an  effective  remedy  for  flatulent  disposition  is  an  infu¬ 
sion  of  5SS  each  of  calumba  and  ginger,  3j  of  senna,  hot  water  Oj,  a  wine- 
glassful  ter  die  (B.,  P.).  Potassium  Permang.,  in  flatulence  attendant  on 
obesity  (B.).  Physostigma,  flatulence  of  women  at  climacteric  (B.).  Sulphur¬ 
ous  Acid,  in  5  to  10  minim  doses,  when  due  to  fermentation  (R.).  Diet. 
Abstain  from  sugar,  starchy  food  and  tea — especially  sugar  ;  eat  little,  slowly 
and  regularly ;  as  a  general  rule  abstain  from  alcoholic  drinks  and  vegetables, 
especially  cabbage.  Pepsin  [or  Ingluvin]  after  meals,  to  promote  digestion 
(R.).  [Compare  Colic,  Dyspepsia. J 


Prescriptions. 


R.  Tinct.  Nucis  Vomicae, 

Tinct.  Physostigmatis, 

Tinct.  Belladonnae,  .  .  aa  3  j. 

M.  Sig. — Fifteen  drops  twice  daily  in  a 
little  water. 


R  .  Tinct.  Illicii  Anisati, 

Tinct.  Gentianae, 

Tinct.  Nucis  Vomicae,  .  aa  3 j. 

Chloroformi, . TTLxv-xxx. 

M.  Sig. — 8  to  10  drops  in  a  winegl.  of 
water,  before  meals. 


R.  Gummi  Camphorae, 

Pulv.  Zingiberis, 

Pulv.  Capsici,  .  .  .  .  aa  gr.  j. 

Ft.  pil.  no.  vj.  Sig. — One  pill  as  re¬ 
quired  for  gastric  and  intestinal  flatulence. 


R .  Bismuthi  Salicyl.,  .  .  .  .  3  lv- 

Magnes.  Calcinat.,  .  .  .  .  3  iv. 

Pulv.  Carb.  Ligni,  .  .  .  .  3  vj. 

Olei  Anisi, . 3  ij. 

Ft.  pulv.  Sig.  —  A  teaspoonful  before 
I  each  meal.  ,  [Hue hard.) 


FLUSHING-HEATS - FRECKLES. 


563 


Flushing-heats. 

Nux  Vomica,  rtyij  of  the  tinct.  with  minim  doses  of  laudanum  in  hysterical 
flushings  of  the  middle-aged,  with  flatulence,  weight  on  head  and  perspirations 
(R.).  Nitrite  of  Amyl,  TT  to  t0  lA  thirty  times  its  volume  of  rectified  spirits. 
Effective  for  flushing  of  face,  or  sensation  of  flushing,  followed  by  coldness, 
with  cold  feet  and  hands  and  great  prostration,  occurring  at  climacteric  chiefly 
(R.).  Potassium  Bromide,  at  climacteric,  with  mental  depression  (R.).  Zinc 
Valerianate,  or  Valerian,  flushings  at  the  climacteric  (R.).  Eucalyptol,  for 
the  flushings,  palpitations  and  flatulence  incident  to  the  change  of  life  (R.). 

Foreign  Bodies. 

In  the  Eye, — Remove  by  bathing,  or  wiping  towards  the  lower  inner  corner 
with  a  soft,  moistened  handkerchief,  or  a  bent  bristle,  the  two  ends  being  held 
in  the  fingers.  Use  tepid  solution  of  vinegar  (gss-^j)  for  removing  lime,  tepid 
water  for  powder.  Then  apply  a  weak  zinc  or  alum  collyrium,  or  instil  a 
solution  of  Atropine,  gr.  ij  to  the  3,  or  Cocaine,  4  per  cent.  In  the  Ear, — 
Examine  carefully  with  speculum  before  removal ;  first  syringe  with  warm 
water,  or  a  drop  of  sweet  oil  to  drive  out  insects,  before  using  forceps  ;  apply 
equal  parts  of  laudanum  and  olive  oil,  a  few  drops  on  cotton,  if  much  pain. 
In  the  Nose, — A  current  of  tepid  salt  water,  forced  up  one  nostril,  may  force 
down  the  body  through  the  other,  if  the  mouth  be  held  open.  In  the  Larynx 
or  Pharynx, — if  water  can  be  swallowed,  the  obstruction  is  in  the  trachea. 
Never  push  a  body  down.  Remove  by  curved  forceps  or  blunt  hook.  If 
passed  into  the  stomach  use  solid  diet  to  imbed  the  article.  If  all  fail  and  the 
case  be  urgent,  resort  to  catheterism  or  tracheotomy.  In  the  Flesh, — remove 
at  once  by  forceps,  or  sponge  and  water. 


Fractures  and  Dislocations. 

Arnica,  is  excellent  to  neutralize  the  ill  effects  of  mechanical  injuries,  TTv-x 
in  a  wineglassful  of  water  every  2  or  3  hours.  When  used  after  amputations, 
it  certainly  has  the  power  of  promoting  the  rapid  union  of  the  surfaces.  The 
infusion  is  better  than  an  alcoholic  preparation  for  external  use  (P.).  Aconite, 
quickly  and  repeatedly  if  feverish  symptoms  ensue  (P.).  Iodine,  int.  and 
frictions,  occasionally  useful  in  ununited  fractures  (Wa.).  Calcium  Phosphate, 
promotes  formation  of  callus  (Wa.).  Opium,  useless  in  surgical  fever,  and 
may  do  harm  (Cl.) ;  for  nervousness  or  muscular  spasms  after  dressing,  gr.  % 
of  morphine  hypodermically  as  anodyne  (Ag.).  Benzoin,  the  tincture  on  lint, 
as  a  dressing  for  compound  fractures  and  other  severe  injuries,  leads  to  rapid 
and  satisfactory  healing  (Bryant).  Carbolic  Acid,  1  to  20  or  1  to  40  solutions, 
for  irrigation  and  dressings  in  compound  fractures,  obviates  pyaemia  and  most 
of  the  other  preventable  causes  of  death  (P.).  Leadwater  and  Laudanum,  on 
lint,  ora  Calendula  lotion  to  the  part,  after  reduction  of  the  injury,  with  mor¬ 
phine  hypodermically  and  perfect  quiescence.  Diet,  should  be  very  simple 
for  a  week  or  ten  days.  [Compare  Wounds.] 

Freckles. 

Iodine,  the  tincture  or  glycerite,  locally  (B.).  Liquor  Potassae,  3j  to  3 ij 
Aquae  Rosae,  as  a  lotion  (Todd).  Benzoin,  the  compound  tincture  with  water, 
as  cosmetic  to  remove  freckles  (P.).  Sodium  Borate,  a  saturated  solution  of 
borax  is  a  safe  and  often  efficient  lotion  to  remove  freckles  (B.).  Lime-water, 
and  olive  oil,  equal  parts,  with  a  little  liq.  ammoniae,  as  liniment  (Wa.).  Po¬ 
tassium  Carbonate,  makes  a  good  lotion  for  freckles,  sunburn  and  tan  (B.). 
Mercury,  the  bichloride,  with  alcohol  and  glycerin,  as  a  lotion,  has  been  found 
effective.  Donovan’s  solution,  r»blxxx  to  3 v i i j  of  Water,  and  3j  every  three 
hours,  has  been  found  highly  successful  (Wa.). 


564 


GANGRENE - GASTRALGIA. 


R .  Potassii  Carbonatis,  .  .  . 

Sodii  Chloridi, . 

Aquas  Aurantii  Flor.,  .  . 

Aquae  Rosae, . 

M.  Sig. — Face- wash. 


Prescriptions. 


3UF 

3'i- 

5  V11J- 


(B.) 


R.  Hydrarg.  Chlor.  Corr.,  .  .  gr.  vj. 
Ac.  Hydrochlor.  Dil. ,  .  .  £j. 
Alcoholis,  Aq.  Rosae,  .  aa  2;  ij. 
Glycerini,  ^j,  Aquae,  .  ad  3  viij. 

M.  Sig. — Apply  at  night,  and  wash  off 
in  the  morning. 


Gangrene. 

Salicylic  Acid,  pure,  in  powder  locally,  to  destroy  fetor  and  change  the 
character  of  the  morbid  action  (B.).  Carbolic  Acid,  acts  in  the  same  way 
(B.);  a  1  per  cent,  solution  as  lotion  in  gangrenous  ulcers  (Wa.).  Sodium 
Sulphite,  in  solution,  1  to  5  or  10  of  water,  as  lotion  or  applied  on  compresses, 
to  destroy  odor,  soothe  pain  and  restore  healthy  action  (Wa.).  Ammonium 
Chloride,  in  solution  as  bath  and  fomentations,  very  successful  in  one  case  of 
senile  gangrene  (Wa.).  Cinchona,  or  better,  quinine,  or  the  hydrochlorate, 
often  proved  of  value  (P.);  generally  decoction  of  cinchona  best  (Wa.).  Tur¬ 
pentine,  locally,  after  removal  of  gangrenous  part,  a  most  efficient  application 
(B.) ;  by  stomach  and  inhalation  from  hot  water  in  gangrene  of  lungs ;  the 
oil  locally  in  dry  and  chronic  gangrene  (P.).  Sanguinaria,  has  been  recom¬ 
mended  (P.).  Oxygen,  as  gaseous  bath  in  senile  gangrene  (R.).  Charcoal,  as 
poultice,  value  doubtful  (R.).  Citric  Acid,  lemon-juice  dropped  into  wound, 
which  is  then  covered  with  lint  steeped  in  a  solution  of  chlorine.  Very  effec¬ 
tive  for  hospital  gangrene,  in  Parisian  hospitals  [ Lancet ,  October,  1879].  Per- 
chloride  of  Iron,  locally,  is  considered  superior  to  the  mineral  acids  (Wa.). 
Nitric  Acid,  strong,  applied  carefully  until  the  ulcer  is  converted  into  a  firm, 
dry  mass  (Wa.) ;  is  probably  the  best  escharotic,  next  to  bromine,  for  gan¬ 
grenous  destruction  (B.).  Bromine,  is  the  best  escharotic  for  hospital  gan¬ 
grene  (B.).  Chromic  Acid,  is  a  very  efficient  caustic,  penetrating  deeply  with 
but  little  pain  (B.).  Opium,  to  soothe  the  pain,  and  diminish  restlessness  and 
irritability  (Wa.). 


Gastralgia  and  Gastrodynia. 

Opium,  in  some  form  necessary  to  relieve  the  pain  in  severe  cases  (Da 
Costa).  Morphine,  is  of  great  value  (P.)  ;  subcutaneously  in  epigastrium  very 
efficient,  or  in  small  doses  with  bismuth  and  milk  before  meals  (R.).  Bella¬ 
donna,  is  useful  in  painful  affections  of  the  stomach  (R.).  Atropine,  often 
relieves  promptly,  and  is  excellent  in  neuralgic  pain  of  the  abdominal  vis¬ 
cera  (P.).  Nux  Vomica,  an  excellent  stomachic,  gtt.  v-x  of  tincture  before 
meals  (B) ;  gtt.  j-ij  every  2  hours  in  many  forms  of  gastric  derangement 
(R.).  Strychnine,  hypodermically  for  gastralgia  and  gastrodynia  (R.) ;  in  very 
small  doses,  gr.  yuo~^>  tw0  or  three  times  daily,  a  very  successful  remedy 
(P.).  Arsenic,  sometimes  dissipates  the  pain  surprisingly  (B.)  ;  a  drop  of  liquor 
arsenicalis  before  food  in  irritative  dyspepsia  and  gastralgia  with  heartburn 
(R.).  Bismuth,  when  gastralgia  due  to  irritation  of  mucous  membrane,  acts 
well  alone,  but  is  most  efficient  when  given  with  aromatic  powder  and  a  little 
morphine  (R.) ;  or  a  combination  of  bismuth  and  arsenic  in  more  chronic  cases 
(B.) ;  subcarbonate  is  especially  adapted  to  gastralgia  with  laborious  digestion 
and  putrid  or  acid  eructations  (Wa.).  Manganese,  the  black  oxide  in  gastro¬ 
dynia  and  pyrosis  (R.).  Zinc  Oxide,  an  excellent  remedy  when  gastralgia 
after  food,  gr.  v-x  with  aromatic  powder  and  morphine,  before  meals  (B.). 
Silver  Nitrate,  in  solution  to  check  the  pain  of  many  stomachal  disorders  (R.)  ; 
a  pill  of  gr.  ss,  with  extr.  hyoscyami  gr.  ij-iv  (Wa.).  Hydrocyanic  Acid,  often 
cures  rapidly  when  gastralgia  from  nervous  derangement  (B.) ;  may  check 
vomiting  as  well  as  relieve  pain  (R.) ;  cherry-laurel  water  a  useful  form  (P.). 
Nitro-hydrochloric  Acid,  gtt.  ij-iij  of  the  dilute  acid,  is  serviceable  (Da  Costa). 
AEther,  a  few  drops  of  sulphuric  ether  or  the  compound  spirit  n\,x-xx,  often 


GASTRIC  DILATATION - GASTRITIS. 


565 


relieves  quickly  (B.).  Chloro'orm,  R\jj-v  on  sugar,  often  relieves  (B.).  Chlo¬ 
ral,  sometimes  relieves  pain  in  gastralgia  (R.).  Pulsatilla,  is  efficient  in  many 
cases  of  painful  dyspepsia,  with  coated  tongue,  headache  and  nervous  depres¬ 
sion  (P.).  Pepsin,  when  gastrodynia  from  indigestion  (P.).  Creasote,  checks 
pain  after  food  (R.).  Alum,  often  affords  relief  (B.).  Ergot,  of  value  in  vis¬ 
ceral  neuralgias  (P.).  Alkalies,  for  pain  in  stomach,  liquor  potassas  generally 
employed  (R.).  Quinine,  in  cases  showing  periodicity,  and  those  of  neuralgic 
type  (P.).  Sodium  Salicylate,  for  gastralgia  with  fermentation  (R.).  Nitro¬ 
glycerin  allays  the  pain  speedily  (B.).  Carbonic  Acid  Water,  in  painful  and  irri¬ 
table  conditions  ;  may  be  mixed  with  milk  (R.).  Milk-cure,  very  efficacious 
in  obstinate  cases  (B.).  Galvanism  of  the  pneumogastric,  and  locally  to  the 
organ  itself  (B.).  Aquapuncture  has  given  extraordinary  relief  (B.).  Diet  is  of 
the  greatest  importance.  Food  should  be  easily  digestible,  varied  and  plainly 
cooked.  Sedentary  livers  should  refrain  from  much  animal  food.  Meals 
should  be  regularly  and  frequent,  eating  little  at  a  time,  and  that  very  slowly. 
Alcoholic  beverages  do  harm  as  a  rule,  but  may  benefit  particular  cases.  Eat¬ 
ing  should  be  done  in  as  agreeable  a  frame  of  mind  as  possible,  and  the  patient 
should  rest  for  a  time  after  a  meal.  [Compare  Acidity,  Dyspepsia,  Neu¬ 
ralgia.] 

Prescriptions. 


R.  Morphinse  Sulph.,  .  .  .  .  gr.  j. 

Ac.  Carbolici, . %  ss. 

Aq.  Menth.  Pip.,  .  .  .  ad  3  iv. 

M.  Sig. — Teasp.  thrice  daily. 

[Da  Costa.) 


R  .  Atropinse  Sulph., . gr.  j. 

Zinci  Sulph., . .  %  ss. 

Aqu?e  Destill.,  . ijj. 

M.  Sig. — 3  to  5  drops  two  or  three 
times  daily.  (B.) 


R.  Bismuthi  Subnit., 

Magnesii  Carb.,  .  .  .  .  aa  gr.  xvj. 
Ac.  Hydrocy.  Dil.,  ....  rr\x. 

Aquae, . •  ,3  iv. 

M.  Sig. — Dessertsp.  for  a  child  of  3 
years  in  flatulent  gastrodynia  and  gastralgia. 


'  R.  Ac.  Hydrocy.  Dil.,  ....  gij. 
Aq.  Laurocerasi,  .  .  .  .  ad  5  iv. 
M.  Sig.  —Teasp.  every  4  hours. 


R.  Bismuthi  Subnit., . ^ij. 

Aq.  Hydrocy.  Dil.,  .  .  .  .  £  ss. 
Mucil.  Acacise, 

Aq.  Menth.  Pip.,  .  .  .  .  aa  ijij. 
M.  Sig. — Tablesp.  thrice  daily. 


R.  Pepsini, . gj. 

Ac.  Hvdrochlor.  Dil.,  .  .  .  Z  ss. 

Glycerini, . ^jss. 

Aq.  Cinnam., . 3  ijss. 

M.  et  filtra.  Sig. — Tablespoonfui  doses 
I  for  slow  and  feeble  digestion. 


Gastric  Dilatation. 

Carbolic  Acid,  internally  to  allay  fermentation,  with  an  occasional  washing 
by  the  stomach  pump  (Da  Costa).  Strychnine,  hypodermically  or  by  the 
mouth,  or  Nux  Vomica,  the  best  remedy,  conjointly  with  washing  of  the  sto¬ 
mach  and  strict  diet  (Da  C.).  Bismuth,  with  magnesia  or  soda,  or  lime-water 
frequently,  for  the  acidity,  which  is  one  of  the  most  distressing  symptoms  (Fen¬ 
wick).  Diet,  should  be  free  from  all  starch  and  sugar,  and  from  vegetables  of 
any  kind  (Fenwick).  Milk  not  advisable,  as  much  fluid  will  further  dilate  the 
organ  ;  solids  better,  as  small  quantities  of  dry,  stale  bread,  or  gluten  bread, 
and  underdone  meat  (Da  Costa). 


Gastritis,  Acute. 

Mercury,  calomel  in  broken  doses,  with  ice,  frequently  swallowed,  for  the 
idiopathic  form,  which  is  occasionally  seen  and  cannot  be  distinguished  from 
that  due  to  irritant  poisons  (Da  Costa).  Bismuth,  subnitrate  or  subcarbonate 
in  full  doses  after  more  acute  symptoms  have  abated  (Da  C.).  Morphine, 


566 


GASTRITIS. 


hypodermically  for  pain  (B.)  Ice,  internally  and  externally  gives  great  relief 
(R.).  Aliment  should  be  given  per  rectum  ;  no  food,  except  milk  and  lime- 
water,  being  admitted  to  the  stomach  for  some  time  (Da  C.).  Antidotes,  in 
cases  of  irritant  poisoning,  as  alkalies  to  neutralize  acids,  dialyzed  iron  or  the 
hydrated  sesquioxide  for  arsenic,  turpentine  for  phosphorus,  etc.  [See  page 
52,  ante .]  Then  oil,  albumen  or  milk,  to  protect  the  mucous  membrane, 
stimulants,  opium,  ammonia,  etc.,  to  antagonize  the  depression  of  the  vital 
powers. 


Gastritis,  Chronic. 


Arsenic,  sometimes  surprisingly  curative  ;  for  the  vomiting  gtt.  j-ij  of  Fowler’s 
Solution  before  meals  (B.).  Pulsatilla,  in  subacute  gastritis  of  phlegmatic 
temperaments,  white  tongue,  heartburn,  nausea,  flatulency,  little  or  no  taste 
(P.).  Hydrastis,  gtt.  v-xv  of  tincture  or  fluid  extract,  daily  before  meals,  espe¬ 
cially  for  gastric  catarrh  of  acute  alcoholism  (B.).  Nux  Vomica,  gtt.  j  of  tinc¬ 
ture  every  5  to  10  minutes  for  8  or  10  doses  in  acute  gastric  catarrh,  with 
headache  or  sick-headache ;  also  drop  or  2-drop  doses  every  2  hours  or 
oftener,  when  chronic  gastric  catarrh  in  the  course  of  chronic  disease  (R.). 
Cinchona,  to  promote  healthy  state  of  mucous  membrane,  the  infusion  best 
with  mineral  acids,  or  quinine ;  the  red  bark  in  gastric  catarrh  of  drunkards 
(B.).  Alkalies,  either  shortly  before  meals,  to  stimulate  production  of  gastric 
juice;  or  some  hours  after,  to  neutralize  the  acids  of  decomposition  (Da  C.). 
Pepsin,  gr.  v  immediately  after  a  meal,  to  assist  digestion  (Da  C.).  Podophyl¬ 
lum,  in  small  doses  at  night,  to  act  on  upper  bowel.  Purgation  as  a  method  of 
treatment  stands  at  the  head  (Da  Costa).  Ipecac,  in  small  doses  may  prove 
highly  useful,  rt^  v-x  of  the  wine  (P.) ;  for  the  nausea  and  vomiting  (R.,  B.). 
Tannic  Acid,  in  4-grain  doses  with  a  drop  of  glycerin  to  make  a  pill  (B.). 
Hydrocyanic  Acid,  is  much  used  (R.) ;  in  subacute  gastritis  it  often  proves 
useful  given  in  an  ordinary  effervescing  draught  (Wa.).  Silver  Nitrate,  in  Y 
or  y2  -grain  doses  with  opium  if  pain,  or  preferably  belladonna,  is  extremely 
useful  (Da  C.) ;  to  check  pain  and  vomiting  (R.).  Silver  Oxide,  is  nearly  as 
good  as  the  nitrate,  and  not  liable  to  produce  staining  (Da  C.).  Opium,  or 
Morphine,  to  quell  pain  in  chronic  gastritis  from  alcoholic  excess  (R.).  Euca¬ 
lyptus,  a  most  useful  stomachic,  not  to  be  used  in  inflammatory  states  (B.) ;  is 
used  with  benefit  (R.).  Mercury,  the  yellow  oxide,  in  doses  of  gr.  ^0— 55, 
chronic  form.  [See  under  Dyspepsia.]  Calumba,  and  other  bitters  are  use¬ 
ful  (B.).  Ammonium  Chloride,  in  high  repute  in  Germany  (B.).  Caffeine, 
especially  when  associated  with  migraine  (B.).  Bismuth,  is  very  useful  in 
chronic  gastritis,  especially  that  of  drunkards,  and  the  chronic  gastric  catarrh 
of  children  with  vomiting  (R.) ;  invaluable  for  its  sedative,  alterative  and 
astringent  action  ;  10-1 5-grain  doses  several  hours  after  meals  (Da  C.).  Lead 
Acetate,  in  chronic  gastritis  with  gastralgia  and  pyrosis,  may  be  combined  with 
morphine  beneficially  (B.).  Alum,  when  vomiting  of  glairy  mucus  (B.).  Ali¬ 
ment,  such  as  will  be  digested  in  the  small  intestines  ;  requires  careful  atten¬ 
tion.  The  milk-cure  has  been  very  effective  in  bad  cases ;  malt  liquors  are 
harmful  (B.).  Mineral  waters  of  purgative  type,  to  keep  the  portal  system 
drained.  Exercise  is  not  beneficial ;  better  live  quietly,  and  occasionally 
spend  a  day  or  two  in  bed  (Da  C.).  Kumyss  very  agreeable,  and  tolerant  to 
stomach ;  the  milk-cure  and  buttermilk  have  been  very  efficacious.  The 
farinaceous  vegetables,  rice,  tapioca,  arrowroot,  aerated  bread.  [Compare 
Dyspepsia,  Gastralgia.] 


Prescriptions. 


R.  Sodii  Bicarbonat.,  ....  ^jss. 
Tinct.  Aurantii  Cort.,  ...  5  ss. 
Infusi  Calumbae,  .  .  q.s.  ad  5  viij. 
M.  Sig. — Two  tablesp.  before  each 
meal.  In  chronic  gastric  catarrh. 


R.  Magnesii  Sulphatis,  .  .  .  ^  j  - i j . 
Sodii  et  Potassii  Tart.,  .  .  gss-j. 

Ac.  Tartarici, . gr.  xx. 

Sig. — Dissolve  in  a  glass  of  water,  and 
drink,  an  hour  before  breakfast. 


GASTRIC  ULCER. 


567 


R.  Aluminis, . 3  ij. 

Ext.  Gentianae, . 7,  ss. 

M.  Ft.  pil.  no.  xxx.  Sig. — Two  twice 
daily. 

R.  Argenti  Oxidi, . gr.  xij. 

Ext.  Belladonna . gr.  iij. 

Olei  Caryophylli,  ....  gtt.  xx. 

M.  Ft.  pil.  no.  xxiv.  Sig. — One  pill 
twice  daily.  {Da  Costa.) 


Gastric  Ulcer. 

Arsenic,  Fowler’s  solution  in  drop  doses  lessens  the  pain  and  relieves  the 
vomiting  remarkably  (B.) ;  has  given  relief  when  commonly-used  remedies 
failed  (R.)  ;  gives  good  results  when  used  in  very  small  doses  (Da  Costa). 
Bismuth  relieves  pain  and  vomiting,  and  contributes  to  the  cure  (B.).  [See 
under  Gastralgia  for  formulae.]  Silver  Nitrate,  in  solution,  to  check  pain 
and  relieve  the  vomiting  (R.) ;  is  next  in  value  to  bismuth,  promoting  cicatriza¬ 
tion  and  easing  the  pain  (B.).  Silver  Oxide  is  equally  efficient,  and  is  not 
liable  to  produce  staining  (Da  C.).  Atropine  often  happily  relieves  the  pain 
and  vomiting,  even  when  given  in  very  small  quantity  (B.).  Morphine,  for  the 
pain  and  vomiting  (R.) ;  in  full  doses  if  perforation  occurs,  to  localize  peritonitis 
until  adhesions  take  place  (Da  C.).  Ergotin,  j  to  water  x,  of  which  gtt.  xv 
hypodermically  several  times  a  day  for  the  hemorrhage.  Gallic  Acid,  in  5- 
grain  pill  every  hour  for  hemorrhage.  Lead  Acetate,  is  sedative  and  hemo¬ 
static  ;  gr.  ss— ij  in  pill  with  opium,  very  useful  to  check  hemorrhage  and  allay 
pain  (R.).  Turpentine,  5  to  10  drops  frequently  repeated  in  hemorrhage  (R.). 
Charcoal  is  said  to  ease  the  pain  by  preventing  formation  of  acid  products  (R.). 
Mercury.  Corrosive  sublimate  an  effective  remedy  ;  gr.  gV^o  thrice  daily 
before  meals  (B.).  Pepsin,  by  facilitating  digestion,  is  useful  (B.).  Iron  for  the 
anaemia:  the  lactate  or  ammonio-citrate  if  stomach  irritable  (Da  C.).  Ice-bag, 
to  the  epigastrium,  for  pain  and  vomiting,  etc.  (R.).  Nutrient  Enemata,  to  rest 
the  stomach.  [See  under  Enemata  for  formula.]  Brandy  may  be  added, 
also  laudanum,  gtt.  x-xx,  if  the  rectum  is  irritable  (B.).  Milk-cure,  has  suc¬ 
ceeded  admirably  (B.)  ;  a  strictly  skimmed  milk  diet  with  lime  water,  2  parts  of 
milk  to  1  of  aqua  calcis  (Da  C.).  Diet,  should  be  of  non-irritating  character, 
which,  with  cold  or  hot  compresses  to  the  epigastrium,  leaves  little  room  for 
medicine.  In  bad  cases  nourish  per  rectum,  so  as  to  give  the  stomach  complete 
rest.  In  any  case  such  food  as  is  chiefly  digested  in  the  small  intestines,  e.g.y 
farinaceous  vegetables,  rice,  arrow-root,  etc.  A  nice  change  from  milk  diet  is 
a  warmed  pancreas,  chopped  up  with  rare  meat,  being  nutritious  and  well 
relished  (Da  C.).  Rest  in  bed  for  several  months  is  imperative  (Da  C.). 
Defibrinated  Blood,  by  injection  into  rectum,  in  doses  of  from  3 iij— vj  (A.  H. 
Smith).  [Compare  Hematemesis.] 


R.  Sodii  Bicarbonat.,  .  .  .  .  gr.  lxxx. 
Spt.  Chloroformi,  ....  3 jss. 
Tinct.  Gentianae,  .  .  .  .  j?  ss. 

Infusi  Rhei, . ^  iv. 

Aq.  Mentk.  Pip.,  q.  s.,  ad  5  viij. 

M.  Sig. — A  tablesp.  or  two  before  each 
meal.  In  chronic  gastric  catarrh,  with  flat¬ 
ulence. 


Prescriptions. 


R.  Argenti  Oxidi, 

Ext.  Hyoscyami,  .  .  .  aa  gr.x 
Ft.  pil.  no.  xx.  Sig. — One  pill  thrice 
daily  before  meals. 


R .  Bismuthi  Subcarb.,  .  .  .  5  iij. 
Morphinae  Sulph.,  .  .  .  .  gr.  j-ij. 

Pulv.  Aromat., . 3j. 

Ft.  pulv.  no.  xij.  Sig. — One  powder  in 
milk  before  each  meal. 


R  .  Argenti  Nitratis, . gr.  v. 


Ext.  Opii, . gr.  iij. 

Ft.  pil.  no.  xx.  Sig. — One  pill  thrice 
daily. 


R  .  Argenti  Oxidi, . gr.  v. 

vel  Zinci  Oxidi, . SSSl 

Morphinae  Sulph.,  .  .  .  .  gr.  j-ij 


Ft.  pil.  no.  x.  Sig. — One  pill  thrice 

daily,  before  meals. 


568 


GLANDERS - GLEET. 


Glanders  and  Farcy. 

Ammonium  Carbonate,  in  water,  hourly,  as  concentrated  as  can  be  swallowed, 
followed  by  an  opiate,  and  preceded  by  an  emetic  of  ipecac,  and  an  incision 
into  each  of  Wharton’s  ducts;  proved  successful  in  a  case  of  acute  glanders 
(Wa.).  Carbolic  Acid,  and  the  Sulphites,  as  sodium  sulphite,  are  most  worthy 
of  trial.  Creasote,  or  Carbolic  Acid,  in  glycerin,  locally  (Wa.)  ;  or  dilute  chlori¬ 
nated  soda,  and  lime-water.  Escharotics,  to  destroy  the  affected  spot,  if  inocu¬ 
lation  occurs.  Iodine,  internally,  also  Arsenic  and  Strychnine,  have  been 
recommended.  Quinine  in  large  doses,  and  Chloride  of  Iron,  may  be  useful. 
No  drug  yet  tried  has  any  marked  specific  effect  on  the  disease  (Durham). 

Glandular  Enlargements. 

Iodine  and  Iodides,  no  remedy  more  efficient,  when  simple  hypertrophy. 
Useless  (with  all  other  medicines)  when  caseation  or  suppuration  has  set  in. 
Iodine  injected  into  cystic  and  glandular  growths  of  neck.  Syrup  of  the  Iodide 
of  Iron  occupies  an  important  place  (B.).  The  iodide  of  potassium  for 
mammae  and  testicles,  but  especially  for  thyroid  (R.).  Iodoform  is  equal,  if  not 
superior  to  iodine,  in  enlarged  scrofulous  glands,  and  other  glandular  swellings 
(Wa.).  Iodide  of  Lead,  as  an  ointment.  Ung.  Hydrarg.  Iodidi  Rubri,  produces 
very  striking  effects  in  goitre,  enlarged  spleen,  etc.  (B.).  Sulphides,  especially 
the  Blue  Lick  water,  are  said  to  abort  or  to  mature  suppuration  in  glands  (R.). 
Calcium  Sulphide,  for  hard,  swollen  glands  behind  the  angle  of  the  jaw,  with 
deep-seated  suppuration  (R.).  Calcium  Chloride,  highly  useful  in  strumous 
inflammation  and  suppuration  (B.).  Pilocarpus,  is  curative  in  acute  affections 
of  parotid  and  submaxillary  glands  (B.).  Mercury,  useful  in  acute  inflamma¬ 
tory  states,  tonsillitis,  parotitis,  etc.  Hydr.  chlor.  corr.  gr.  or  hydr.  cum  creta, 
gr.  L,  every  2  hours  (B.).  The  oleate  of  mercury  and  morphine  in  obstinate  and 
painful  tonsillitis,  and  inflammation  of  lymphatic  glands  (R.).  Belladonna, 
especially  in  tonsillitis  (P.).  Valerian  with  Guaiacum,  in  strumous  enlarge¬ 
ment  (P.).  Hydrastis,  frequently  controls  (P.).  Carbolic  Acid  Injections,  a  2 
per  cent,  solution  injected  into  substance  of  gland  (B.).  [Compare  Bubo, 
Goitre,  Tabes  Mesenterica,  Parotitis,  Tonsillitis,  etc.] 

Glaucoma. 

Atropine,  gr.  ^  hypodermically  beneficial  (Anstie)  ;  imprudently  used  has 
caused  the  disease  (Von  Graefe,  Scelberg  Wells).  Eserine,  lowers  intra-ocular 
tension,  and  is  indicated  with  Quinine  in  all  cases  of  threatened  glaucoma,  to 
preserve  the  eye  from  the  risk  of  consecutive  glaucoma,  and  after  iridectomy 
or  sclerotomy  (De  Wecker).  Iridectomy,  the  only  remedy  for  the  disease, 
medicine  being  worse  than  useless.  The  operation  should  be  performed  as 
soon  as  a  state  exists  which  can  be  called  glaucomatous.  Even  when  vision  is 
lost,  the  operation  will  best  relieve  the  pain  (C.).  Almost  a  certain  cure  in  early 
stages  ;  in  later,  nearly  always  palliative ;  often  curative.  Drainage  of  Eye, 
by  gold  wire  or  catgut,  has  had  success  (De  Wecker). 

Gleet. 

Cantharides,  in  drop  doses,  when  frequent  desire  and  pain  in  region  of 
prostate  (R.) ;  of  benefit  in  subjects  of  relaxed  fibre  and  feeble  circulation 
(B.).  Blisters,  to  the  perinaeum,  of  undoubted  benefit  (B.,  R.).  Piper  Me- 
thysticum,  has  cured  obstinate  gleet  (Switzer).  Bismuth,  1,  glycerin  1,  water 
6  parts,  as  an  injection,  often  useful  in  gleet  (R.).  Eucalyptol,  is  used  with 
benefit  in  chronic  catarrh  of  the  genito-urinary  tract  (R.).  Iron,  the  tincture 
of  the  chloride,  3ss  in  Oss  of  water  with  5j  of  laudanum,  makes  a  good  injection 
for  gleet  (R.) ;  internally  for  anaemic  subjects  (St.).  Mercury,  yi  grain  of  cor¬ 
rosive  sublimate  in  3yj  of  water,  is  a  good  injection  in  gleet,  used  every  2,  3 


GLOSSITIS - GOITRE. 


569 


or  4  hours  (R.).  Zinc  Salts,  the  sulphate  or  chloride,  gr.  ij  of  the  latter  to  a 
pint  of  water,  as  injection  every  hour  (R.).  Bougies,  of  gelatin,  medicated 
with  astringents,  are  extremely  efficient.  Turpentine,  in  moderate  doses,  when 
due  to  relaxed  condition  (B.,  R.).  Copper  Sulphate,  a  solution  as  injection 
(R.).  Astringent  injections  may  be  used  with  benefit  (Wa.).  Copaiba,  smeared 
on  a  bougie,  and  introduced  into  the  urethra,  will  sometimes  cause  gleet  to 
yield  (Wa.).  Oil  of  Sandalwood,  tr^xv  ter  die  (R.).  Glycerite  of  Tannin, 
with  equal  quantity  of  olive  oil  or  mucilage,  as  injection,  £ij  enough.  Per¬ 
severe  8  or  10  days  after  discharge  ceased,  and  do  not  use  at  bedtime  (R.). 
Balsams  of  Peru  and  Tolu,  Buchu,  Canada  Balsam,  Copaiba,  Mastic,  and 
Tannin,  are  used  with  advantage  (P.,  R.).  Often  kept  up  by  over-treatment. 
Will  some  time  or  other  come  to  an  end  (St.).  Diet  and  Habits  important. 
Stimulants,  both  solid  and  liquid,  should  be  rigidly  avoided,  also  coffee.  Fre¬ 
quent  ablutions,  fresh  air,  good  nourishment.  [Compare  Gonorrhoea.] 


Pi'escnptions. 


R.  Tinct.  Ferri  Chlor.,  .  .  .  £vj. 
Tinct.  Cantharidis,  .  .  .  .  gij. 

M.  Sig. — 15  drops  in  water  three  times 
daily. 


R.  Zinci  Sulphatis, . gr.  iij. 

Ac.  Carbol., . rr^ij . 

Ext.  Hydrastis, 

Ext.  Belladonna,  .  .  .  aagr.  vj. 
Gelatini, . q.  s. 


M.  Ft.  bougia  no.  vj.  Sig. — One  in 
urethra  at  bedtime. 


R .  Pulv.  Cantharidis,  .  .  .  .  gr.  iij. 

Ol.  Terebinth., . ^j. 

M.  Ft.  pil.  no.  xij.  Sig. — One  thrice 
daily  in  obstinate  gleet.  If  strangury 
occur,  stop  for  a  day  or  two. 


R .  Ac.  Tannici, . gr.  x. 

Bismuthi  Subnit.,  .  .  .  .  fg  ij. 

Aq .  Rosae, . 5  vj . 

M.  Sig. — Shake  and  use  as  an  injection 
thrice  daily.  (Afaury.) 


Glossitis. 

Bismuth,  gr.  xx  of  subnit.,  with  gj  of  glycerin  and  3 vij  of  water,  as  lotion, 
for  erythematous  inflammation  of  tongue  (A.).  Purgatives,  with  gargles, 
leeches,  antiphlogistic  regimen  generally  (D.).  Quinine  and  Iron,  should  be 
given  internally,  with  dilute  acid  washes,  and  free  purgation  (Cl.).  Alum,  dry, 
powdered,  may  be  dusted  on  tongue  (CL).  Leeches,  applied  beneath  the  jaw, 
if  symptoms  are  urgent  (Cl.).  Abscess,  should  be  opened,  if  any  form.  In¬ 
cisions,  along  superior  surface,  followed  by  vapor  of  hot  water,  may  instantly 
relieve  congestion  (A.).  Tracheotomy,  or  Laryngotomy,  if  suffocation  is  immi¬ 
nent  (A.). 

Glottis,  CEdema  of. 

Emetics,  non-depressing  when  oedema  slight  (A.).  Inhalations,  of  steam 
with  benzoin,  or  conium,  of  great  service  (A.);  or  of  tannin,  gr.  viij  or  x  to 
^j  of  water;  or  alum,  gr.  x  to  the  5,  or  a  saturated  solution  of  potassium 
chlorate,  all  as  spray  (Walker).  Ethyl  Iodide,  by  inhalation,  proved  curative 
in  one  case  in  which  it  was  repeated  twelve  times  (See).  Scarification,  by 
laryngeal  lancet,  of  paramount  value  (A.).  Tracheotomy,  if  the  above  fail 
(A.).  O’Dwyer’s  laryngeal  tubation  promises  well.  [Compare  Croup.  Laryn¬ 
gitis.] 

Goitre. 

Iodine,  is  curative  in  simple  hypertrophy  (ordinary  goitre),  used  both  inter¬ 
nally  and  externally.  Deep  injection  of  the  tincture  is  very  successful  in  cystic 
degeneration  of  the  gland  (B.)  ;  also  in  the  fibrous  and  fibro-cystic  varieties, 
if  injection  be  made  into  the  tumor;  dangerous,  if  into  a  vein  or  into  the 
surrounding  areolar  tissue  (Wa.).  Mercuric  Iodide,  as  oint.  assisted  by  the  sun’s 
rays,  a  piece  the  size  of  a  large  pea  rubbed  in  daily,  very  successfully  used  in 
India  for  simple  hypertrophy  (R.) ;  the  official  unguent,  hydrarg.  ioclidi  rubri, 
1  in  10  daily  (B.)  ;  is  too  strong  (Gross) ;  gr.  xv  to  the  5  strong  enough  for  the 
worst  cases  (Wa.).  Potassium  Iodide,  internally,  also  externally  as  ointment, 


570 


G0X0RRHCEA. 


in  simple  hypertrophy  of  the  gland  (R.).  Strychnine,  gr.  thrice  daily,  has 
been  successful  in  several  cases  (Holmes).  Chloride  of  Iron,  injections  of  the 
solution  used  in  thirty-eight  cases  with  curative  results  (Mackenzie).  Ergotin, 
injected  with  benefit  into  the  parenchyma  of  the  goitre  (P.)  ;  also  used  hypo¬ 
dermically  with  good  results  (Wa.).  Ammonium  Chloride,  as  an  internal 
remedy,  has  proved  curative  (Stevens).  Electrolysis,  has  sometimes  cured  in 
cases  of  simple  hypertrophy  and  cystic  gland  (B.).  Spongia  Usta,  was  formerly 
considered  a  sovereign  remedy  (Wa.).  Seton  has  cured.  Fluoric  Acid,  in 
doses  of  tr^xv  to  5j  thrice  daily,  largely  diluted,  cured  seventeen  cases  out  of 
twenty  (Woakes).  Excision,  is  a  very  difficult  operation,  only  to  be  considered 
in  extreme  cases;  it  has  been  performed  successfully  by  Desault,  Harris, 
Hedenus,  Billroth  and  Greene.  [Compare  Exophthalmos.] 


Prescriptions. 


$ .  Ammonii  Chloridi,  .  .  .  3  vss. 

Syrupi  Simplicis,  .  .  .  .  3  ss. 

Aq.  Cinnamomi,  .  .  .  .  ~  iv. 

M.  Sig. — Teasp.  thrice  daily. 


R. 


Ung. 


Hydrarg.  Iodidi  Ru- 


Tbri>  ; . 3J*„ 

\  aselini, . 3  vij. 

M.  Sig. — Use  as  directed.  (Gross.) 


Gonorrhoea. 

Aconite,  a  drop  of  tinct.  each  hour  in  the  acute  stage  (R.);  when  inflam¬ 
mation  (Pf.,  St.).  Gelsemium,  serviceable,  acute  stage  (Pf.).  Cannabis  Sativa, 
after  acute  symptoms  subside,  a  few  drops  3  or  4  times  a  day,  is  fully  as  effect¬ 
ual  as  copaiba  or  sandal,  and  infinitely  more  pleasant  to  take  (Pf.).  Canna¬ 
bis  Indica,  relieves  pain,  diminishes  discharge  (P.) ;  occasionally  useful  (R.). 
Mercury,  excellent  results  from  corrosive  sublimate  (Pf.) ;  gr.  to  3  viij  aquae 

destill,  in  subacute  and  chronic  stages,  as  injection  thrice  daily;  may  have 
gr.  ss-j  of  zinc  chloride  added  with  benefit.  Often  effectual  (Wa.).  See  page 
462  for  formula.  Hydrastis,  the  infusion  best  for  injection,  oj  of  root  to  3 viij 
aquae  (Pf.) ;  the  fluid  extract  is  one  of  the  best  injections,  properly  diluted  ;  or 
the  muriate  of  berberine  (hydrastin)  oj  to  5D  of  mucil.  acaciae  (B.).  Col- 
chicum,  the  wine  of  the  seed  has  frequently  cured  gonorrhoea,  and  was  used 
in  thirty-minim  doses  nightly  for  the  relief  of  chordee  by  Brodie  (B.).  Chlo¬ 
ride  of  Iron,  when  acute  stage  has  passed  and  the  discharge  is  degenerating 
into  gleet,  few  remedies  are  more  useful  than  this  tincture,  in  doses  of  n\,xv- 
xx  thrice  daily  (Wa.).  See  Erysipelas  for  formula.  Alkalies,  citrates  or 
bicarbonates  to  render  the  urine  alkaline  (R.)  ;  Lithium  Carbonate  in  five-grain 
doses  thrice  daily  for  the  same  purpose.  Alkalies  are  the  chief  factor  in 
Otis’s  treatment ;  Potassium  Bicarb.,  gr.  x  in  a  tumbler  of  water,  or  in  flaxseed 
tea,  or  infusion  of  triticum,  with  gr.  xv  of  Potass.  Bromide,  if  great  pain 
present.  Vichy  Water  (Celestin’s)  freely  (Otis.).  Turpentine,  in  chronic 
stage,  when  parts  are  relaxed,  moderate  doses  are  of  great  benefit  (B.).  Can- 
tharides,  drop-doses  may  be  used  (R.) ;  in  the  chronic  stage  (B.).  Pulsatilla, 
in  subacute  and  gonorrhoeal  ophthalmia  (P.).  Copaiba,  especially  adapted  to 
gonorrhoea  (B.) ;  pour  it  upon  a  half  a  wineglassful  of  water  to  which  add  some 
bitter  tincture  (Chapman) ;  if  given  too  early  in  the  disease  it  will  aggravate 
the  symptoms  (P.) ;  should  not  be  used  until  pain  in  urinating  is  nearly  gone, 
chordee  ceased,  and  the  discharge  is  diminishing  and  of  yellow  color  (Wa.) ; 
is  no  good,  but  rather  injurious,  and  prolongs  the  disease  (Otis).  See  page 
459  for  formula.  Sandalwood  Oil,  valuable  in  subacute  (P.)  ;  a  good  quality 
difficult  to  obtain  (Pf.).  Best  internal  remedy  ;  Copaiba  next  (St.).  Silver 
Nitrate,  a  weak  solution  (gr.j-v-.5j)  as  injection.  In  vaginal  gonorrhoea  a 
strong  solution  (Sj~sj)  through  speculum  to  every  part  of  canal  (B.).  As 
abortive  injection  is  useless  and  dangerous  (St.).  Cubeba,  unlike  copaiba,  given 
with  good  effect  in  acute  stage  ;  best  results  from  mixture  of  both  as  in  electu¬ 
ary.  See  formula  below.  Is  not  irritating  to  the  stomach,  and  agrees  with  some 
patients  better  than  copaiba  (Wa.).  Zinc  Salts,  a  weak  injection  of  the  chlo¬ 
ride,  gr.  j  to  3yj  or  viij  of  rose-water;  or  the  sulphate  gr.  j  to  the  ,5,  frequently 
repeated,  is  probably  the  best  treatment  (B.).  The  best  injections  are  those  of 


GONORRHCEA. 


571 


the  sulphate  or  acetate,  gr.  vj-xij  to  ,$iv  aquas,  after  the  acute  inflammation 
subsides  (St.).  Bismuth,  the  oleate,  smeared  on  a  sound,  and  inserted  for  5 
minutes  (Shoemaker) ;  with  mucilage  as  an  injection,  excellent  in  chronic  gon¬ 
orrhoea  (Hill).  Lead  Acetate,  the  dilute  solution  of  the  subacetate,  as  injection, 
may  be  employed  at  any  stage  (B.).  Chloral,  a  week  solution,  gr.  j-iv  to  the 
3,  a  very  good  injection  (Hill).  Resorcin,  a  1  per  cent,  solution  makes  a  use¬ 
ful  injection  (Wa.).  Injections,  of  tannin,  copper  sulphate,  iron,  cadmium,  port- 
wine,  brandy-and-water,  and  1000  other  agents  (R.).  Injections  are  very  bad, 
especially  in  the  acute  stage ;  should  never  be  used  until  the  5th  week  and 
then  only  if  the  case  is  not  progressing  (Otis).  True  gonorrhoea  is  never  cured 
in  less  than  four  weeks  (Van  Buren  and  Keyes) ;  urethritis  is  a  different 
disease  entirely  (Otis).  Balsams  of  Peru  and  Tolu,  also  Buchu,  Uva  Ursi,  Chi- 
maphila,  Pareira,  etc.,  are  among  the  numerous  remedies  used  for  gonorrhoea 
(R.).  Alcohol,  as  a  beverage,  or  any  other  stimulant,  must  be  avoided  entirely 
(R.).  Soluble  Bougies  made  of  iodoform,  eucalyptus  and  cacao-butter,  are 
highly  recommended  to  cut  the  disease  short  (Wa.) ;  a  series  of  similar  prepa¬ 
rations,  having  a  basis  of  gelatin  and  glycerin,  medicated  with  the  usual  astrin¬ 
gent  and  sedative  drugs,  is  manufactured  by  C.  L.  Mitchell  of  Philadelphia, 
and  may  be  obtained  of  the  drug  trade.  Wrappings  of  several  folds  of  cotton 
are  heating  and  uncomfortable,  also  dirty  and  productive  of  balanitis,  etc.  Pin 
a  false  front  to  shirt  for  covering  (St.).  Rest  in  bed  is  an  absolute  desideratum, 
especially  during  the  inflammatory  stage.  Hot  water,  ioo°  F.,  to  the  penis 
during  urination,  extreme  cleanliness,  milk  diet;  water  freely  as  a  beverage; 
flavored  with  a  few  drops  of  oil  of  gaultheria,  or  flaxseed  tea,  or  infusion  of  triti- 
cum  with  potassium  bicarbonate.  Sexual  thoughts  to  be  entirely  avoided  (Otis). 
[Compare  Chordee,  Gleet, Orchitis,  Rheumatism  Gonorrhceal,  Urethri¬ 
tis,  Urethral  Stricture,  Vaginitis.] 


Prescriptions. 


For  Internal  Use. 

R.  Potassii  Citratis, . 

3  SH  • 

Spt.  Limonis, . 

3SS- 

Syr.  Simplicis, . 

3'J- 

Aquae, . 

Si- 

M.  Sig. — Dessertsp.  largely  diluted,  3 

or  4  times  daily.  As  alkali  for  the  increas- 

ing  stage. 

( Otis.) 

The  Black  Paste. 

R .  Pulv.  Cubebae, 

7  i'J* 

Copaibae, . 

.3  jss. 

Aluminis, . 

3  >j- 

Sacchari  Albi, . 

3J- 

Magnesiae, . 

3  jss- 

Olei  Cubebae, . 

3J- 

Olei  Gaultheriae,  .... 

33- 

M.  fiat  elactuarium.  Sig. — A 

piece  the 

size  of  a  walnut  after  each  meal. 

( Otis. ) 

R .  Oleoresinae  Cubebae,  .  .  . 

Z  iv. 

Potassii  Bromidi,  .... 

3  J- 

Olei  Sassafras, . 

npx. 

Syr.  Acaciae, . 

3  'J- 

Aquae, . q.  s.  ad 

3  VJ- 

M.  Sig. — Dessertsp.  3  or  4  times  daily. 

(/.  Wm.  White.) 


[For  Alkaline  Emulsion  of  Copaiba  see 
ante,  page  459.] 


For  Local  Use. 

R.  Resorcini, . ^j. 

Ac.  Bond, . gr.  xx. 

Zinci  Acetatis, . gr-X-/^* 

Aquae  Destil . 5  iv. 

M.  Sig. — Dessertsp.  as  injection. 


R .  Pulv.  Iodoformi,  .  .  .  .  5  ss. 

Ac.  Carbolici, . ^  ij. 

Glycerini, .  ~  ij. 

Aquae  Destil.,  .  ...  ad  3  viij. 
M.  Sig. — Teasp.  as  injection. 


R.  Zinci  Sulphatis, . gr.  vj. 

Plumbi  Acetatis . gr.  viij. 

Ammonii  Chloridi,  .  .  .  .  gr.  iv. 

Aluminis, . gr.  v. 

Aquae  Rosae, . £j. 


M.  Sig. — Injection,  to  be  used  after 
acute  symptoms  subside. 


R  .  Zinci  Sulphatis, . gr.  viij. 

Liq.  Plumbi  Subacet.  Dih,  £  iv. 

M.  Sig. — Use  as  an  injection. 


R  .  Zinci  Chloridi, . gr.  j. 

Aquae  Rosae, . 5  vj-viij. 

M.  Sig. — Use  as  injection. 

[For  Injection  Brou  and  others,  see  ante, 
page  462.] 


1 


572 


GOUT. 


Gout. 

Morphine,  hypodermically,  as  close  to  the  affected  joint  as  possible  outside 
of  the  red  areola,  is  miraculous  in  giving  immediate  relief.  Antipyrine, 
remarkably  efficient  for  relieving  the  pain  as  well  as  prophylactic  against 
future  attacks  (Marshall).  Aconite,  may  certainly  relieve  pain  (P.).  Belladonna, 
the  best  remedy  to  effectually  and  speedily  soothe  pain  ;  also  in  gout  of  the 
stomach,  5-rrp  doses  efficacious  (P.).  Potassium  Iodide,  especially  when  pain 
is  worse  at  night  (R.).  Colchicum  is  merely  palliative  ;  a  large  dose  (3j)  of  the 
wine  often  removes  the  severest  pain  in  an  hour  or  two,  and  soon  after  the  swell¬ 
ing  and  heat  subside  (R.) ;  it  is  especially  useful  in  acute  and  rheumatic  gout  (B.) ; 
is  not  specific,  nor  a  lasting  or  final  remedy  for  gout,  but  acts  very  directly  on 
the  pain  and  inflammation  of  acute  attacks.  Laville’s  tincture  is  a  colchicum 
preparation,  though  colocynth  is  also  a  constituent  (P.)  :  is  useful  in  the  bron¬ 
chitis,  asthma,  dyspepsia,  urticaria,  etc.,  of  gouty  subjects  (R.).  Veratrine,  as 
ointment  to  painful  joints  (R.).  Sulphides,  as  baths  in  chronic  gout,  or  fumi¬ 
gation  with  sulphurous  acid,  and  bed-clothes  exposed  to  strong  fumes  (R.) ;  sul¬ 
phur  waters  certainly  benefit  (B.).  Iodine,  painted  round  joints  in  chronic  (R.). 
Strychnine,  hypodermically  for  later  stage  of  gout  paralysis  (R.).  Arsenic,  very 
serviceable  in  a  form  of  chronic  arthritis  allied  to  neuralgia  (B.).  Lithium,  the 
bromide  internally  and  a  strong  solution  of  lithia  to  the  joints  (B.) :  the  bro¬ 
mide  is  the  most  efficient  agent  in  combating  the  disease  (Aulde)  :  the  carbo¬ 


nate  (gr.  v  to  the  3)  on  lint  around 


gouty 


enlargements,  joints,  etc.  (R.). 


Sodium  Salicylate,  gr.  x  internally  every  2  hours,  also  3(j  to  3vij  water  warmed, 
as  lotion  on  lint  covered  with  oiled  silk.  Guaiacum  has  long  had  high  repute, 
and  may  be  given  for  a  long  time  without  injury  (Wa.).  Rhubarb  with  an 
alkali,  regularly  during  intervals,  very  serviceable  (Halford).  Manganese, 
syrup,  ferri  et  mang.  iodidi  (np  x-3ss)  for  the  cachectic  state  (B.).  Alkalies,  to 
relieve  indigestion,  especially  lithium  salts.  Alkaline  mineral  waters  have  long 
had  a  deserved  reputation  (B.) :  Magnesia  and  its  carbonates  often  of  great 
service;  the  latter  dissolved  in  excess  of  C02  an  elegant  form  of  administra¬ 
tion  (Wa.).  Alkaline  Poultice,  9  of  linseed  meal  to  one  of  sodium  bicarb,  is  a 
useful  application  (R.).  Turkish  Baths,  are  useful  in  chronic  gout  (B.,  R.). 
Aliment.  Farinaceous  vegetables  and  acid  fruits.  Avoid  animal  or  saccha¬ 
rine  food.  Milk-cure  has  improved  cases,  and  apparently  removed  the  diathe¬ 
sis  (B.).  Cod-liver  oil  in  chronic  gout(B.,  R.).  Entire  abstinence  from  alcoholic 
beverages  is  best ;  the  worst  wines  are  port,  sherry  and  madeira.  Local 
Measures.  The  affected  limb  should  be  raised,  and  surrounded  with  hot,  moist 
flannels.  Wrap  the  hands  in  flannel  dripping  with  water,  and  cover  with 
water-proof  bag,  to  dissolve  gouty  deposits.  [Compare  Rheumatic  Arthritis, 
LlTH/EMIA.] 

Prescriptions. 


Scudamore"1  s  Mixture  ( Modified ). 

R.  Vini  Colchici  Radicis,  .  .  Jjj.  R  • 

Magnesii  Sulphatis,  .  .  .  3j. 

Magnesias  Optimas,  .  .  .  .  3  ij. 

Aquae  Menth.  Pip.,  .  .  .  .  3  x. 

M.  Sig. — Tablesp.  every  hour  until  it 
operates. 


M. 


Lallemand' s  Specific. 

Ext.  Colchici  Acet.  (B.  P.), 

Ext.  Opii  Aquosi,  .  .  .  aa  gr.  xv. 

Potass.  Iodidi, . 3’iv. 

Potass.  Acetatis, . 39. 

Aquae  Destill., . ^  iijss. 

Vini  Albi, . 3  ss. 

Sig. — 20  drops  thrice  daily. 


R  .  Colchicinae, . gr.  j. 

Ext.  Colocynthidis  Co.,  .  .  3  ss. 
Quininae  Sulphat.,  ....  3  iij. 
Ft.  pil.  no.  lx.  Sig. — One  every 

hours. 


R. 


aa 


four 

(B.) 


R .  Vini  Colchici  Sem.,  .  .  . 

Tinct.  Digitalis, . 

Liq.  Potassii  Citratis,  .  .  . 
M.  Sig. — A  teasp.  in  water 
hours. 


!  SS. 


o 

7\  ij* 

3ijss. 
every  six 


Lithii  Citratis, 

Magnesii  Carbonat., 

M.  et  div.  in  pulv.  no.  1. 

Sig. — One  in  water  thrice  daily.  In 
chronic  gout. 

R.  Lithii  Bromidi, . ^j. 

Liq.  Potas.  Citrat.,  .  .  .  .  3W. 

Syr.  Tolutan., . 3  ij. 

M.  Sig. — A  teasp.  in  plenty  of  water 


after  each  meal. 


{Aulde.) 


GUMS - HAIR - HAY-FEVER. 


573 


Gums. 


Myrrh,  the  tincture  for  spongy  and  ulcerated  gums  (P.) ;  3ij-iv  in  5  iv  of 
water  or  infusion  of  cinchona,  is  highly  serviceable  as  a  gargle  or  mouth-wash 
(Wa.).  Alum,  for  spongy  and  ill-conditioned  gums,  tending  to  recede  from  the 
teeth,  whether  of  mercurial  or  scorbutic  origin  (Wa.).  Catechu,  a  piece  dis¬ 
solved  slowly  in  the  mouth  is  often  of  service  in  similar  conditions  (Wa.). 
Rhatany,  the  powder  as  a  dentifrice,  keeps  gums  in  good  order  (P.).  Potassium 
Chlorate,  gr.  ij  every  four  hours  for  a  child  of  one  year,  for  inflammation  of 
gums  in  teething  (Wa.).  Carbolic  Acid,  gr.  iij  ad  3j  aquae,  as  lotion  in  diseases 
of  the  gums  (Hilditch).  Pomegranate,  the  bark  an  excellent  basis  for  gargles 
in  relaxed  gums  (P.).  Potassium  Iodide,  gr.  x  thrice  daily,  for  periostitis  of 
alveolar  processes,  marked  by  looseness  of  teeth,  pain  and  swelling  of  gums 
(Graves).  Iodine,  gr.  j  ad  $j  aquae,  applied  by  a  camel’s-hair  brush,  after  each 
meal,  for  retraction  of  gums  with  loosening  of  the  teeth  (Stille).  Tannin,  the 
glycerite,  for  spongy  and  bleeding  gums  (B.).  Carbolate  of  Iodine,  when  fetor, 
(B.).  Benzoin,  the  tincture  a  good  application  (B.).  [Compare  Scurvy, 
Teeth.] 

Prescriptions. 


R  .  Aluminis, . 3  ss. 

Tinct.  Myrrhae,  .  .  .  .  gj. 
Tinct.  Cinchonae,  .*  .  .  .  3  iv. 

Mel.  Rosae, . 2;  j. 

Vini  Albi, . .  3  viij . 


M.  Sig. — Mouth-wash 


R. 

M. 


Tinct.  Orris, 

Spt.  Rosae, 

Alcoholis, . aa  5  iv. 

01.  Amygd.  Amar.,  .  .  .  gtt.  ij. 

Sig. — Violet  Mouth-wash. 

(Pi esse.) 


Hair. 

Rosemary,  encourages  the  growth  of  hair,  mitigates  baldness,  and  is  supposed 
to  prevent  uncurling  in  a  damp  atmosphere  (P.).  Hydrogen  Peroxide,  and 
other  preparations  of  oxygen,  are  used  to  “blonde”  the  hair,  for  purposes  of 
fashion  (Wilson).  Hair-dyes,  comprise  potassium  permanganate,  pyrogallic 
acid,  black  oxide  of  lead,  which  are  temporary,  and  the  black  oxide  of  silver, 
which  is  permanent  in  its  action  (Wilson).  Depilatories  usually  consist  of 
powders  containing  quicklime  3  parts,  sodium  sulphide  1,  and  starch  4.  A 
powerful  depilatory  is  barium  sulphide  made  into  a  thin  paste  with  starch 
(Wilson).  Another  contains  yellow  sulphide  of  arsenic,  gr.  xx,  quicklime,  3 ss, 
starch,  3'\).  A  very  effective  one  is  barium  sulphide  and  oxide  of  zinc  (B.). 
Sarsaparilla  is  stated  by  Teste  to  possess  the  curious  property  of  changing  red 
hair  to  a  light  flaxen  color  when  taken  internally  for  three  months.  [Compare 
Alopecia,  Syphilis,  Tinea  Tonsurans,  etc.] 


Prescriptions. 


R .  Sodii  Boratis, . 3  iv. 

Aq.  Ammoniae, . 3j. 

Spt.  Myrciae, . 3  ij. 

Aq.  Rosae, . 3xiij. 


M.  Sig. — Shampoo  Hair  Wash. 

R  .  Ac.  Salicylici, . gr.  xl. 

Tinct.  Benzoini,  .  .  .  .  3  ss. 
Alcoholis,  Glycerini,  .  aa  3  viij. 
M.  Sig. — Hair  Wash. 


R.  01.  Ricini, . J-jss. 

01.  Bergamii, . 3JSS* 

01.  Cinnamomi, 

01.  Caryophylli,  .  .  .  .  aa  rqyij. 

01.  Lavandulae, . lrpxl. 

Tinct.  Cantharidis,  .  .  3j. 

Aq.  Ammoniae, . 3  ij . 

Alcoholis,  .  .  .  .  q.  s.  ad  Oj. 


M.  Sig. — Hair  Tonic. 


Hay-Fever. 

Arsenic,  especially  valuable  when  disease  is  more  of  catarrhal  than  of  asth¬ 
matic  type,  3-minim  doses  of  liquor  arsenicalis  (Mackenzie) ;  as  cigarettes,  2 
or  3  daily  (see  Asthma  for  formula)  (B.).  Belladonna,  when  nasal  secretion  is 


574 


HAY-FEVER. 


very  profuse  (B.).  Euphrasia,  of  decided  benefit  for  the  catarrhal  symptoms 
(Pf.).  Quinine,  very  useful  after  the  more  acute  symptoms  have  subsided  (R.) ; 
injected  into  the  nares  checks  catarrhal  discharge  and  spasmodic  symptoms 
(P.) ;  a  solution  of  the  hydrochlorate,  gr.  iv-viij  ad  §j  aquae,  applied  locally  to 
nasal  mucous  membrane  by  a  spray-producer  or  a  brush,  will  arrest  the  disease 
if  confined  to  the  nares  and  fauces  (B).  Ipecacuanha,  in  hay-asthma  (R.)  ; 
is  of  great  value,  though  the  smallest  doses  cause  similar  effects  (P.).  Aconite 
is  better  than  arsenic  in  true  hay-fever  (R.)  ;  has  been  used  with  the  best  results 
(P.).  Grindelia  benefits  cases  of  asthmatic  type  (B.).  Iodides  are  very  ser¬ 
viceable,  locally  and  internally;  large  doses  until  some  iodism  observed,  may 
be  combined  with  arsenic  (B.).  Opium,  especially  as  morphine,  of  great  value 
in  any  stage,  but  great  danger  of  the  opium-habit  (B.) ;  the  tincture  in  doses  of 
rr^ij  — iij  every  2  hours  for  three  doses,  then  rrpj  every  2  hours  until  the  discharge 
abates,  has  given  excellent  results  (Wa.).  Black  Coffee  is  highly  recommended 
(P.).  Cocaine,  a  5  to  20  per  cent,  solution  of  the  hydrochlorate,  brushed  over 
the  nasal  mucous  membrane  after  drying  it  as  far  as  possible,  is  the  most  effi¬ 
cient  palliative  yet  obtained  (R.) :  a  4  per  cent,  solution  dropped  from  a  medi¬ 
cine-dropper  well  into  anterior  nares,  the  head  being  thrown  well  backward,  or 
sprayed  up  the  nostrils  from  a  small  atomizer;  gives  immediate  relief,  and 
though  not  curative  it  prevents  so  much  suffering  and  distress  that  in  no  case 
should  it  be  left  untried  (Da  Costa).  Ignatia,  the  tincture  has  seemed  to  benefit 
some  cases,  and  to  favorably  influence  the  course  of  the  disorder  (Da  C.). 
Lobelia,  has  been  found  an  efficient  remedy  (Wa.).  Tobacco,  smoking  helps 
some  and  aggravates  the  symptoms  in  other  instances.  Internally  ad  nauseam 
it  helps,  but  there  are  better  and  safer  remedies  (Wa.).  Removal  to  the  sea- 
coast,  or  a  barren,  mountainous  district,  gives  the  only  relief  to  sorrte  sub¬ 
jects  ;  though  many  of  the  worst  cases,  hitherto  unaffected  by  medicine,  are 
now  relieved  by  the  local  application  of  Cocaine.  [Compare  Asthma, 
Catarrh,  Conjunctivitis,  Influenza.] 


Prescriptions. 


For  Internal  Use. 

R .  Potassii  Iodidi, . qj. 

Liq.  Potass.  Arsenit.,  .  .  .”j. 

Aquae  Cinnam., . 5  iv. 

M.  Sig. — Teasp.  every  4  hours. 

For  Local  Use. 

R .  Tinct.  Iodi, . ^j. 

Ac.  Carbol., . gtt.  x. 

Aq.  Destill., . [5  iv. 

M.  Sig. — For  local  use  with  atomizer 
or  post-nasal  syringe. 

R.  Ext.  Hyoscyami,  .  .  .  .  gr.  xij. 

Potassii  Iodidi, . ^j. 

Potassii  Bicarb., . gij. 

Ext.  Glycyrrhizae  Pur.,  .  .  3  iv. 

Aq.  Anisi, . ~  ivss. 

M.  Sig. — Dessertsp.  every  4  hours  until 

relieved.  ( IVeber.) 

R.  Menthol, . ^j. 

Ac.  Carbol., . ^ss. 

Zinci  Oxidi, . ^j. 

01.  Amygd.  Dulcis,  .  .  .  ^jss. 

Cerati  Simplicis,  .  .  .  .  q  ij. 

M.  Sig. — Apply  thoroughly  to  the  nos¬ 
trils  every  few  hours. 

R.  Liq.  Potassii  Arsenit.,  .  .  5j. 

Tinct.  Belladonnas,  .  .  .  ~ij. 

M.  Sig. — 5  to  10  drops  after  meals,  as 
a  prophylactic. 

R.  Quininae  Bisulph.,  .  .  .  .  ^  iij. 

Aquae, . ^  iv. 

M.  Sig. — Irrigate  the  nares,  after 

cleansing  with  a  weak  alkaline  solution. 

R.  Tinct.  Euphrasia,  ....  gjss. 

Aq.  Camphorae,  .  .  .  ad  3  ij. 

M.  Sig. — Teasp.  four  times  daily,  for 
the  catarrh. 

R.  Cocainae  Hydrochlor.,  .  .  gr.  vj. 
Aquae  Destill.,  .  .  .  .  £ij. 

M.  Sig. — 5  per  cent,  solution.  A  few 
drops  to  be  instilled  into  nares  while  head 
is  lowered.  ( Da  Costa.) 

HEADACHE. 


575 


Headache,  Bilious-sick. 


Antipyrine,  the  most  valuable  single  remedy  for  headaches ;  an  8-grain  dose 
in  dyspeptic  headache,  in  a  little  water,  at  commencement  of  attack,  the 
patient  lying  down  in  a  dark  room.  A  second  dose  one  hour  after  is  generally 
enough,  but  a  third  or  fourth  may  be  required.  Sleep  generally  follows,  and 
there  are  no  unpleasant  after  effects.  Acetanilide,  in  4-gr.  dose,  equally  effec¬ 
tive.  Nux  Vomica,  gtt.  j  of  tinct.  frequently,  when  acute  gastric  catarrh,  with 
headache  and  nausea  (R.) ;  gtt.  j  every  10  minutes,  soon  after  meals,  often 
gives  marked  relief  in  sick-headache  not  of  neurotic  origin  (A.  A.  Smith). 
Strychnine,  with  aloin  and  belladonna,  in  minute  granules,  for  bilious  head¬ 
ache  from  obstinate  constipation,  effective  if  given  several  times  a  day  for  a 
week  or  ten  days  (Roy).  Belladonna,  the  extract  in  doses  of  gr.  in 

similar  form.  Iris,  blinding  headache  in  right  supraorbital  region,  nausea, 
vomiting,  usually  the  result  of  hepatic  derangement.  rr\j  every  half-hour  for 
three  doses.  Usually  relieves  promptly  (Pf.).  Bryonia,  ordinary  bilious  with 
vomiting  (P.).  Picrotoxin,  gr.  by  stomach,  in  periodical  form  (B.).  Cha¬ 
momile,  a  popular  remedy  (R.).  Podophyllum,  in  sick  headache,  with  dark, 
bilious  diarrhoea,  or  constipation  with  dark  motions  (R.).  Sanguinaria,  when 
due  to  stomach  derangement,  a  few  doses  relieve  (P.).  Hydrastis,  from  con¬ 
stipated  bowels  (P.).  Mercury,  as  “blue  pill,”  to  prevent  or  mitigate;  or, 
gr.  T£n  of  bichloride  when  with  light-colored  diarrhoea  (R.).  Ammonium 
Chloride  is  an  efficient  remedy  in  most  forms  of  headache  (Wa.).  Sodium 
Phosphate,  a  useful  laxative  in  so-called  “  bilious-sick-headache  ”  (B.).  Po¬ 
tassium  Bromide,  a  large  dose  in  ordinary  or  sick-headaches  (R.).  Ginger, 
in  paste,  as  counter-irritant  (P.).  Water,  as  cold  or  hot  affusion,  or  ice-bag 
to  head;  hot  sometimes  best.  The  purgative  waters  (as  Friedrichshall)  before 
breakfast  in  a  cup  of  hot  water  (R.) ;  a  brisk  saline,  purgative,  or  small  doses 
of  Epsom  salts  thrice  daily,  very  effectual  for  frontal  headache  with  constipa¬ 
tion  (Br.).  Nitro-muriatic  Acid,  10  drops  of  the  dilute  acid  in  a  winegl.  of 
water,  before  each  meal,  often  an  effectual  remedy  (Br.).  Charcoal,  two  tea¬ 
spoonfuls  stirred  in  half-glass  of  water,  as  a  draught,  is  an  efficient  remedy 
for  sick-headache  with  sour  stomach  and  flatulence,  etc.  [Compare  Hemi- 
CRANIA.] 


Prescriptiotis. 


R.  Ammonii  Chloridi,  .  .  .  3  iij. 

Morphinae  Acetatis,  .  .  .  gr.  j. 

Caffeinse  Citratis,  .  .  .  .  5  ss. 

Spt.  Ammonii  Aromat.,  .  .  ,"j. 

Elix.  Guaranae, . 5  iv. 

Aquae  Rosae, . ^iv. 

M.  Sig. — Dessertsp.  every  quarter-hour 
until  relieved.  ( Carpenter .) 


R .  Podophylli  Resinae,  .  .  .  gr.  ij. 
Tinct.  Zmgiberis,  .  .  .  .  5pj. 
Alcoholis,  .  .  .  .  q.  s.  ad  5j. 

M.  Sig. — Teasp.  in  a  winegl.  of  water 
every  night  at  bed-time,  or  every  second, 
third  or  fourth  night  as  required. 

{Dobell.) 


Headache,  Congestive. 

Aconite,  to  reduce  the  circulation  (R.).  Veratrum  Viride,  at  menstrual 
periods  (R.).  Belladonna,  relieves  cerebral  congestion,  and  distress  from  light 
and  sound  (P.) ;  pain  over  brows  and  in  eyeballs — often  due  to  stomach  or 
uterine  derangements — especially  in  young  women  ;  rtpiij  of  tinct.  every  three 
hours  (R.).  Potassium  Bromide,  a  large  dose  (gr.  xv-xx)  in  ordinary  or  sick- 
headaches  (R.) ;  Bromides  are  useful  when  nervous  system  has  been  irritated, 
but  when  exhausted  they  do  harm  (Hammond).  Calomel,  gr.  every  hour 
for  ten  or  twelve  doses,  will  relieve  the  headache  of  syphilis  occurring  at  night 
(Tr.).  Cannabis  Indica  is  given  with  uniformly  good  results  in  the  headache 
of  the  climacteric.  Potassium  Iodide,  throbbing,  intolerance  of  light,  pain 
passing  from  back  of  neck  over  vertex  to  brow,  nocturnal,  tender  scalp,  almost 
unbearable  ;  ten-grain  doses  ter  die  will  cure  (R.).  Hydrastis,  when  consti¬ 
pated  bowels  (P.).  Amyl  Nitrite,  for  headaches  with  severe  flushing  heats  at 
menstruation  or  climacteric,  a  sufficient  dose  (R.).  Mustard,  in  hot  foot- 


576 


HEADACHE,  NERVOUS. 


bath,  or  as  poultice  to  nape  of  neck  in  various  forms  of  headache  (R.).  Water, 
cold  water  poured  gently  over  forehead,  sometimes  warm  water  better  (R.).  A 
very  hot  foot-bath  often  effectually  relieves  (Wa.).  Purgatives  are  often  bene¬ 
ficial,  especially  when  congestive  headache  arises  from  suppression  of  hemor¬ 
rhoidal  discharge,  or  in  persons  of  phlegmatic  habit;  aloes  best  (Wa.) ;  or 
colocynth,  as  derivative,  when  cerebral  hypersemia  (Da  Costa). 


Prescriptions. 


R  .  Ext.  Colocynthidis  Co.,  .  .  gr.  xij. 

Pulv.  Capsici, . gr.  iv. 

Ext.  Gentians, . gr.  xxiv. 

Ft.  pil.  no.  xij.  Sig. — One  pill  thrice 
daily.  Also  a  25  grain  dose  of  Sodium 
Bromide  every  night  at  bedtime. 

[Da  Costa.) 


R.  Spt.  Ammonioe, . $j. 

Spt.  Camphorse, . ^  ss. 


M.  Sig. — For  a  quart  of  water  in  which 
a  handful  of  common  salt  has  been  dis¬ 
solved.  Cork  tightly  and  use  locally  on 
lint  as  an  evaporating  lotion. 


Headache,  Nervous. 

Cannabis  Indica,  ten-minim  doses  of  the  tincture  thrice  daily  in  the  intervals, 
often  curative  in  bad  cases  of  neuralgic  headache;  or  %  to  )4-grain  doses  of 
the  extract  (P.).  See  under  Hemicrania.  Belladonna,  tr\Jij  of  tinct.  every 
3  hours,  when  pain  over  brows  and  in  eyeballs,  especially  when  at  men¬ 
strual  periods ;  also  when  from  overstudy  or  fatigue  (R.).  Nux  Vomica,  if  with 
gastric  symptoms  (R.) ;  is  better  than  strychnine,  and  should  be  given  in  quarter- 
grain  doses  of  the  extract  after  meals,  combined  with  iron  and  quinine  if  patient 
is  chlorotic  (Hammond).  Bromides,  when  the  nervous  system  has  been  irritated 
are  useful,  but  harmful  when  it  is  exhausted  (Hammond).  Silver  Nitrate,  half¬ 
grain  doses  with  minute  doses  of  pil.  coloc.  comp.,  invaluable  in  headaches  of 
hysterical  women,  and  especially  stomach  headaches  of  delicate  and  literary 
men  (Wa.).  Ignatia,  removes  clavus  hystericus  (Pf.).  Ammonia,  the  aromatic 
spirits  (3ss-3ij)  or  the  carbonate  (gr.  v-x)  in  nervous  headache  (B.) ;  the  hydro¬ 
chlorate  (gr.  x-xx)  in  bilious  and  hysterical  headaches,  especially  in  hard-worked 
and  delicate  young  women  (Wa.).  Amyl  Nitrite,  inhaled  when  extreme  pallor 
of  face  (B.).  Arsenic,  throbbing  supra-orbital  (R.) ;  as  a  nerve  tonic  stands 
next  in  value  to  Zinc  (Hammond).  Cimicifuga,  in  nervous  or  hysterical  women, 
especially  at  menstrual  periods  (R.) ;  in  rheumatic  headaches  and  menstrual 
(P.).  Coffee  and  Tea,  when  from  nervousness  or  exhaustion  (R.) ;  coffee  espe¬ 
cially  useful  (P.).  Guarana,  a  very  effective  palliative,  gr.  xx  every  half-hour 
for  three  doses  (P.) ;  rr^xv  of  the  fluid  extract  every  quarter-hour  increased  to 
rr\pd  will  often  relieve  periodical  headaches  not  of  malarial  origin  (A.  A.  Smith). 
Sodium  Salicylate,  in  small  doses,  gr.  ij-iij  every  quarter-hour,  is  very  efficient 
in  neuralgic  headache  (Br.).  Caffeine  Citrate,  two-grain  doses,  in  capsule,  every 
half-hour,  a  very  effectual  remedy  for  nervous  and  sick-headache,  but  causes 
insomnia  if  used  in  the  evening.  Phosphorus,  as  dilute  phosphoric  acid,  in 
doses  of  Rbxxx  well  diluted,  thrice  daily  ;  or  zinc  phosphide,  gr.  ^  in  pill,  ter 
die,  very  useful  in  most  forms  of  nervous  headache  (Hammond).  Cajuput  Oil, 
well  rubbed  in  twice  daily  (P.).  Menthol,  locally  to  forehead  in  frontal  head¬ 
ache  (Wa.).  Potassium  Cyanide,  locally  in  reflex  headaches,  as  gastric,  cardiac, 
pulmonary,  menstrual  (B.).  Valerian  is  of  great  value  in  excitable  persons 
(P.).  Camphor,  a  saturated  solution  in  eau-de-cologne  rubbed  on  head,  when  of 
uterine  origin  (R.) ;  in  hysterical  females,  internally,  with  magnesium  carbonate 
(P.).  Podophyllum,  purgative  doses  often  give  relief  when  near  menstrual 
periods,  with  constipation  and  dark  stools  (R.).  Zinc  Oxide,  two-  to  five-gr. 
doses  useful  (R.);  a  remedy  of  great  value  (Hammond).  Bismuth,  the  sub¬ 
carbonate,  in  two-grain  doses  after  each  meal,  often  better  than  zinc,  especially 
where  gastric  disturbance  (Hammond).  Ether  Spray,  for  frontal  headache 
after  acute  illness  or  fatigue  (R.).  Chloroform,  ffbxv-xxx  of  the  spirit  internally, 
often  effective  (Wa.).  Galvanism,  sometimes  valuable;  the  constant  current 
always,  avoiding  too  great  intensity  lest  amaurosis  ensue  (Hammond).  [Com¬ 
pare  Hemicrania,  Neuralgia.] 


HEART  DISEASES. 


577 


R.  Potassii  Cyanidi, . gr.  x-xx. 

Aquae  Laurocerasi,  .  .  .  .  ^  iv. 

M.  Sig. — Apply  locally  on  a  compress 
for  %  to  yz  an  hour.  (B.) 


R.  Zinci  Phosphidi, . gr.  iij. 

Ext.  Nucis  Vom.,  .  .  .  .  gr.  x. 
Confect.  Rosae,  q.  s. 

M.  et  div.  in  pil.  no  xxx. 

Sig. — One  pill  after  each  meal. 

( Fordyce  Barker.') 


Extracti  Nucis  Vom.,  .  .  .  gr.  iij. 

Ferri  Reducti, . gr.  xij. 

Quininae  Sulphatis,  .  .  .  gr.  vj. 

Ft.  pil  no.  xij.  Sig. — One  after  each 
meal.  (Hammond.) 


R .  Ext.  Cann.  Ind.  FI.,  .  .  .  5  ss. 

Pulv.  Acaciae, . g  v. 

Syr.  Aurantii  Cort.,  .  .  .  ^ij. 

Aquae, . q.  s.  ad  5  vj. 

M.  Sig. — Teasp.  every  3  hours. 


Prescriptions. 

R. 


Heart  Diseases. 

Aconite,  in  the  highest  degree  serviceable  to  diminish  excitement  or  irrita¬ 
bility.  It  is  more  a  remedy  for  functional  derangement  than  for  organic  disease 
(Wa.).  In  pericarditis  (R.).  Nervous  palpitations  and  hypertrophy  (P.,  B.). 
The  heart  seldom  affected  in  rheumatic  fever  if  aconite  be  used  from  the  start 
(P.).  Veratrum  Viride,  as  cardiac  depressant  (B.) ;  in  chronic  cardiac  diseases 
where  excessive  hypertrophy,  i.  e.,  when  digitalis  is  contraindicated  (W.).  Cimi- 
cifuga,  safer  than  digitalis  in  fatty  heart  (B.).  Its  action  is  strongly  stimulating 
and  tonic  ;  it  relieves  excessive  dyspnoea  when  weak  heart  (P.).  Caffeine,  an 
excellent  cardiac  stimulant,  and  diuretic,  gr.  ij-v  of  the  citrate  every  three  hours 
(Da  C.).  Arsenic,  for  dyspnoea  from  weak  heart  (R.)  ;  in  all  cardiac  neuroses 
it  is  especially  valuable  when  combined  with  iron  and  strychnine,  and  is 
regarded  as  indispensable  in  all  forms  of  weak  heart  accompanied  by  pain 
(Wa.).  Digitalis,  acts  as  a  stimulant  tonic  (P.)  ;  small  doses  for  sedative  action ; 
tonic  or  physiological  doses  to  create  hypertrophy  in  dilatation  (Tr.);  irregularity 
of  pulse  is  best  indication  (R.).  Irritable  heart  (Da  Costa).  The  freshly-made 
infusion  the  best  preparation  (B.) ;  especially  indicated  in  weak  heart  acting 
rapidly  because  of  its  weakness,  and  in  valvular  disease  (Wa.).  Convallaria 
Majalis,  will  usually  succeed  in  all  cases  in  which  digitalis  is  useful,  acting 
similarly  to  that  drug,  but  with  less  reliability  ;  is  useful  in  aortic  disease  and  in 
others  where  digitalis  cannot  be  used  (Wa.)  ;  valuable  in  all  forms  of  heart 
disease  where  there  is  oedema  of  tissues  (See).  Strychnine,  in  medicinal  doses, 
said  to  strengthen  heart-beats  (R.).  Blisters,  flying,  over  prascordial  region,  to 
stimulate  action  in  extreme  weakness  (R.).  Alcohol,  brandy  when  heart  sud¬ 
denly  enfeebled  by  fright,  loss  of  blood,  etc.  (R.).  Ether,  rrpxx  hypodermically, 
repeated  soon,  is  a  very  promptly-acting  stimulant  in  sudden  heart-failure. 
The  compound  spirit  in  gj  doses  for  less  urgent  cases.  Morphine,  next  to 
Digitalis,  is  in  general  the  most  indispensable  remedy  in  the  treatment  of  severe 
heart  disease,  being  by  far  the  most  efficient  agent  for  the  dyspnoea  (Striimpell), 
hypodermically,  is  employed  in  many  cardiac  disorders  with  marked  advan¬ 
tage,  especially  in  dyspnoea  and  angina  with  diseased  coronary  arteries  ;  mitral 
regurgitation,  with  its  dyspnoea  and  insomnia  ;  aortic  disease,  etc.  Iron,  useful 
in  various  forms,  especially  anaemic  disorders  and  palpitation.  Also  in  dilata¬ 
tion  and  fatty  heart,  and  mitral  regurgitation  (B.).  Hyoscyamus,  in  functional 
derangement  from  emotion,  is  specially  indicated  ;  requires  large  doses  (npxl- 
lx),  or  gr.  of  hyoscyaminae  sulph.  hypodermically  (Wa.).  Amyl  Nitrite 
relieves  heart-pains  resisting  all  other  treatment  (W.).  [Compare  Angina  Pec¬ 
toris,  Dropsy,  Endocarditis,  Pericarditis,  and  the  five  following  articles.] 


Prescriptio?is. 


R.  Ext.  Ergotae  FI., . ^ iijss. 

Tinct.  Digitalis, . 5  ss. 

M.  Sig. — Teasp.  thrice  daily  in  enlarged 
heart  without  valvular  lesion.  (B.) 


R.  Spt.  Adheris  Comp., 

Liq.  Morphinae  Sulph. 

(U.  S.  P.,  1870),  .  aa  J  j. 

M.  Sig. — Teasp.  as  required  for  the 
dyspnoea. 


37 


578 


HEART,  DILATED - PALPITATION. 


.  Heart,  Dilated. 

Digitalis,  where  much  dilatation,  and  hypertrophy  of  left  ventricle  without 
valvular  disease.  Is  not  contraindicated  when  aortic  disease  (R.)  ;  physiologi¬ 
cal  doses  (Tr.).  In  simple  dilatation  gives  most  favorable  results  (W.).  Very 
useful  in  mitral  disease,  with  dilatation  of  the  left  ventricle  (P.) ;  gives  miracu¬ 
lous  relief,  is  not  sufficiently  appreciated,  but  requires  skilful  administration. 
Use  the  infusion  in  preference  to  other  preparations,  a  tablespoonful  thrice  daily, 
watching  its  effects  (Da  Costa).  Scoparius,  the  infusion  (broom-tea),  to  main¬ 
tain  the  kidney  action  if  digitalis  is  not  sufficient  (Da  C.).  Purgation,  brisk, 
free,  watery  stools  next  to  digitalis  are  the  best  treatment  (Da  C.).  Morphine, 
hypoderm.  gr.  y%-yi  two  or  three  times  a  week  in  dilated  heart  with  dyspnoea 
(B.).  Amyl  Nitrite,  dyspnoea  from  dilatation  (R  ) ;  is  useful  when  great  dysp¬ 
noea  (cardiac  asthma)  (P.).  Ether,  the  compound  spirit  an  excellent  remedy  for 
the  dyspnoea  (Da  Costa).  Mercury,  a  classical  pill  and  a  very  efficient  one  as 
a  diuretic  in  dropsy  from  cardiac  disease  is  the  combination  of  gr.  j  each  of  Pulv. 
Digitalis,  Pulv.  Scillae  and  Hydrarg.  cum  Creta  (B.  Foster). 


Heart,  Fatty. 

Iron,  the  tinct.  ferri  perchlor.  in  small  doses  for  a  long  time,  has  been  of 
remarkable  benefit  (Wa.).  Cimicifuga,  safer  than  digitalis  (B.) ;  the  latter  should 
not  be  used  (Wa.).  Digitalis  of  no  value  except  for  very  temporary  use  and  for 
some  special  indication  (Da  Costa).  Strychnine,  often  the  first  remedy  to  do 
good.  Unduly  pushed  will  produce  nervous  worry  and  be  injurious  (P.) ;  is  the 
remedy  with  iron,  nourishing  but  not  fat  making  diet,  and  wine  to  keep  up  the 
tone  of  the  blood  (Da  C.).  Ergot,  occasional  doses  have  been  given  with  appa¬ 
rent  benefit  (Wa.).  Ether,  the  compound  spirit  for  sudden  attacks  of  pain  or 
dyspnoea  (Da  C.).  Amyl  Nitrite,  for  the  same,  but  chloral  must  be  entirely 
debarred  (Da  C.).  Stimulants,  freely,  in  an  acute  attack  of  any  kind,  give  the 
only  chance  (Da  C.). 


Heart,  Hypertrophied. 

Aconite,  often  better  than  digitalis  (R.) ;  dangerous  in  hypertrophy  of  left  side, 
with  diseased  valves,  but  useful  in  simple  hypertrophy  (P.) ;  for  overaction,  with 
hypertrophy  (B.) ;  the  one  remedy  which  can  be  depended  on.  Small  doses  for 
months,  say  gtt.  j  of  a  good  tincture  ter  die,  to  lower  the  heart  gradually  and 
keep  it  low  (Da  Costa).  Digitalis,  very  useful  in  pure  hypertrophy  due  to  val¬ 
vular  disease  or  excessive  muscular  exertion  (R.).  The  primary  action  (small 
doses)  required,  as  it  creates  hypertrophy  when  given  in  physiological  or  tonic 
doses  (Tr.).  Veratrum  Viride,  as  a  cardiac  depressant  (gtt.  v  ter  die)  will 
relieve  in  simple  hypertrophy,  and  irritable  heart  from  abuse  of  tobacco,  inad¬ 
missible  when  valvular  lesions  exist  (B.) ;  gives  the  best  results,  next  after  aco¬ 
nite  (Da  C.).  Lead  Acetate,  for  violent  palpitations,  in  some  instances  (Wa.). 
Amyl  Nitrite,  in  dyspnoea,  syncope  (R.).  Ergot,  in  enlarged  heart  without  val¬ 
vular  lesion;  may  be  combined  with  digitalis  (B.).  Potassium  Iodide,  small 
doses  long  continued,  benefit  some  cases  (Wa.).  Camphor,  in  doses  of  gr.  iij-xij 
daily  for  tumultuous  palpitations,  and  dyspnoea  of  hypertrophy  with  dilatation 
(Wa.).  Iron  is  necessary  where  anaemia  exists  (Da  C.).  Quiet  Life  of  great 
importance,  no  stair-climbing,  no  long  walks ;  rest  in  bed  often  of  service  for 
days  at  a  time,  moderate  diet,  avoiding  fattening  foods,  meat,  and  stimulants 
(Da  C.). 


Heart,  Palpitation. 

Aconite,  for  “  fluttering  ”  of  nervous  persons,  and  nervous  palpitations  (R.) ; 
for  over-action,  with  hypertrophy  (B.) ;  for  palpitation  with  simple  hypertrophy 
(P.).  Hydrocyanic  Acid,  when  from  dyspepsia  (P.).  Iron,  when  due  to  anae¬ 
mia,  a  very  frequent  cause.  Other  causes  are  tobacco,  coffee,  tea,  etc.,  to  excess, 


HEART,  VALVULAR  DISEASE. 


579 


dyspepsia,  venery,  excessive  exercise  (Da.  C.).  Spigelia  Anthelmia,  when  due 
to  mitral  and  aortic  disease,  with  much  dyspnoea  (P.).  Digitalis,  in  small  doses 
as  sedative  (Tr.);  combined  with  iron  in  palpitations  with  valvular  disease,  or 
alone  in  very  severe  cases  (Wa.) ;  suits  a  large  number  of  cases,  especially  for 
temporary  purposes  (Da  C.) ;  the  only  remedy  for  positive  service  for  the  actual 
palpitation  (Richardson).  Camphor,  recommended  in  nervous  palpitations 
(R.).  Veratrine,  as  ointment  to  chest,  when  rapid,  irregular  pulse,  hurried 
breathing,  dropsy  and  lividity,  palpitation,  inability  to  lie  down  (R.).  Nux 
Vomica,  of  great  value  in  nervous  palpitation.  Bromides,  in  “fluttering” 
heart  (B.) ;  are  useful  when  tolerated  by  the  stomach  (Da  C.).  Hyoscyamus,  in 
nervous,  and  violent  palpitations  from  excited  state  of  the  brain  (P.) ;  in  large 
doses,  for  functional  disturbance  arising  from  emotion  (Wa.).  Belladonna,  in 
small  doses,  may  also  be  applied  externally,  when  irregularity  of  rhythm  (Da  C.) 
Valerian,  nervous,  with  dyspnoea  (P.).  Eucalyptus,  palpitation  and  weak  heart 
(B.).  Galvanization,  of  cervical  sympathetic  and  pneumogastric,  for  palpitation 
(B.).  Hot  Foot-Bath  relieves  palpitations  (R.).  Milk-cure,  has  been  beneficial 
in  irregular  action  (B.).  Ice,  to  the  cardiac  region,  has  benefited  many  cases  ; 
is  of  chief  value  when  patient  can  be  kept  in  bed,  which  sometimes  becomes 
necessary  (Da  C.). 


Prescriptions. 


R .  Pulv.  Digitalis,  .  .  .  .  gr.  xx. 

Pulv.  Colchici  Sem.,  .  .  gr.  xl. 

Sodii  Bicarb., . gr.  lx. 

M.  et  div.  in  pil.  no.  xl.  Sig. — One  pill 
at  first  3  or  4  times  daily,  gradually  reduced 
to  one  at  bedtime.  For  irregular  cardiac 

action.  ( Bozvditch .) 


R.  Tinct.  Digitalis, . gij. 

Spt.  Etheris  Nitrosi,  .  .  .  5j. 

Liq.  Ammonii  Acet.,  .  ad  ^  iv. 

M.  Sig. — A  dessertsp.  every  4  hours. 
If  prolonged  insomnia  with  palpitation  add 
of  Morph.  Sulph.  gr.  to  each  dose. 

( Richardson .) 


Heart,  Valvular  Disease. 

Digitalis,  in  aortic  regurgitation  (R.) ;  most  effective  in  mitral  insufficiency 
(P.)  ;  in  rapid  action  with  low  arterial  tension  ;  and  in  mitral  disease.  Infusion 
best ;  tablesp.  doses  twice  daily  (B.) ;  rrpj  of  tinct.  every  ]/2  hour  or  hour,  often 
gives  more  relief  than  larger  doses  (A.  A.  Smith) ;  when  heart  is  weak  and 
struggling  (Da  Costa).  Morphine,  hypodermically  for  dyspnoea,  better  in  mitral 
than  in  aortic  disease  (R.) ;  the  agent  above  all  others  in  aortic  insufficiency, 
combating  the  two  great  symptoms  therein,  the  cerebral  anaemia  and  the  dysp¬ 
noea  ;  is  to  aortic  regurgitation  what  digitalis  is  to  mitral  (Dujardin-Beau- 
metz).  Aconite,  useful  for  the  palpitation,  but  dangerous  in  hypertrophy  of  left 
side  with  diseased  valves  (P.) ;  for  cases  presenting  excessive  growth  and  strong 
action,  diminishes  the  blood-pressure  in  the  arterial  system,  and  gives  great 
relief  (Da  C.).  Veratrum  Viride,  has  similar  applicability,  but  is  more  apt  to  nau¬ 
seate.  An  admirable  sedative,  and  one  which  does  not  sicken  is  a  mixture  of 
Tinct.  Aconiti,rr\j,  Tinct.  Verat.  Vir.,TT\jij,  Tinct.  Zingib.,  Trpvij  (Da  C.).  Strophan- 
thus,  is  a  cardiac  tonic  like  Digitalis,  but  does  not  contract  the  vessels  nearly  as 
much  (Br.).  Nitroglycerin,  is  the  best  of  all  remedies  when  actual  cardiac  pain  ; 
it  lessens  blood-pressure  and  diminishes  the  resistance  the  heart  has  to  over¬ 
come  (Da  C.).  Caffeine,  as  a  tonic  and  diuretic,  of  especial  value  in  cases  where 
urine  is  scanty,  with  cardiac  pains,  headache  and  dyspnoea,  and  weak  heart; 
gr.  ij  of  the  citrate  every  three  hours  (Da  C.).  Adonidine,  in  doses  of  gr.  ^  to 
£  thrice  daily,  acts  excellently  as  a  cardiac  regulator  (Da  C.).  Barium  Chlo¬ 
ride,  gr.  yq  in  pill  three  or  four  times  daily,  is  diuretic,  lessens  cardiac  pain, 
increases  tone  in  the  vessels,  and  is  a  good  general  and  cardiac  tonic  (Da  C.). 
Purging,  with  Jalap,  etc.,  in  engorgement  of  right  side  of  heart  (R.) ;  occasion¬ 
ally  purging  (Da  C.).  Treatment  is  directed  chiefly  to  the  dilatation  or  hyper¬ 
trophy  resulting  from  the  valvular  disease.  The  simplest  rule  is  to  use  judg¬ 
ment  as  to  when  the  heart  needs  strengthening  by  Digitalis  or  reducing  by 
Aconite  or  by  Veratrum  Viride  (Da  C.).  [Compare  Endocarditis.] 


580 


HECTIC  FEVER - HEMATEMESIS - HEMATOCELE. 


Hectic  Fever. 

Quinine,  large  doses,  gr.  xv-xx  daily,  if  stomach  and  intestines  don’t  rebel 
(P.) ;  given  before  the  paroxysm,  to  limit  it  (Roberts).  Antipyrine,  is  better 
than  quinine,  but  must  be  used  in  much  smaller  dosage  than  ordinarily  employed, 
say  gr.  iv  or  v  about  ]/z  hour  before  fever  rises,  then  doses  of  gr.  ij  hourly  as 
long  as  temp,  remains  above  100. 50.  This  daily,  will  give  excellent  results  in 
hectic  of  phthisis  (Pribram).  Aconite  in  small  doses,  a  remedy  of  much  value 
in  the  irritative  fever  of  phthisis  (Da  C.).  Morphine  and  other  anodynes,  are  of 
especial  value,  given  in  full  doses  toward  bed-time  (Gross).  Prunus  Virginiana, 
the  bark  has  been  found  useful,  especially  when  irritable  cough  (P.).  Calcium 
Phosphate,  is  especially  useful  (R.).  Calumba,  excellent  for  tonic  effects  (P.). 
Digitalis,  the  tincture,  combined  with  tinct.  ferri  chloridi,  abates  the  tempera¬ 
ture  and  diminishes  the  sweats  (B.).  Iron,  the  mistura  ferri  composita  has 
obtained  great  celebrity,  especially  when  much  debility  and  anaemia  (Wa.) ;  the 
sulphate  and  tincture  of  the  chloride  of  especial  value  in  the  treatment  of  hectic 
(Gross).  Ipecacuanha.  A  fewr  grains  of  Dover’s  powder  at  bed-time,  will  stop 
the  profuse  perspirations  (Wa.).  Salicin,  for  profuse  perspirations  (Wa.)  ;  as 
antipyretic.  [Compare  Perspiration,  Phthisis.] 


Prescriptions. 


R  .  Tinct.  Digitalis, . 3  iij.  . 

Tinct  Ferri  Chlor  ,  .  .  .  3  v. 

M.  Sig. — 15  drops  3  or  4  times  a  day. 

(B.) 


R.  Quininae  Sulph., . ^jss. 

Elix.  Taraxaci, . 3  iv. 

M.  Sig. — Teaspoonful  every  hour  for 
six  hours. 


Hematemesis. 

Ipecacuanha,  is  decidedly  effective  in  small  doses,  also  when  hematemesis 
is  vicarious  of  menstruation  (P.,  Wa.).  Hamamelis,  rt\J  — ij  of  tinct.  every  2  or 
3  hours  (R.) ;  effective  from  its  tannin  (B.).  Alum,  serviceable  in  passive  hem¬ 
orrhage  ;  iron  better  (B.).  Turpentine,  especially  in  passive  hemorrhage 
with  debility  (R.) ;  and  in  hemorrhagic  transudations  on  the  free  mucous  sur¬ 
faces — hematemesis,  etc.  (B.).  Ergot,  has  often  cured  when  other  means  failed 
(P.) ;  most  valuable.  In  urgent  cases  ergotine  in  2-  to  5-gr.  doses  hypodermi¬ 
cally  (R.).  Iron,  the  subsulphate  (Monsel’s  solution)  or  pernitrate,  the  best 
remedies  ;  gtt.  j  — ij  frequently,  diluted  with  ice-water  (B.).  Lead  Acetate,  espe¬ 
cially  in  gastric  ulcer,  gr.  ss-gr.  v  (B.).  Tannic  Acid,  gr.  x-^j,  when  from 
gastric  ulcer  or  obstructive  disease  of  liver  (B.).  Gallic  Acid,  an  extremely  useful 
agent;  is  best  used  in  combination  with  dilute  sulphuric  acid(Wa.).  Ice,  small 
pieces  swallowed,  a  most  useful  agent,  with  perfect  rest  for  stomach  ;  when 
hematemesis  from  that  organ,  nutrient  enemata  must  be  employed.  Iced  cham¬ 
pagne  to  arrest  faintness,  if  persistent ;  when  moderate  need  not  give  cause  for 
alarm. 


Prescriptions. 


R.  Olei  Terebinth  ,  .  .  . 

Ext.  Digitalis  Fluid.,  . 

•  •  3)- 

Mucil.  Acaciae,  .  .  . 

■  •  3  ss 

Aq.  Menth.  Pip.,  .  . 

•  •  3J- 

M.  Sig. — Teasp.  every  3 

hours. 

R  .  Ac.  Gallici, . 3  j. 

Ext.  Ergotas  Aquosi, 

Digitalis, . aa  gr.  xx. 

M.  et  div.  in  pil.  no.  xx.  Sig. — One 
every  4  hours. 


Hematocele,  Pelvic. 

Opium,  or  morphine,  if  needed  for  pain,  with  absolute  rest  in  bed,  and  a 
moderately  tight  abdominal  bandage  (E.).  Hemostatics,  as  gallic  acid,  lead, 
turpentine,  etc.,  to  arrest  the  hemorrhage,  if  it  still  be  going  on,  combined  with 
opiates,  and  the  use  of  ice-bags  or  cold  lotions  to  the  abdomen  or  per  vaginam. 
Tonics,  as  iron  and  quinine,  while  resolution  of  the  extravasation  is  going  on. 


HEMATURIA - HEMERALOPIA. 


581 


Bromides  and  Iodides,  to  quiet  the  action  of  the  ovaries,  if  the  hemorrhage 
recurs  at  different  periods.  Potassium  Iodide,  as  an  absorbent,  may  be  given 
with  quinine  (Braxton  Hicks).  Iodized  Cotton,  an  excellent  application  to  the 
cervix  uteri  in  cases  of  hematocele  (Wa.).  Leeches,  should  be  applied  early 
in  cases  of  peri-uterine  hematocele  ;  later,  except  to  check  inflammation,  they 
are  inadmissible  (Wa.).  Mercury,  gr.  ^  of  the  bichloride  thrice  daily,  with 
iron  and  ergot,  conjoined  with  vaginal  injections  of  hot  water  morning  and 
evening  ;  later  in  lieu  of  the  mercurial  the  syrup  of  the  iodide  of  iron  in  20- 
drop  doses  thrice  daily,  was  thoroughly  efficient  treatment  in  one  very  bad  case  of 
retro-uterine  hematocele  (Hengst).  Surgical  interference  has  many  advocates, 
but  is  criminal  in  a  large  majority  of  the  cases  (E.).  If  the  case  does  not  end 
in  resolution  it  will  terminate  in  pelvic  abscess. 


R.  Iodi.,  .  .  .  . 

Potassii  Iodidi, 
Glycerini,  .  . 


Prescription. 


Mix  and  saturate  8  oz.  of  cotton  with  the 
mixture  ;  then  carefully  dry,  and  label 
“  Iodized  Cotton.” 


Hematuria. 

Turpentine,  when  with  constitutional  debility  (B.) ;  in  very  small  doses  (R.) 
often  is  very  efficacious  (P.).  [See  ante,  Hematemesis,  for  formula.]  Hama- 
melis,  has  arrested  severe  cases  (R.).  Chimaphila,  controls  hematuria  (P.). 
Gallic  Acid,  the  most  uniformly  successful  remedy  (B.) ;  gr.  x-xx  every 
hour  or  two  (Da  Costa).  Sulphuric  Acid,  alone  or  with  gallic  acid,  is  an 
efficient  remedy  (Da  C.).  Acetic  Acid,  in  a  case  of  alarming  hemorrhage 
from  the  bladder,  which  occurred  after  an  operation  for  vesico-vaginal  fistula, 
and  resisted  all  other  means,  an  injection  of  apple-vinegar  and  ice-water, 
equal  parts,  succeeded  in  arresting  it  (Ghent).  Quinine,  large  doses  necessary  ; 
cures  when  intermittent  or  from  malarial  infection  (B.)  ;  useful  in  some  cases 
of  intermittent  hematuria  (R.).  Iron.  Tinctura  ferri  perchlor.,  rtpx-xx  several 
times  daily;  in  this  affection  the  best  form  of  iron  for  internal  use  (Wa.),  Ipeca¬ 
cuanha,  exercises  a  powerful  influence  (Wa.).  [See  ante,  Hematemesis.]  Ergot, 
by  stomach  or  subcutaneously  ;  may  be  combined  with  ipecac,  krameria,  or 
other  astringents  (B.).  Ergotine,  hypodermically,  is  far  superior  for  efficacy 
and  rapidity  of  operation  (Wa.).  Matico,  the  infusion,  in  doses  of  3 ij  every  2 
or  3  hours,  is  fully  equal  to  gallic  acid,  lead,  etc.  (Thompson).  Ammonium 
Benzoate,  in  5-grain  doses,  for  the  albuminuria  and  hematuria  of  scarlatina 
(Hillier).  Cannabis  Indica,  is  especially  indicated  in  dysuria  and  strangury 
when  there  is  bloody  urine  (R.).  Camphor,  in  2  to  5-grain  doses  is  said  to 
promptly  remove  the  renal  hyperaemia  with  bloody,  coagulable  urine,  caused 
by  cantharis,  turpentine,  oil  of  mustard,  copaiba,  etc.  (R.).  Ice  in  rectum  or  to 
perineum,  for  vesical  hemorrhage  (Thompson). 


Prescriptions. 


Acidi  Gallici,  .  .  . 

.  .  .  3ss. 

Ac.  Sulphurici  Dil., 

•  •  •  3b 

Tr.  Opii  Deodor.,  . 

.  •  .  3j- 

Infusi  Digitalis,  .  . 

•  •  •  giv. 

M.  Sig. — Tablesp.  every  4  hours  or 
oftener.  In  hematuria,  menorrhagia,  pur¬ 
pura  hemorrhagica,  and  the  hemorrhagic 
diathesis.  (D.) 


R.  Ext.  Ergotae  Fluidi, 

Tine.  Krameriae,  .  .  .  aa  Jj. 

M.  Sig. — A  teasp.  every  hour  or  two. 


R.  Ext.  Ergotae,  (Squibb),  .  .  3  j. 

Aquae . %'). 

M.  Sig. — For  hypodermic  use ;  tt^x 

contain  gr.  j. 


Hemeralopia  and  Nyctalopia. 

Strychnine,  night-blindness;  small  doses,  gradually  increased,  of  service 
(Wa.).  Mercury,  Hydrarg.  chlor.  corr.  gr.  ij  ad  aquae  3 j ,  dropped  into  the  eye 
twice  daily,  with  blister  on  each  temple,  and  mild  aperients,  cured  hemeralopia 


582 


HEMICRANIA. 


(Smith).  Quinine,  in  as  large  doses  as  can  be  borne,  after  cathartic  and  emetic, 
for  night  and  day-blindness  (Howard).  Blisters,  small,  1  yz  inches  in  diameter, 
close  to  external  canthus  of  the  eye  (Bampfield).  Electricity,  occasionally 
useful  (Wa.).  Rest,  protection  of  eyes  from  bright  light,  constitutional  reme¬ 
dies,  as  indicated  by  state  of  general  health,  change  of  climate,  speedily  cures 
hemeralopia.  It  is  sometimes  merely  a  symptom  of  pigmentary  degeneration 
of  the  retina,  or  a  feature  of  scurvy. 

Hemicrania. 

Belladonna,  when  due  to  vaso-motor  spasm,  the  face  being  pallid  (B.) ;  the 
tincture  in  small  and  repeated  doses  if  the  disease  be  of  reflex  character  (H.). 
Iris,  in  blinding  form,  from  hepatic  trouble,  right  supra-orbital  region;  w\J 
every  half-hour  for  3  doses,  usually  relieves  promptly  (Pf.).  Cannabis  Indica, 
one  of  the  most  valuable  remedies  for  megrim  or  sick  headache,  apparently 
acting  on  the  nervous  centre  whence  the  disorder  springs ;  is  most  useful  in 
the  intervals  to  prevent  the  attacks,  and  especially  when  the  paroxysms  are 
becoming  more  frequent ;  it  may  be  combined  in  pill  with  either  iron  or  aloes 
(K.) ;  in  the  congestive  form  of  especial  value,  the  tincture  in  repeated  doses 
until  physiological  action  is  induced  (H.) ;  gr.  y$  of  the  extract  before  each 
meal,  increased  gradually  to  ]/2  or  %  grain,  in  the  intervals,  kept  up  for  3 
months  (Seguin)  ;  gr.  y  of  the  solid  extract  night  and  morning,  very  efficient 
in  migraine,  if  used  continuously  for  some  time  (Hare).  Camphor,  gr.  iij-v, 
with  xx  or  xxx-grain  dose  of  magnesic  carbonate,  is  very  useful,  especially  in 
hysterical  females  (P.).  Croton-chloral,  in  milder  forms  without  severe  vomit¬ 
ing,  headache  being  predominant;  the  bromides  are  useful  after  it  (R.) ;  rarely 
of  any  use,  but  if  given  it  should  be  in  20-grain  doses  twice  daily  (H.) ;  Gua- 
rana,  is  useful  (B.),  a  very  effective  palliative ;  gr.  xx  every  y2  hour,  for  three 
hours  (P.) ;  efficacy  diminishes  by  degrees,  attacks  usually  become  longer  (Tr.); 
£ij  of  fluid  extract  in  course  of  an  hour  or  two,  to  anticipate  the  attack  when 
expected  (Seguin).  Caffeine,  in  typical  migraine;  gr.  j  ad  rr^xxv-xxx  aquae 
hypodermically  (P.);  is  especially  adapted  when  chronic  gastric  catarrh,  gr.  j 
every  yz  -hour  (B.).  The  citrate  in  grain  doses  every  hour  for  some  time  before 
a  paroxysm  (Wa.) ;  gr.  j  every  ^-hour  often  gives  marked  relief  (A.  A.  Smith). 
Valerian,  of  especial  value  when  in  excitable  temperaments  ;  after  profuse  or 
painful  menstruation  (P.).  Ammonium  Chloride,  is  exceptionally  serviceable  ; 
seldom  fails  to  cut  short  an  attack  (Austin),  x-xv  gr.  doses  (B.,  R.) ;  as  a  diffu¬ 
sible  stimulant  is  very  efficient,  gr.  xx  up  to  £j  every  hour  during  the  attack 
(H.).  Sodium  Chloride,  in  small  doses,  proved  very  efficient  in  six  positive 
cases  attended  by  gastric  distress  (Rabon).  Antipyrine,  the  most  valuable 
single  remedy  for  headache,  especially  in  migraine  and  those  cases  of  it  for 
which  Ergot  and  Amyl  Nitrite  are  indicated.  5  grains  at  beginning  of  the  attack 
often  sufficient  (Birdsall) ;  of  great  value  in  true  migraine,  employed  in  twenty 
cases  with  unfailing  benefit;  less  useful  in  the  malarial  or  dyspeptic  forms,  and 
useless  in  uraemic  (Thompson);  one  dose  of  gr.  xx,  or  2  doses  of  gr.  x  each, 
J^-hour  apart,  given  in  the  prodromal  period,  or  at  the  very  beginning  of  a 
paroxysm,  will  invariably  cut  it  short  within  an  hour  (Sprimon,  Ungar,  etc.). 
Podophyllin  or  Mercury,  bilious  origin  (R.).  Bromides,  for  true  migraine.  Ras- 
pail’s  eau  sedative  locally,  gives  great  relief  (B.).  When  due  to  uterine  disorder 
(R.).  Potassium  Bromide,  very  serviceable  in  the  paroxysm,  also  in  continu¬ 
ous  form  (R.).  Eucalyptus,  in  cerebral  anaemia  (B.).  Digitalin,  granules  (^ 
bis  die),  for  congestive  hemicrania  (B.).  Ergot,  if  due  to  miliary  aneurisms  of 
intercranial  arterioles ;  also  in  congestive  migraine,  and  in  nearly  all  kinds 
(B.).  Menthol,  locally  in  frontal  headache  due  to  migraine,  is  said  to  be  very 
efficient  (Wa.).  [See  formula  below.]  Piscidia,  is  highly  recommended  (Wa.)  ; 
efficient  in  doses  of  5>j  of  the  fluid  extract  (Ford).  Arsenic,  for  cerebral  con¬ 
gestion  and  hemicrania  (B.) ;  for  throbbing  pain  in  one  brow  (R.).;  often  has 
the  best  effect.  Watson  believed  that  gtt.  iv-vj  of  liq.  arsenic,  3  or  4  times  a 
day,  with  due  attention  to  the  bowels,  would  cure  9  out  of  every  10  cases 
(Wa.).  Aconitine  or  Veratrine,  ointment,  over  brow  (R.) ;  Aconitine  is  of  great 


HEMIOPIA - HEMIPLEGIA - HEMOPTYSIS. 


583 


service  internally  (Seguin).  Phosphorus,  is  strongly  recommended  (R.).  Amyl 
Nitrite,  by  inhalation,  in  migraine,  with  pallor  of  face  (B.,  R.).  Sanguinaria, 
a  few  doses  very  successful,  when  m.  due  to  stomach  derangement  (P.).  Igna- 
tia,  removes  clavus  hystericus  (Pf.).  Nux  Vomica,  when  of  gastric  origin  (R.). 
Cimicifuga,  is  strongly  recommended  (P.).  Rubber  Bandage,  applied  tightly 
from  eyes  up,  protecting  the  temporal  arteries  by  pads,  or  a  dry  muslin  band¬ 
age  wetted  after  being  put  on  (Weir  Mitchell).  Acupuncture,  the  needle  run 
down  to  the  cranium,  will  give  relief  to  clavus  hystericus,  when  nothing  else 
will  do  so  (Pancoast). 

Prescriptions. 


Quininae  Sulph., 

.  .  .  .  3SS- 

Pulv.  Belladon.,  . 

.  .  .  .  gr.  x. 

Ext.  Digitalis, 

.  .  .  .  gr.  xv. 

Ext.  Valerianae,  . 

.  .  .  .  ^ss. 

Mellis,  .... 

Ft.  pil.  no.  xl.  Sig. — 2  to  10  pills  daily, 
gradually  increased,  during  3  or  4  days  be¬ 
fore  the  expected  attack. 


R.  Amgnonii  Chloridi,  .  .  .  gvj. 

Ammonii  Bromidi,  .  .  .  £  iv. 

Spt.  Etheris  Nitrosi,  .  .  .  j. 

Syr.  Pruni  Virgin.,  ...  5  iij. 

Aquae, . q.  s.  ad  g  vj. 

M..  Sig. — Dessertsp.  3  or  4  times  daily, 
conjoined  with  the  use  of  Raspail's  Eau 
Sedative  (see  page  94),  locally. 


R.  Mentholi, . £j. 

Alcoholis, . 5J. 


01.  Caryophylli, 

01.  Cinnam.,  ....  aa  rt\xx. 

M.  Sig. — Apply  with  finger  over  seat 
of  pain. 


R.  Aconitine  (Duquesnel),  .  gr.  TL. 
Alcoholis, 

Glycerini, . aa  ^j. 

Aq.  Menth.  Pip.,  .  q.  s.  ad  5  ij. 

M.  Sig. — Teasp.  thrice  daily. 

[Seguin.) 


Hemiopia. 

When  established,  hemiopia  offers  little  hope  of  cure,  though  it  has  no  ten¬ 
dency  to  progress.  In  hemiopia  scintillans,  Potassium  Bromide,  gr.  xl-lx 
daily,  or  band  of  such  metal  as  idiosyncrasy  of  the  patient  may  decide,  with 
stimulants  to  ward  off  the  aura  ;  Quinine,  Iron,  Hydropathy,  when  Potassium 
Bromide  fails  (De  Wecker). 


Hemiplegia. 

Strychnine,  is  most  useful  when  members  are  relaxed ;  hypodermically, 
when  paralysis  incomplete,  and  the  muscles  flaccid  but  not  wasted  (B.).  [See 
Paralysis  for  formula.]  Potassium  Iodide,  gr.  x-xviij  daily,  occasionally 
proves  effectual  (Wa.).  Galvanism,  constant  current  to  the  brain  or  cord, 
faradic  to  the  muscles  opposite  those  contracted  (Hammond).  Physostigma, 
prevents  muscle  wasting,  and  hence  is  given  with  benefit  to  hemiplegics ;  gr. 

of  the  extract  repeated  frecpiently  (R.).  Massage,  in  hemiplegia  and 
other  forms  of  paralysis  due  to  intercranial  lesions,  when  cold  and  blue  skin, 
wasting  and  contracted  muscles,  ulcerations,  etc.  (B.).  Cocculus,  in  hysterical, 
epileptic,  and  choreic  hemiplegia,  acts  well ;  also  in  hemiplegia  from  cold  (P.). 
[Compare  Paralysis,  Facial.] 


Hemoptysis. 

Gallic  Acid,  exceedingly  effective  (P.) ;  may  be  combined  with  ergotin  and 
digitalis.  [See  Hematemesis  and  Hematuria  for  formulae.]  Acetate  of 
Lead,  with  opium  (B.) ;  proves  signally  useful  (Wa.).  Ergot,  the  fluid  extract 
in  30  to  40-minim  doses,  every  3  01*4  hours,  or  hourly  in  severe  cases;  or 
Ergotin  hypodermically  for  urgent  cases,  in  2  to  3-grain  doses  (R.).  Opium, 
should  be  freely  used  for  the  attendant  excitement  (W.).  Turpentine,  drachm- 
doses  every  3  hours,  may  cause  unpleasant  symptoms  which  soon  disappear  on 
its  discontinuance  (R.) ;  has  proved  very  efficient  (P.)  ;  after  other  hemostatics 
fail  it  is  worthy  of  trial  (Wa.).  Alum  is  serviceable  in  purely  atonic  hemor¬ 
rhages  (Wa.) ;  in  10-grain  doses  every  2  hours  (B.).  Oil  of  Erigeron,  is  very 


5  §4 


HEMORRHAGE. 


efficient  when  no  fever  or  other  signs-of  constitutional  irritation  (Wa.).  Hama- 
melis,  TT\j— ij  of  tincture,  every  2  or  3  hours  (R.) ;  tr^ij-x  of  fresh  tincture  sev¬ 
eral  times  a  day  (Pf.).  Ipecacuanha,  has  been  highly  praised  (R.)  ;  in  emetic 
doses  (Tr.) ;  arrests  as  emetic  (B.)  ;  arrests,  though  in  poisonous  doses  pro¬ 
ducing  hemoptysis  (P.).  Ferric  Acetate,  a  little  added  to  water  so  as  to  taste, 
this  constantly  sipped  (R.).  Iron  spray  will  often  arrest  (B.).  Digitalis,  has 
undoubted  power  over  hemoptysis  (B.).  Small  doses  daily  (P.).  Infusion  in 
large  doses  (R.).  Arnica,  of  great  service,  if  from  violence  (P.).  Aconite, 
employed  with  best  results  (P.).  Sodium  Chloride,  half  a  teaspoonful  of  com¬ 
mon  salt,  taken  dry,  repeated  till  nausea  (R.).  Sulphuric  Acid,  the  dilute  acid 
a  useful  adjunct  to  other  treatment  (Wa.).  Spinal  Hot-Water  Bag,  to  cervical 
or  upper  dorsal  vertebrae  (R.).  Auxiliaries. — Cold  externally,  acidulated 
drinks,  perfect  rest,  and  antiphlogistic  diet  (Wa.). 


Prescriptions. 


R.  Ext.  Ergotae  FI.,  ....  ^jss. 
Ext.  Ipecac.  FI., 

Tr.  Opii  Deod.,  .  .  .  aa  gij. 
M.  Sig. — Teasp.  every  yz  hour. 


R.  Plumbi  Acetat., . gr.  xx. 

Pulv.  Digitalis, . gr.  x. 

Pulv.  Opii, . gr.  v. 

M.  ft.  pil.  no.  x.  Sig.  —  One  every  4 
hours.  (B.) 


R.  Aluminis, . gj. 

Sacch.  Alb., . gss. 

Pulv.  Ipecac.  Comp.,  .  .  .  gr.  xx. 

M.  ft.  pulv.  no.  vj.  Sig. — One  every  2 
hours.  [Skoda.) 


R .  Liq.  Ferri  Subsulph.,  .  .  rrpxx. 

Aquae, . gij. 

M.  Sig. — Use  as  spray  by  inhalation 
for  5  minutes  every  hour. 


Hemorrhage,  Hemorrhagic  Diathesis. 

Acids.  Sulphuric  sometimes  very  effective  in  uterine  hemorrhage  (B.). 
Dilute  Vinegar  to  leech-bites,  piles,  cuts,  etc.  (R.).  Apple-Vinegar  as  injec¬ 
tion  for  vesical  hemorrhage.  [See  under  Hematuria.]  Iron,  when  hemor¬ 
rhagic  diathesis  due  to  anaemia ;  the  tincture  of  the  chloride  preferred  (B.). 
The  tincture  of  ferric  perchloride  as  styptic  (Wa.) ;  1  or  2  teaspoonfuls  of  the 
concentrated  solution  in  a  glass  of  water,  an  excellent  hemostatic  (Tr.).  The 
acetate,  just  enough  to  make  water  taste,  in  hemorrhage  of  lungs  and  kidneys 
(R.).  Ergot,  in  uterine  hemorrhage  of  any  kind,  and  many  forms  of  hemor¬ 
rhage,  ergot  or  ergotine  of  great  value  (P.) ;  not  to  be  relied  on  alone  (B.). 
Alum,  is  sanctioned  by  high  authority  (B.) ;  dusted  on  in  slight  cases  (R.)  ;  in 
uterine  and  traumatic  hemorrhage,  when  small  vessels  open  (Tr.).  Hamamelis, 
Trpj-ij  of  tincture  every  2  or  3  hours,  effective  in  many  forms  (R.).  Ipecac¬ 
uanha,  produces  hemorrhage  in  poisonous  doses,  yet  has  great  energy  in 
arresting  it  (P.) ;  exercises  a  powerful  influence  on  internal  hemorrhage  gener¬ 
ally,  and  in  exhaustion  therefrom  ;  gr.  j-ij  every  %  hour  (Wa.).  In  emetic 
doses  serviceable  (Tr.).  Turpentine,  few  agents  more  useful  in  the  passive 
forms  (B.) ;  small  doses  in  hematuria  (R.) ;  for  serious  hemoptysis,  and  hemor¬ 
rhage  of  typhoid  (P.).  Belladonna,  hemorrhage  from  rectal  ulcers  (P.).  Digi¬ 
talis,  in  uterine,  and  many  other  forms,  of  great  value  (P.) ;  with  restoratives 
has  undoubted  power  in  the  hemorrhagic  diathesis  (B.).  [See  Hemoptysis.] 
Chimaphila,  controls  hematuria  (P.).  Gallic  and  Tannic  Acid,  in  all  passive 
hemorrhages,  especially  in  that  of  the  bladder  (P.).  Tannic  acid  for  local 
use,  Gallic  for  systemic  effects  upon  remote  parts.  When  hemorrhage  occurs 
in  relaxed  and  debilitated  constitutions,  Gallic  Acid  may  be  combined  with 
Ergot  and  Digitalis  (B.).  Matico,  proves  useful  in  many  cases,  especially 
menorrhagia,  hematuria  and  hemoptysis  (Wa.).  Nux  Vomica,  in  hemorrhagic 
diathesis,  especially  when  occurring  in  anaemic  subjects.  Also  the  syrup  of 
iron,  quinine,  and  strychnine ;  no  prescription  more  generally  useful  (B.). 
Aconite,  to  reduce  the  circulation,  in  epistaxis,  hemoptysis,  etc.  (P.).  Cinchona, 
internally  very  efficient  in  some  forms  of  hemorrhage  (Tr.).  Copper  Sulphate, 
in  stick,  solution,  or  ointment,  to  arrest  hemorrhage  from  small  vessels  (R.), 


HEMORRHAGE,  INTESTINAL - POST-PARTUM. 


585 


Arnica,  in  hemorrhages  (ecchymoses),  from  mechanical  violence  (P.).  Rhatany, 
the  extract,  one  of  the  most  powerful  hemostatics  (Tr.).  Grape-cure,  as  tonic 
for  convalescents  (P.).  Alcohol,  in  hemorrhagic  diathesis,  to  elevate  the  arte¬ 
rial  tension  (B.) ;  brandy,  wine,  when  heart  suddenly  enfeebled  by  hemorrhage 
(R.).  Venesection,  will  promptly  arrest  pulmonary  hemorrhage  (B  ).  Styptics, 
are  either  needless  or  inefficient,  hence  practically  useless  in  general  surgery  ; 
hemorrhage  should  be  controlled  by  either  pressure  or  ligation  (Roberts).  Hot 
Water,  sponged  over  a  bleeding  surface,  the  best  agent  to  stop  hemorrhage 
(Gross).  Transfusion,  when  death  imminent  (B.).  Ice,  internally  in  wounds 
or  hemorrhage  of  lungs,  or  from  stomach  ;  small  pieces  frequently  (R.).  Rest. 
Perfect  rest  often  indispensable,  especially  in  hematemesis,  in  which  nutrient 
enemata  may  be  required.  [Compare  Dysentery,  Epistaxis,  Hematemesis, 
Hemoptysis,  Hemorrhoids,  Hematuria,  Hemorrhage,  Post-Partum — 
Intestinal,  Menorrhagia,  Metrorrhagia,  Purpura,  Wounds,  etc.] 

Prescriptions. 


PagliarV s  Styptic. 

R.  Tinct.  Benzoini, . ^  viij. 

Aluminis, . lb.  j. 

Aquae, . lb.  x. 

Boil  6  hours  in  a  glazed  earthenware 
vessel,  adding  hot  water  in  lieu  of  that 
vaporized,  and  keeping  well  stirred  ;  filter, 
and  put  up  in  stoppered  bottles. 


R.  Infusi  Digitalis, . g\). 

Ext.  Ergotae  Fluidi, 

Tinct.  Krameriae,  .  .  .  aa  gj. 

M.  Sig. — A  tablesp.  as  required  in 

hemorrhagic  conditions  generally.  (B.) 


Pancoast's  Styptic. 

R.  Potassii  Carbon  at.,  .  .  .  .  ^ij. 

Saponis, . j  — ij . 

Alcoholis, . ^  iij . 

Mix  and  use  as  a  styptic  especially  for 
operations  about  the  face.  (  /os  Pancoast .) 


R.  Ext.  Ipecac.  FI., . 3  ij. 

Ext.  Ergotae  FI.,  .  .  .  .  3  iv. 

Ext.  Digitalis  FI.,  .  .  .  .  ^ij. 

M.  Sig. — Halfteasp.  to  a  teasp.  at  a 
dose,  repeated  as  required.  An  excellent 
anti-hemorrhagic  combination. 

(B.) 


Hemorrhage,  Intestinal. 


Turpentine,  should  be  used  (B.) ;  especially  in  typhoid  (P.).  [See  Hema¬ 
temesis,  for  formula.]  Belladonna,  for  irritable  and  bleeding  rectal  ulcers 
(P.).  Iodine,  in  passive,  gtt.  j-ij  of  tinct.  frequently  repeated,  of  great  service 
(B.).  Sulphuric  Acid,  is  serviceable  (B.)  Acetate  of  Lead,  often  of  great 
service,  especially  when  used  as  an  enema  (Jenner).  Tannin,  one  of  the  most 
serviceable  remedies  for  the  intestinal  hemorrhage  of  typhoid  fever  (B.). 
Hamamelis,  very  effective  in  intestinal  hemorrhage,  owing  to  its  large  propor¬ 
tion  of  tannin  (B.).  Ergot  is  most  valuable;  may  be  given  hypodermically  in 
urgent  cases  (R.).  Gallic  Acid,  gr.  xv  with  gtt.  iij— v  of  laudanum,  in  a  winegl. 
of  iced  water,  every  2  or  3  hours  in  the  hemorrhage  of  typhoid  (Jenner). 
Opium,  a  valuable  adjunct  to  astringents,  allaying  the  nervous  excitement 
(Wa.) :  is  most  useful  (Da  Costa).  [Compare  Hemorrhoids,  Dysentery, 
Typhoid  Fever.] 


Hemorrhage,  Post-Partum. 

Hamamelis,  for  persistent  oozing  (R.).  Ipecacuanha,  in  flooding  after  de¬ 
livery  (R.).  Iron,  Monsel’s  solution,  j-iij  of  water,  strong  enough  and  safe 
as  injection  (B.) ;  the  perchloride  diluted  (R.).  Amyl  Nitrite,  rrpv  by  inhala¬ 
tion,  has  stopped  a  hemorrhage  promptly  and  permanently  (Kerr).  Ergot, 
a  full  dose  of  the  fluid  extract  as  soon  as  birth  is  completed  as  a  prophylactic 
(Playfair) ;  hypodermically  in  urgent  cases,  gr.  ij  of  Bonjean’s  Ergotine  deeply 
into  the  tissues  of  the  arm  (Wa.) ;  £ss  doses  of  the  fluid  extract  every  4  hours 
in  secondary  hemorrhage.  Cimicifuga,  will  check  post-partum  hemorrhage, 
especially  when  tediously  prolonged  (P.).  Digitalis,  the  infusion  best;  a 
tablesp.  bis  die,  or  in  urgent  cases  every  half  hour  for  4  doses  (B.).  Nux 
Vomica,  gtt.  xx  ;  ext.  ergot,  fl.  gtt.  xxx ;  each  hour  for  2  or  3  doses  (B.). 


586 


HEMORRHOIDS. 


Opium,  the  tincture  3j,  with  brandy,  in  profuse  flooding  (R.).  Vinegar,  a 
handkerchief  soaked  in  vinegar  and  carried  into  the  uterus,  will  often  check 
a  severe  hemorrhage  (Landis) ;  is  antiseptic,  astringent  and  sufficiently  irri¬ 
tating  to  produce  contraction,  yet  not  so  irritating  as  to  cause  subsequent  mis¬ 
chief,  and  always  acts  promptly  (Penrose).  Tamponade  by  absorbent  cotton, 
plugs  of  linen,  etc.,  is  indicated  in  hemorrhage  from  abortion  or  placenta 
praevia  (Parvin)  ;  never  tampon  after  delivery  !  you  might  as  well  hang  the 
woman  by  the  neck  (Wallace).  Auxiliary  Measures  of  importance  are  firm 
pressure  on  the  uterus,  compression  of  the  abdominal  aorta,  the  plug,  and  if 
necessary  intra-uterine  injections  (Wa.).  Hot  Water,  iio°  to  1220  F.,  injected 
into  uterus,  extremely  successful  in  checking  post-partum  hemorrhage  (Att- 
hill)  ;  the  most  prompt  and  certain  method,  and  the  least  unpleasant  to  the 
patient  (Parrish).  See  also  Dr.  Cameron  in  Canada  Med.  and  Surg.  Jour., 
March,  1878,  with  record  of  16  cases  so  treated.  Ice,  to  abdomen  or  within 
the  womb  (B.) ;  into  womb  or  rectum  (R.).  As  a  prophylactic  against  hem¬ 
orrhage  and  to  secure  firm  contraction  of  the  uterus,  a  good  method  is  to 
grasp  the  womb  through  the  abdominal  parietes  with  a  hand  kept  cold  by 
frequent  immersion  in  a  pan  of  broken  ice,  while  waiting  for  the  expulsion  of 
the  placenta.  While  one  hand  is  kept  on  the  uterus  the  other  may  be  im¬ 
mersed  in  the  ice.  Transfusion  of  milk  into  veins  may  be  necessary  in  cases 
of  collapse  (Thomas). 


Hemorrhoids. 

Galls,  as  ointment,  very  useful :  the  official  unguentum  gallae,  or  combined 
with  lead  and  opium.  See  formula  below  (R.).  Iron,  a  solution  of  the  sub¬ 
sulphate  as  wash  to  bleeding  piles,  which  should  then  be  well  oiled  (B.) ;  or 
an  ointment  of  the  subsulphate,  gr.  xv  to  the  3,  locally  night  and  morning, 
with  gr.  j  of  the  salt  thrice  daily  by  mouth  ;  gives  excellent  results.  Haraa- 
melis,  by  mouth,  also  lotion  or  injection  in  bleeding  piles  (R.) ;  is  employed 
with  satisfaction  ;  rr^ij — x;  of  tincture  several  times  a  day ;  also  enema  or 
suppository  ( P f . ) .  Nux  Vomica,  emphatically  beneficial  (P. ).  Sulphur,  gr. 
v-x,  with  3j  confec.  sennae,  as  laxative  (R.).  Exercises  a  most  soothing  in¬ 
fluence  (Wa.).  Sulphides,  especially  Blue  Lick  waters  (B.).  Podophyllum, 
as  cathartic  for  hemorrhoids  of  recent  formation,  bleeding  from  stasis  in  portal 
circulation  (B.).  Aloes,  causes  congestion  of  pelvic  viscera,  yet  Fordyce 
Barker  shows  it  to  be  curative  in  piles,  especially  in  recent  ones,  as  after  de¬ 
livery  (B.) ;  to  greatly  relieve  bowels  (R.)  ;  cures  by  removing  constipation 
(P.).  Hydrastis,  as  lotion  or  ointment  to  external  piles,  of  great  value  ;  h\,v 
of  tincture  ter  die  internally  at  same  time  (P.).  Ergot,  with  or  without  nux 
vomica,  in  dilated  hemorrhoidal  veins  without  new  tissue,  given  by  the  stomach 
and  used  locally  will  .often  cure  (B.).  [See  Diarrhcea  for  formula.]  Stil- 
lingia,  will  remove  permanently  when  due  to  constipation,  and  temporarily 
when  from  hepatic  obstruction  (B.).  Senna,  to  procure  soft  and  easy  evacu¬ 
ations,  use  the  confectio  sennae  at  bedtime,  gr.  cxx  in  a  bolus  (B.).  Iodoform, 
the  ointment,  and  in  suppository  (B.).  Nitric  Acid,  as  caustic,  followed  by 
free  use  of  olive  oil  (B.,  R.)  ;  ^ss-^j  ad  Oss  of  water  as  lotion  for  bleeding 
piles  (R.).  Hyoscyamus  or  Stramonium,  leaves  bruised,  or  ointment,  locally, 
for  pain  (P.).  Oleum  Lini.  Linseed  Oil,  boiled,  in  doses  of  3 ij  twice  daily, 
has  quite  a  reputation  as  a  remedy  for  piles  (W.).  Alum,  to  painful  bleeding 
piles,  a  crystal  trimmed  and  passed  into  rectum,  or  as  an  ointment  (B.).  Ice, 
to  painful,  bleeding  piles,  or  cold  water  injected  daily  (B.) ;  locally,  for  pain 
after  operation  (R.).  Leeches,  directly  to  swollen,  irreducible,  and  painful  piles 
(B.).  Alkaline  Mineral  Waters,  excellent  (B.).  Carbolic  Acid,  3  parts  to  I 
of  olive  oil,  a  few  drops  injected  into  the  tumor.  A  favorite  and  successful 
treatment  by  itinerants  (Andrews) ;  uncertain  in  all  cases  and  in  many  fraught 
with  danger  (Gross).  A  good  procedure,  use  4  drops  each  of  pure  carbolic 
acid  and  glycerin,  and  inject  one  tumor  at  a  time  (Hunt).  Grape-cure,  is  used 
with  success  (B.).  Saline  Purgatives,  notably  Epsom  salts,  in  bleeding  piles, 
combined  with  sulphuric  acid,  will  often  stop  the  hemorrhage  (B.).  [See  Dys- 


HEPATALGIA - HEPATIC  CIRRHOSIS. 


587 


entery  for  formula.]  Diet,  etc.  Avoid  stimulants,  indigestible  food  and  over¬ 
eating  ;  during  an  attack  use  little  animal  food.  Petroleum  soap  when  piles 
protrude,  with  cold  or  tepid  water  ablutions.  Injections,  Oj  cold  or  tepid 
water,  are  very  useful.  Stool  should  be  at  night.  Surgical  Methods  are — the 
ligature  for  internal  hemorrhoids,  excision  for  external  ones.  Ligation  is  the 
proper  treatment  for  the  former,  all  other  methods  of  operating  radically  being 
now  discarded  as  unsurgical,  and  dangerous  to  life  (Gross).  The  thermo-cau¬ 
tery  is  used  by  Smith  of  London  and  many  other  surgeons,  but  is  apt  to  leave 
behind  fissures  and  ulcers,  which  are  with  difficulty  healed.  Prevention.  Soft 
seats  favor  the  production  of  piles,  as  also  of  uterine  disorders,  by  pressure  on 
the  arteries  as  they  emerge  from  the  pelvis,  and  so  tend  to  drive  the  blood  into 
the  interior  of  that  cavity  (Holden). 


Prescriptions. 


R  .  Pulv.  Galke, . gr.  xxx. 

Pulv.  Opii, . gr.  x. 

Ung.  Plumbi  Subacet.,  .  .  gr.  xl. 

Ung.  Simplicis,  - . g  j. 

M.  et  ft.  unguentum.  Sig. — Ointment 

for  piles.  ( CEsterlen .) 


R.  Ext.  Colocynth.  Co.,  .  .  .  gr.  xx. 
Ext.  Nucis  Vom.,  .  .  .  .  gr.  vj. 
Hydr.  Chlor.  Mitis, 

Ext.  Hyoscyami,  .  .  .  aa  gr.  xij. 

M.  et  div.  in  pil.  no.  xij. 

Sig. — One  as  required  for  sluggish  bowels. 

{Barker.') 


R  .  Ac.  Carbolici, . gij. 

Ac.  Tannici, . gj. 

Alcoholis, . giv. 

Glycerini, . 3j. 


M.  Sig. — Hypodermic  injection  for  piles. 

(  Girard. ) 


R.  Iodoformi, . ^j. 

Balsam.  Peruv.,  .  .  .  ,  .  gij. 
Magnes.  Calcin.,  ....  gj. 
01.  Theobromse, 

Cerae  Albae, . aa  ^jss. 


M.  et  fiant  suppositoria  xij.  Sig. — One 
twice  daily. 

R .  Pulv.  Gallce, 

Pulv.  Opii, 

Plumbi  Acetat,  .  .  .  .  aa  gr.  xx. 
Ung.  Picis  Liquidae, 

Cerati  Simplicis,  .  .  .  aa  5  ss. 

M.  et  ft.  unguentum.  Sig. — Apply  night 
and  morning  after  bathing  parts  with  cold 
water. 


R  .  Ext.  Opii, . gr.  x. 


Pulv.  Stramonii, . ^j. 

Pulv.  Tabaci, . £ss. 

Ung.  Simplicis, . Ejss. 


M.  Sig. — Ointment  for  piles. 

[Shoemaker.) 


Hepatalgia. 

.  Ammonium  Chloride,  grains  xx-xxx,  every  4  hours,  is  highly  efficacious 
(Anstie).  Bryonia,  worthy  of  commendation  in  many  liver  affections  (P.).  Nux 
Vomica,  has  been  found  of  much  benefit.  Dose  should  be  small,  gr.  TLy  to 
twice  or  three  times  a  day  (P.).  Quinine,  would  naturally  be  thought  of  in 
malarial  subjects,  but  does  not  afford  any  relief  (Anstie). 


Hepatic  Cirrhosis. 

Nitric  Acid,  in  long-standing  diseases,  as  this,  will  augment  flow  of  bile  after 
liver  has  struck  work  from  mercury  (R.).  The  mineral  acids  do  not  benefit 
(B.).  Arsenic,  small  doses  perseveringly,  give  good  results  in  improving  the 
nutrition  of  the  organ  (B.)  Bryonia,  of  great  value  in  many  liver  complaints 
(P.).  Iodides,  are  the  best  remedies  for  the  first  stage  (B.) :  the  potassium  iodide 
is  highly  recommended  by  some  authorities  (Da  Costa) :  the  great  measures  in 
the  treatment  of  this  affection  are  potassium  iodide,  hydrotherapy,  and  a  milk 
diet  (Lanceraux).  Stillingia  and  Alkaline  Mineral  Waters,  are  important  in 
the  first  stage  (13.) ;  alkalies  early,  especially  Carlsbad  water,  with  total  absti¬ 
nence  from  alcoholic  beverages  (Legg).  Mercury.  Corrosive  sublimate  in 
small  doses,  gr.  thrice  daily,  for  a  long  time,  does  benefit  the  condition,  and 
has  possibly  cured  a  few  cases  (Da  C.).  Sodium  Phosphate  is  said  to  produce 


588 


HEPATIC  CONGESTION. 


good  results  (Da  C.) ;  has  power  to  retard  the  sclerosis,  and  may  possibly  arrest 
the  changes  and  restore  a  state  of  comparatively  normal  function  (B.).  Chloride 
of  Gold  and  Sodium,  in  doses  of  gr.  3^,  as  an  hepatic  alterative,  may  be  used 
conjointly  with  phosphate  of  sodium  (B.).  Tapping  becomes  necessary  for 
the  dropsy,  though  purgation  and  diuresis  may  help  to  lessen  it  (Da  C.).  Diet, 
should  be  easily  digested,  especially  milk,  avoiding  starches  and  fats,  and  quit¬ 
ting  alcohol  (Da  C.). 

Hepatic  Congestion. 

Nitric  Acid,  in  chronic  congestion,  will  augment  flow  of  bile  after  liver  has 
struck  work  from  excessive  use  of  mercury  (R.).  Nitro-Muriatic  Acid,  is  found 
useful  in  India,  with  the  acid  bath  ( 3 iij  ad  gall,  j)  to  hypochondrium  (B.) : 
formerly  held  high  rank  but  is  now  superseded  by  ammonium  chloride ;  the 
acid  baths  being  now  rarely  employed  (Fayrer).  See  page  462  for  formula. 
Sulphur,  Sulphates  in  purgative  natural  waters,  small  doses  often  repeated ; 
potassium  sulphate  is  occasionally  poisonous  (R.).  Chelidonium,  as  deobstruent 
(P.) ;  energetically  affects  the  liver  (Pf.).  Iodine,  tincture  and  unguent,  locally 
for  hepatic  engorgement  after  malarial  attack.  The  iodide  of  ammonium  in 
moderate  frequent  doses  in  functional  derangement,  from  malarial  disease  (B.). 
Sodium  Phosphate,  £j-ij,  3  or  4  times  daily,  in  plenty  of  water,  as  a  purgative 
(B.).  Ammonium  Chloride,  in  passive  congestion,  and  chronic  torpidity,  is 
well  worthy  of  attention  ;  gr.  xx  every  4  hours  (Wa.) ;  an  excellent  remedy 
(Da  Costa).  Turpentine,  epithems,  hot,  often  found  very  beneficial  (Wa.). 
Quinine,  gr.  xv-xx  with  morphine,  gr.  in  the  acute  congestion  due  to 

climatic  or  malarial  causes,  no  remedy  so  efficient  (B.).  Bryonia,  is  worthy  of 
commendation  in  liver  affections  of  various  kinds  (P.).  Iris,  really  serviceable 
when  stools  clay-colored  and  skin  jaundiced  (B.) ;  is  one  of  the  best  aperients 
in  hepatic  derangement  (P.).  Mercury,  valuable  only  as  a  purgative ;  its  use 
restricted  to  cases  where  there  is  deficiency  or  excess  of  bile  (B.) ;  a  full  calo¬ 
mel  purgative  is  of  utility  in  cases  of  congestion  (Wa.).  Podophyllum,  the  resin 
in  congestion  of  the  portal  circulation,  is  especially  useful  (B.) ;  l/6-%  gr.  doses 
every  six  hours  will  speedily  relieve  symptoms  (P.).  Sanguinaria,  is  useful  in 
hepatic  engorgement  without  organic  disease  (P.).  Colchicum,  in  hepatic  con¬ 
gestion  and  dropsy ;  an  active  remedy  in  congestion  of  the  liver  (B.).  Resin¬ 
bearing  Purgatives,  as  Rhubarb,  Podophyllum,  Iris,  Euonymus,  etc.,  are  all 
actively  cholagogue.  (See  list  on  page  39.)  Ipecacuanha,  decidedly  stimulant 
to  the  flow  of  bile  (B.);  is  the  Indian  treatment  now  for  the  local  liver,  given 
in  large  doses  for  a  week  or  two  (Da  C.).  Taraxacum,  has  had  a  reputation, 
but  I  cannot  recommend  it  (DaC.).  Aliment.  No  starches  or  fats.  Milk, 
eggs,  oysters,  beef  broth,  whitefish,  etc.  (B.).  Cold  Water  Belt  around  the 
abdomen,  covered  with  oiled  silk,  gives  great  comfort  in  chronic  cases  (DaC  ). 
[Compare  Biliousness,  Jaundice,  etc.] 


R  .  Elaterii,  ........  gr.  j. 

Spt.  ^Etheris  Nitrosi,  .  .  .  ^ij. 
Tinct.  Scillae, 

Tinct.  Colchici,  .  .  .  .  aa  5  ss. 
Syrupi  Simplicis,  .  .  .  .  §j. 

M.  Sig. — Teaspoonful  thrice  daily.  (B.) 


R.  Hydrarg.  Chlor.  Mitis,  .  .  gr.  vj. 

Pulv.  Ipecac., . gr.  j. 

Sodii  Bicarb., . gr.  x. 

Div.  in  pulv.  no.  ij.  Sig. — One  at  bed¬ 
time,  followed  by  the  following  :  — 

R.  Ac.  Nitro-hydrochlor.  Dil.,  iij. 

Elix.  Taraxaci  Co.,  .  .  ad  25  vj. 

M.  Sig. — Dessertspoonful  before  meals, 
and  a  milk  diet. 


Ext.  Taraxaci, . gr.  lxxij. 

Ext.  Aloes, . gr.  xxiv. 

Ext.  Colchici  Rad., 

Pulv.  Ipecac.,  .  .  .  .  aa  gr.  xij. 

M.  et  div.  in  pil.  no.  xxiv. 

Sig. — 2  nightly  in  chronic  enlargement 


and  torpidity.  ( Martin .) 

R.  Sanguinariae, . gr.  viij. 


Podophyllini, . gr.  iij. 

Ext.  Hyoscyami,  .  .  .  .  gr.  iij. 

Saponis, . gr.  viij. 

M.  et  div.  in  pil.  no.  xx. 

Sig. — 2  to  4  pills  daily.  In  hepatic  tor¬ 
por  without  organic  disease.  ( Phillips .) 


Prescriptions. 

R. 


HEPATIC  DISEASES. 


589 


& .  Pil.  Hydrargyri,  .  .  . 

Pulv.  Aloes  Socot.,  .  .  aa  gr.  iv. 
Pulv.  Rhei, 

Extr.  Hyoscyami,  .  .  aa  gr.  vj. 

M.  et  div.  in  pil.  no.  vj. 

Sig. — 2  pills  every  other  night. 

R .  Cinchonidinae  Sulph., 

Euonyraini, 

Leptandrini, 

Juglandini, 

Irisini, . aa  3]. 

Podophyllini, 

Ext.  Belladonnae, 

Ext.  Hyoscyami,  .  .  .  aa  gr.  x. 

M.  et  div.  in  pil.  no.  lx. 

Sig. — One  pill  thrice  daily.  In  obstinate 
hepatic  torpor.  ( Blackwood .) 


R.  Euonymini,  .  . . gr.  xij. 

Ext.  Hyoscyami,  .  .  .  .  gr.  vj. 

M.  et  div.  in  pil.  no.  vj. 

Sig. — One  at  bedtime,  followed  next 
morning  by  a  full  dose  of  an  aperient  min¬ 
eral  water. 


R.  Potass.  Bicarb., 

Potass.  Citratis,  .  .  .  .  aa^j. 

Syrupi  Simplicis, . 5vj* 

M.  Sig. — A  teaspoon ful  to  a  tablesp. 
with  a  similar  quantity  of  lemonjuice,  in  ]4 
glass  of  water;  the  whole  to  be  drank 
while  effervescing.  (  Wood .) 


Hepatic  Diseases. 

Ammonium  Chloride  is  highly  serviceable  in  all  cases  of  liver  disease, 
whether  due  to  organic  changes  or  to  functional  derangement ;  especially 
indicated  after  the  more  acute  symptoms  have  abated  (Wa.).  Nitro-hydro- 
chloric  Acid  formerly  held  high  rank,  but  is  now  superseded  by  ammonium 
chloride  (Wa.) ;  even  the  acid  baths,  so  long  considered  of  great  importance, 
are  now  but  little,  if  ever,  used  in  India  (Fayrer).  Nitric  Acid  acts  in  some 
way  beneficially  on  long-standing  liver-diseases,  as  in  chronic  congestion  and 
cirrhosis  (R.) ;  with  vegetable  bitters,  long  continued,  useful  in  waxy  liver 
(Wa.).  Podophyllum  has  a  high  reputation  in  a  variety  of  liver  diseases  (P.)  ; 
is  actively  cholagogue  (R.).  Mercury,  mercurial  purgatives  are  used  for  both 
deficiency  and  excess  of  bile;  harmful  in  many  acute  forms  of  hepatic  disease, 
and  generally  are  of  doubtful  propriety  in  liver  affections  (B.) ;  in  hepatic  con¬ 
gestion  a  full  calomel  purge  is  of  great  benefit  (Wa.).  Red  Iodide  of  Mercury, 
as  ointment,  gr.  j  to  3  v,  gives  best  results  in  malarial  enlargement  of  the  liver 
(W.).  Calomel  is  used  in  inflammatory  disorders  of  the  liver,  but  is  less  suited 
to  parenchymatous  than  to  serous  inflammations  (Da  Costa).  Ipecacuanha 
promotes  the  flow  of  bile  (B.) ;  may  be  used  in  small  doses  with  great  advan¬ 
tage  in  functional  derangement  of  the  organ  (Wa.).  Resinous  Purgatives,  as 
Leptandra,  Iris,  Euonymus,  Rheum,  etc.,  are  decidedly  cholagoguo  (B.). 
Euonymin  is  of  great  value  in  torpid  liver  and  its  accompanying  headache 
(W.).  Bryonia  is  worthy  of  commendation  in  liver  affections  of  various  kinds 
(P.).  Chelidonium  powerfully  affects  the  liver  (Pf.).  Taraxacum  is  highly 
recommended  in  all  chronic  affections  of  the  liver,  especially  in  indolent 
enlargement  and  incipient  scirrhus  (Watson).  Sodium  Phosphate  is  cholagogue, 
and  extremely  useful  in  liver  affections,  especially  the  jaundice  of  children  and 
hepatic  calculi  (Thudicum).  Phosphorus  specifically  affects  the  liver,  and  used 
early  in  acute  yellow  atrophy  may  have  an  action  of  antagonism  upon  the 
disease  (B.).  Potassium  Salts,  as  depuratives,  are  of  decided  value,  especially 
the  citrate,  in  hepatic  torpor  and  other  affections  (W.).  See  preceding  article 
for  formula.  Sulphur,  the  sulphurous  mineral  waters,  prolonged,  give  excel¬ 
lent  results  in  liver  disorders  (B.).  Alkaline  Waters  are  very  serviceable  (B.) ; 
especially  the  sulphur  waters.  Glauber’s  salt  in  their  place  (Da  Costa).  Chlo¬ 
rine  Water  has  been  employed  with  benefit  in  chronic  hepatic  affections,  in 
doses  of  3  ss-ij  in  t^iij  or  iv  of  water  (W.).  Iron  preparations,  long  continued, 
in  amyloid  degeneration  (Da  C.).  Gentian,  and  other  bitter  tonics,  in  func¬ 
tional  disorder;  also  Nux  Vomica  occasionally,  but  use  mercurials  and  podo¬ 
phyllum  sparingly  (Da  C.).  Iodine  and  Iodides  in  waxy  enlargement,  simple 
hypertrophy  and  chronic  congestion,  of  great  value  (Wa.) ;  the  iodide  of 
potassium  alternately  with  the  iodide  of  iron  in  waxy  liver  (Frerichs);  a  few 


590 


HEPATITIS - HERNIA — HERPES. 


drops  injected  into  hydatids  (B.).  Sanguinaria  is  of  great  value  in  hysteria 
from  chronic  hepatitis,  and  in  hepatic  engorgement  without  organic  disease 
(P.).  See  preceding  article  for  formula.  Stillingia,  for  torpid  liver  and  jaun¬ 
dice  following  ague,  in  the  first  stage  of  cirrhosis,  and  in  ascites  from  hepatic 
changes  (B.).  Malt  Liquors  are  harmful  in  all  chronic  affections,  especially  in 
fatty  liver  (B.).  Galvano-puncture  for  hydatids,  the  negative  needle  into  the 
hydatid  (B.).  [Compare  Lists  of  Agents  acting  on  the  Liver,  page  39,  ante ; 
also,  the  articles  in  this  section  entitled  Biliousness,  Calculi,  Cancer, 
Hepatalgia,  Hepatic  Congestion,  Hepatic  Cirrhosis,  Hepatitis,  Jaun¬ 
dice.] 

Hepatitis  and  Hepatic  Abscess. 

Ammonium  Chloride,  is  almost  a  specific  in  hepatitis  and  abscess  of  the  liver 
(Stewart) ;  often  preventing  the  latter  disorder,  and  in  many  instances  curing 
it  (Wa,).  Quinine,  in  large  doses  for  the  acute  parenchymatous  inflammation 
(Da  Costa).  Tartar  Emetic,  gr.  every  two  or  three  hours,  with  opium  or 

calomel  as  indicated  by  symptoms ;  of  especial  value  early  in  the  acute  attack 
(Wa.).  Leeches  to  margin  of  the  anus  in  the  acute  type  (B.) ;  to  unload  the 
portal  system  (Wa.).  Mercury  is  used,  but  is  better  suited  to  serous  inflamma¬ 
tions  than  to  parenchymatous  ones  (W.).  Chelidonium  has  been  used  with 
benefit  in  both  acute  and  chronic  hepatitis  (P.).  Alkalies  and  Colchicum, 
when  the  affection  is  of  a  gouty  nature  (Wa.).  Sulphites  are  recommended  in 
chronic  forms  (Da  Costa).  Sinapisms  and  linseed  poultices  over  the  hepatic 
region  in  acute  hepatitis  (Wa.).  Saline  Purgatives,  as  the  sulphates  of  sodium 
or  magnesium,  to  increase  the  watery  exudation  from  the  mucous  membrane 
of  the  intestines,  in  acute  hepatitis  (Wa.).  Nitro- Hydrochloric  Acid,  for  some 
time  in  chronic  form  tending  to  abscess  (Da  C.).  Aspiration,  when  pus  forms ; 
early  operation  the  rule  of  practice  ;  has  induced  many  recoveries  (Da  C.). 
[Compare  Jaundice.] 

Hernia. 

Opium,  or  morphine  hypoder.  to  narcotism,  often  obviates  the  necessity  of 
an  operation  in  strangulated  hernia  (Wa.).  Chloroform,  of  evident  benefit 
(Wa.) ;  inhaled  to  assist  reduction  (R.) ;  has  superseded  the  use  of  tobacco  and 
lobelia  in  strangulated  hernia  (P.).  Coffee,  large  doses,  has  certainly  a  remark¬ 
able  influence  in  aiding  or  causing  reduction  of  strangulated  hernia  (Wa.). 
Oak  Bark  extract,  as  injection  into  the  tissues,  for  a  radical  cure  by  stimulating 
the  occlusion  of  the  rings  (Heaton’s  radical  cure).  A  similar  operation  was 
patented  by  a  Dr.  Gage  in  1840,  the  oil  of  cloves  being  the  injection  used. 
Professor  Pancoast  injected  tincture  iodine  for  the  same  purpose.  Operations 
for  radical  cure  all  satisfactory.  A  properly  adjusted  truss  (Ag.)  :  is  the  best 
remedy  for  a  reducible  hernia,  answering  the  purpose  of  a  retentive  apparatus, 
and  often  permanently  curing  the  disease  by  the  steady,  gentle  and  uniform 
pressure  of  its  block  (Gross).  Ice  Poultice  is  of  use  if  no  strangulation  of  gut 
or  omentum  (Wa.).  Sternutatory,  as  snuff  or  ipecac,  to  cause  sneezing  while 
patient  lies  on  his  shoulders  with  elevated  hips  and  legs  over  the  back  of  a 
chair,  frequently  successful  after  taxis  has  failed  to  effect  reduction. 

Herpes. 

Ferrum  Arseniate,  in  doses  of  gr.  ^  daily,  will  effect  the  cure  of  a  herpetic 
affection  in  the  adult,  however  extensive  or  long  established  (Duparc).  Mer¬ 
cury,  calomel  ointment,  3j  to  the  5,  is  one  of  the  best  mercurial  preparations 
(Pereira).  Potassium  Carbonate,  as  lotion,  gr.  xxx  to  Oj,  to  allay  irritation 
(Wa.) ;  or  as  ointment,  gr.  xx  to  3 j ,  smeared  over  eruption  at  night,  and 
washed  off  in  the  morning  with  a  solution,  gr.  xxx  to  Oj  (Neligan).  Glycerin, 
diluted,  is  a  serviceable  application  in  herpes  labialis  (Wa.).  Ergot,  the  oil 
prepared  by  the  action  of  benzin  upon  ergot,  which,  upon  evaporation  of  the 
solvent,  makes  a  valuable  application  in  herpes  genitalium  and  other  skin 


HERPES  ZOSTER - HICCOUGH. 


591 


affections  (Shoemaker).  Alum,  in  herpes  praeputialis,  a  solution  of  3j  to 
aquae,  applied  on  lint  to  the  glans  penis,  is  generally  effectual  (Wa.).  Collo¬ 
dion,  the  flexible  form,  is  applicable  to  various  kinds  of  herpes  (Wa.).  Mag¬ 
nesium  Citrate,  as  a  cooling  laxative,  with  soothing  and  protective  lotions  and 
ointments,  and  the  Liquor  Picis  Alkalinus,  diluted  10  to  20  times  for  the  itch¬ 
ing  (Bulkley).  Astringent  Lotions,  of  tannin  or  zinc  sulphate,  in  herpes  prae¬ 
putialis,  to  render  the  parts  less  sensitive  (Da  Costa).  [For  Herpes  Circinatus 
see  Tinea  Circinata.] 


Prescriptions. 


R  .  Tragacanthae, . %  ij-iv. 

Liq.  Calcis, . 5  iv. 

Glycerini . 3  j. 

Aquae  Rosae, . 5  iij. 


M.  Sig. — A  soft  jelly  for  local  use  as 
ointment. 


R  .  Ac.  Carbolici, . gtt.  v-xv. 

Pulv.  Calaminae  Praep., 

Zinci  Oxidi, . aa  "  ss-j. 

Ung.  Aq.  Rosae,  .  .  .  .  gj. 

M.  et  ft.  unguentum. 

A  soothing  and  protective  application. 


Herpes  Zoster. 

Rhus  Toxicodendron,  very  readily  subdues,  especially  when  burning  or  itch  - 
ing  (P.).  Aconite  and  Opium,  locally  for  pain  (Wa.).  Morphine,  oleate  ext*, 
without  friction  (R.)  ;  hypoder.  to  mitigate  the  pain  (Anstie).  Celandine  has 
been  recommended  (P.).  Dulcamara  has  an  old  reputation  (P.).  Silver  Ni¬ 
trate,  painted  on  the  warning  patch  of  erythema,  before  or  as  soon  as  ves  icles 
begin  to  form  (R.).  As  a  local  application,  reported  on  favorably  (Wa.).  Vera- 
trine,  as  ointment,  Bj-ij-jfj,  in  neuralgia  following  shingles  (R.).  Zinc  Phos¬ 
phide,  gr.  ^3  every  3  hours,  is  said  to  control  the  pain  and  abort  the  eruption 
(Hughes).  Grindelia  is  reputed  to  relieve  the  pain  (Stille).  Mercury,  the  Ung. 
Hydrarg.  Ammoniat.  is  said  to  relieve  the  pain  and  irritation  remarkably  (Wa.). 
Blisters,  for  subsequent  neuralgia  (R.).  Hot  Fomentations  will  often  disperse 
(R.).  Baths  daily,  exercise  out  of  doors,  abundant  nutritious  food.  Flexible 
Collodion,  constantly  reapplied  to  exclude  air  (Anstie).  Galvanization  of  the 
affected  intercostal  nerves,  the  positive  pole  over  their  points  of  emergence,  the 
negative  brushed  over  the  terminal  filaments  in  the  skin  (B.).  Starch,  dusted 
over  the  eruption,  and  on  a  muslin  band  sewed  tightly  around  the  body  to  pro¬ 
tect  it  from  the  friction  of  the  clothes,  gives  the  greatest  relief  (Bulkley).  Rest, 
absolute,  when  eruption  is  extensive  (Fournier). 


Prescriptions. 


R .  Zinci  Phosphidi, 

Ext.  Nucis  Vomicae,  .  .  aa  gr.  x. 

M.  et  div.  in  pil.  no  xxx. 

Sig. — One  every  2  to  4  hours,  as  a  nerve 
tonic.  [Bulkley.) 


R. 


iv. 


Liq.  Sodii  Hypochlorit., 

Aquae, . ^  ij. 

M.  Sig. — Wash  for  ulcerated  vesicles. 

[Fournier.) 


R .  Bismuthi  Subnit.,  .  .  .  .  3  iv. 
Hydr.  Chlor.  Mitis, 

Zinci  Oxidi, . aa  gj. 

M.  ft.  pulvis.  Sig. — To  be  dusted  on 
cotton-wool,  and  applied  to  the  ulcerated 
vesicles,  after  washing  with  the  solution  of 
Sodium  Hypochlorite.  [Fournier). 


Hiccough. 

Nux  Vomica,  in  5-  or  io-np  doses  of  tincture,  with  rr^xv  of  dilute  nitric  acid; 
a  short  course  frequently  curative  (P.).  Chloroform,  combined  with  opium  (R.). 
Pepper,  gr.  ij-x,  to  stop  hiccough  (P.).  Laurel-water,  a  useful  remedy,  ffbv  (P.). 
Morphine,  hypoderm.,  often  arrests  (R.).  Camphor  has  been  recommended 
(R.).  Mustard,  ,3j  infused  in  jfiv  aq.  fervid,  has  cured  most  obstinate  cases 
(R.).  Pilocarpine,  gr.  ^  of  the  muriate,  has  cured  bad  cases  which  resisted 
all  other  means  (Ortille).  Ether,- as  spray  to  the  epigastrium  for  ten  minutes, 
then  the  site  of  the  phrenic  in  the  neck  (Regoni) ;  or  the  spirit,  nuxx-xxx  in 


592 


HYDROCELE - HYDROCEPHALUS - HYDROPHOBIA. 


some  aromatic  water,  given  internally,  will  often  arrest  the  spasm  immediately 
(Wa.).  Zinc  Valerianate,  gr.  %  with  a  small  portion  of  extr.  belladonnae,  cured 
a  severe  case  of  fifteen  days’  duration  (Danet).  Nitro-glycerin,  sometimes 
arrests  (R.).  In  mild  cases  deep  inspirations,  holding  breath  as  long  as  pos¬ 
sible,  or  a  firm  belt  around  epigastrium  (T.). 

Hydrocele. 

Iodine,  injection  of  tincture  i,  water  2,  into  the  sac  to  excite  obliterative 
inflammation,  the  usual  procedure  for  radical  cure  after  tapping  the  sac  (Wa.); 
may  be  used  full  strength,  or  with  equal  part  of  water ;  the  latter  the  safest 
method  in  ordinary  cases,  but  relapses  are  not  infrequent  (Gross).  Carbolic 
Acid,  3ss,  with  a  minute  quantity  of  water  or  glycerin  to  render  it  fluid,  injected 
into  sac  and  manipulated  to  bring  all  portions  under  its  action,  after  which 
rest  in  bed  and  support  to  scrotum  (Levis) ;  a  very  efficient  method  for  radical 
cure,  but  may  cause  erosion  of  vessels  and  hemorrhage  into  sac  (Gross).  Am¬ 
monium  Chloride,  as  discutient  lotion  to  the  scrotum  in  hydrocele  of  children 
(Wa.).  Galvano-puncture,  a  current  of  20  to  40  elements,  by  two  needle  elec¬ 
trodes,  will  invariably  cure  (B.).  Operations  for  radical  cure  include  that  by 
iron-wire  sutures  to  excite  adhesive  inflammation  (Simpson);  and  the  incision 
of  the  hydrocele  under  antiseptic  precaution  (Volkmann);  the  same  end  may 
be  obtained  by  the  simpler  methods  of  injection  noted  above  (Gross).  [Com¬ 
pare  Dropsy,  Orchitis.] 

Hydrocephalus,  Acute. 

Iodine,  lotions  to  scalp,  or  inunction  of  iodine  ointment  together  with  ferric 
iodide  and  cod-liver  oil  internally,  offer  the  best  chance  of  success,  although 
most  remedies  often  fail  (Wa.).  Tartar  Emetic,  oint.  as  counter-irritant  to 
scalp  in  tubercular  meningitis  (R.) ;  in  large  doses  internally  was  formerly 
employed  (Wa.).  Croton  Oil,  is  said  to  have  removed  the  excess  of  fluid  from 
the  ventricles  (R.).  Mercury,  hydrarg.  chlor.  corr.,  in  doses  of  gr.  to  Tx^,  has 
proved  successful  (Wa.).  Magnesium  Carbonate,  £j-ij  saturated  with  lemon- 
juice,  every  2  or  3  hours,  a  useful  purgative  in  hydrocephalus  (Wa.).  Turpen¬ 
tine,  in  doses  of  n^v-x  with  tr^xx-xl  of  castor-oil,  or  terebinthinate  enemas,  in 
incipient  hydrocephalus  (Wa.).  Purgatives,  in  small  doses  every  4  or  6  hours 
after  having  overcome  the  constipation,  to  maintain  action  for  some  days. 
A  single  dose  of  calomel,  followed  up  by  magnesium  sulphate  at  short  intervals. 
Their  value  can  hardly  be  overrated  (Wa.).  Leeches,  on  crown  of  head  rather 
than  on  temples,  when  much  febrile  action  ;  inadmissible  if  patient  is  much 
debilitated  ;  sometimes  serviceable  (Wa.). 

Hydrocephalus,  Chronic. 

Mercury,  holds  a  high  place  in  the  opinion  of  many.  Calomel  gr.  ^->2 
twice  daily,  with  mercurial  inunction  to  the  shaved  head,  or  the  latter  alone  ; 
child  to  wear  a  woollen  cap.  This  treatment  for  30  or  40  days  (Wa.).  Ferric 
Iodide,  with  cod-liver  oil,  always  gives  good  results  among  the  poor  (Wa.). 
Iodine,  lotions.  [See  Hydrocephalus,  Acute.]  Potassium  Iodide,  may  arrest 
progress  (Wa.);  is  of  value  certainly;  appears  to  have  power  of  promoting 
absorption  (W.).  Cod-liver  Oil,  sometimes  improves  the  condition,  especially 
in  scrofulous  children  (Wa.).  [Compare  Dropsy.] 

Hydrophobia. 

Belladonna,  in  all  hypersemic  states  of  the  brain  and  spinal  cord,  is  one  of 
the  very  best  remedies  (P.).  Stramonium,  is  used  by  Brahmins  in  India  with 
apparent  success.  Glonoin,  may  be  of  benefit  (Wa.).  Nicotine,  rightly  used,, 
will  probably  prove  to  be  our  best  remedy  (B.).  Amyl  Nitrite,  should  be  fairly 


HYDROTHORAX - HYPOCHONDRIASIS - HYSTERIA. 


593 


tried  (B.).  Curare,  is  encouraging,  grm.  0.02  injected,  7  doses  in  5^  hours, 
dispelled  the  symptoms,  but  replaced  them  by  paralysis  of  limbs  continuing 
over  2  months  (Ros.)  ;  has  seemed  to  antagonize  the  convulsive  phenomena 
(B.)  Chloride  of  Lime,  a  filtered  solution  injected  into  wound,  very  effective 
in  snake  bites  (Binz.).  Morphine,  chiefly  palliative.  For  deep  injection  into 
the  tetanized  muscles  (B.).  [See  Tetanus.]  Coniine,  is  indicated  ;  has  not 
succeeded  (B.).  Cauterization,  with  hot  iron  or  caustic  potash  after  cleansing 
wound,  which  should  be  kept  open  by  unguentum  basilicon  for  5-6  weeks  (Ros., 
A.);  with  Silver  Nitrate  sharpened  to  a  point,  and  applied  freely  to  every 
sinuosity  of  the  wound  as  preventive  (Wa.).  Excision,  the  safer  practice  (Wa.). 
Baths,  warm  and  hot,  produce  calm  (Ros.).  Pasteur’s  Inoculation,  with  a 
“  modified  virus,”  is  claimed  to  protect  the  person  bitten  from  the  disease. 

Hydrothorax. 

Digitalis,  in  purely  dropsical  form,  also  in  passive  pleuritic  effusions  ;  used  as 
a  diuretic  (3  j-ij  of  infusion  bis  die,  or  oftener)  of  great  value  (R.).  Ela- 
terium,  unquestionably  of  value  as  a  derivative,  though  many  fear  it  (P.). 
Jaborandi,  produces  good  results  (B.).  Iodine,  3 j  of  tincture  injected  in  re¬ 
turning  hydrothorax  (B.).  Sanguinaria,  has  been  used  with  the  best  effects 
(Wa.).  Blisters,  when  effusion  has  taken  place,  certainly  seem  to  stimulate 
the  absorbents  to  action  (Wa.).  Dry  Cupping,  over  the  chest,  gives  relief 
(Da  Costa).  Thoracentesis,  if  much  distress.  [Compare  Dropsy.] 

Hypochondriasis. 

Arsenic,  in  the  aged,  gives  great  comfort,  especially  when  combined  with 
opium  (B.).  Ignatia,  is  useful.  Tincture,  best  (P.).  Cimicifuga,  of  singular 
value  in  puerperal  hypochondria,  and  in  that  accompanying  spermatorrhoea, 
etc.  (P.).  Aurum,  Chloride,  gr.  to  ^  ter  die  gives  excellent  results,  when 
depression,  vertigo,  cerebral  anaemia  (B.).  Valerian,  quickly  relieves  flatulence 
(B.).  Asafcetida,  especially  indicated  in  cases  marked  by  flatulence  and  gloom 
(B.).  Potassium  Bromide,  especially  among  female  town-dwellers,  but  also  in 
male  (R.)  ;  effects  are  variable,  relieves  some,  not  others  (Wa.).  Hyoscyamus, 
when  syphiliphobia  (P.).  Opium,  stimulant  doses  of  the  tincture  are  of  great 
importance  (B.).  Caffeine,  the  citrate  (gr.  j-v)  has  been  used  as  a  cerebral 
stimulant  with  advantage  (B.).  Alcohol,  in  hypochondriasis  gives  temporary 
relief ;  should  never  be  given  for  its  narcotic  stimulant  effects  in  these  cases 
(W.).  Cocaine,  especially  useful  in  cases  marked  by  debility  and  nervousness, 
and  in  mental  affections  accompanied  by  depression  ;  the  fluid  extract  of  Coca 
may  be  used,  either  alone  or  in  wine  (Br.).  Turkish  Baths,  are  useful  for  town- 
dwellers,  with  soft,  flabby  tissues,  and  mental  depression  (R.).  [Compare 
Melancholia.] 

Hysteria. 

Ignatia,  useful  in  many  forms  of  hysteria,  with  feeling  of  suffocation,  sensa¬ 
tion  as  of  a  ball  rising  to  the  throat,  convulsive  crying,  flatulence,  etc.  (P.). 
Camphor,  in  hysterical  excitement  (P.).  Musk,  for  many  anomalous  and  dis¬ 
tressing  symptoms  (R.).  Chamomile  Oil,  in  the  spasmodic  and  pseudo-neuralgic 
affections  of  hysterical  women,  a  very  excellent  remedy  (P.).  Cimicifuga,  in 
hysterical  chorea,  is  rapidly  curative  (P.) ;  for  the  headache  (R.).  Asafcetida, 
in  hysterical  convulsive  affections,  with  flatulence  and  cough  (P.)  ;  arrests 
paroxysm,  valuable  for  flatulence  (B.)  ;  removes  headache,  peculiar  sensations 
in  head,  and  flatulence  (R.).  Valerian,  has  great  value,  £ss  doses  of  fluid  ex¬ 
tract  (B.)  ;  useful  in  most  cases,  especially  those  of  hysterical  dyspepsia  (P.). 
Zinc  Valerianate,  especially  at  the  climacteric  age,  for  hysterical  symptoms 
which  can  be  traced  to  no  particular  cause  (R.).  Ergot,  with  iron  and  other 
tonics  (see  formula  below),  in  cases  depending  on  sub-involution  of  the  uterus, 
with  indigestion  and  antemia  (B.).  Nux  Vomica,  of  great  use  in  middle-aged 
subjects,  with  flatulence,  weight  on  head,  flushings  and  perspirations  (R.). 

38 


594 


ICHTHYOSIS - IMPETIGO. 


Atropine,  for  hysterical  aphonia,  gr.  to  g1^  morning  and  evening  (B.).  Ether, 
for  the  flatulence,  and  for  the  hysterical  paroxysm  in  sudden  seizures  (B.). 
Ammonia,  the  aromatic  spirits  for  the  acidity  and  eructations  (B.) ;  the  fetid  spirit 
for  flatulent  colic,  etc.,  may  be  given  with  great  advantage  in  doses  of  3ss-j 
(\Va.).  Potassium  Bromide,  gives  control,  and  prevents  paroxysms.  When 
verging  on  nymphomania  large  dosgs  required  (R.).  Iron,  a  course  often  use¬ 
ful,  especially  when  anaemia  or  uterine  obstructions  (R.).  Phosphorus,  in 
hysterical  paralysis  (R.).  Arsenic,  lessens  mobility  of  nervous  system,  and 
improves  nutrition  (B.).  Opium,  gtt.j  of  laudanum  with  gtt.  ij  of  tinctura  nucis 
vomicae  3  or  4  times  a  day,  for  flushings,  weight  on  head,  depression  (R.). 
Ovarian  Compression,  has  in  many  cases  relieved  recent  hysterical  contractions, 
and  many  other  similar  phenomena  (Bourneville).  Electricity,  for  aphonia, 
paralysis  and  anaesthesia,  and  to  educate  the  nervous  control.  Electricity  is 
the  sworn  enemy  of  hysteria.  Accessory  Measures.  Occupation  of  mind  and 
body.  Removal  from  influence  of  friends.  Complete  abandonment  of  use  of 
alcohol.  The  shower-bath,  or  cold-bath,  as  an  educator  of  the  will,  as  well  as 
to  invigorate  the  body.  Excitement  to  be  avoided.  The  word  “  Hysteria  ” 
should  never  be  applied  to  the  case  in  the  patient’s  hearing.  Disorders  of 
vision  are  often  found  at  the  bottom  of  hysteria;  look  for  hypermetropia  and 
astigmatism. 

Prescriptions. 


R  .  Ext.  Ergotx, . 3  j. 

Ferri  Sulphatis, . gss. 

Ext.  Nucis  Vomicae,  .  .  .  gr.  viij. 
Hydr.  Chlor.  Corros.,  .  .  gr.  ss. 

M.  Fiant  pil.  no.  xxx.  Sig. — One  pill 
thrice  daily.  To  improve  digestion  and 
anaemia.  (B  ) 


R .  Tinct.  Asafcetidae, 

Tinct.  Valerianae  Ammon., 

Tinct.  Castorei,  .  .  aa  .  .  %  ij. 

Aquae  Camph., . jvij. 

M.  Sig. — A  tablespconful  or  two  every 
hour. 


Ichthyosis. 

Zinc,  the  ointment  or  glycerite  of  the  oxide,  especially  the  latter  with  a  little 
camphor  added  to  it,  is  a  most  useful  application  (Wa.) ;  an  ointment  of  the 
sulphate,  3j  to  5J,  found  very  efficient  (Wilson).  Sodium  Bicarbonate,  as  oint¬ 
ment,  gr.  xv-xxx  to  3j,  or  lotion,  3  ij  — i ij  to  Oj  (Devergie).  Copper  Sulphate, 
gr.  x  ad  5j  Unguentum  Sambuci,  a  useful  application  (Wilson).  Ulmus,  in 
decoction,  used  internally,  has  cured  the  disease  (Wa.).  Cod-liver  Oil,  applied 
locally  with  friction,  has  proved  promptly  curative.  Warm  Baths,  may  gener¬ 
ally  be  employed  with  benefit  (R.) ;  alkaline  and  vapor  baths,  with  sapo  mollis  ; 
and  inunctions  of  oil  or  simple  ointment,  to  prevent  Assuring  of  the  new  skin 
(Duhring)  ;  frequent  alkaline  baths,  with  internal  and  external  use  of  oily 
preparations,  as  linseed  and  cod-liver  oils,  yield  the  best  results  (Bulkley). 

Impetigo. 

Arsenic,  is  very  useful.  [See  Eczema.]  The  iodide  in  doses  of  gr.  T\y  has 
been  employed  with  great  success.  Or  Donovan’s  Solution,  rr\,v-x  (Wa.). 
Nitric  Acid,  internally,  frequently  benefits  (Wa.).  Glycerite  of  Tannin,  an 
excellent  application  (B.);  during  day,  with  poultice  at  night  to  remove  scabs 
(R.).  Quinine,  Mineral  Acids,  when  from  imperfect  digestion  (R.,  B.).  Zinc, 
the  ointment  of  the  oxide,  after  subsidence  from  inflammation  (R.).  Sulphur, 
internally,  serviceable  (R.).  Calcium  Chloride,  gr.  xv-xxx,  daily,  in  some 
vegetable  infusion,  well  spoken  of  (Wa.).  Mercury.  Citrine  ointment  dilute, 
locally,  is  an  excellent  application  (Wa.)  ;  a  very  weak  white  precipitate  oint¬ 
ment  answers  best  in  impetigo  contagiosa,  with  a  little  carbolic  acid  lotion  (1  to 
20)  if  it  does  not  yield  (Bulkley).  Calomel  to  cover  the  floor  of  the  pustules, 
after  opening,  evacuating  and  washing  them  out  (Da  Costa).  Laurel-water, 
relieves  itching  (P.).  Grape-cure,  has  proved  excellent  (P.).  Flexible  Collo- 
dium,  or  liquor  guttae  perchae,  to  cover  the  pustules,  if  located  where  they  are 
liable  to  irritation  (Da  Costa).  [Compare  Eczema.] 


IMPOTENCE - INFLAMMATION. 


595 


Impotence. 

Phosphorus,  no  remedy  more  efficient.  The  pill  of  zinc  phosphide  the  most 
convenient  form  (B.)  ;  gr.  thrice  daily.  Phosphoric  Acid,  full  doses,  with 
gr.  ss  of  pulvis  cantharidis,  an  effective  combination,  especially  in  impotence  of 
old  age  (B.).  Chloride  of  Gold,  prevents  decline  of  sexual  power  (B.).  Can- 
tharis,  with  iron,  is  beneficial  (B.).  In  large  doses  (gtt.  xx-xxx),  with  iron  and 
phosphoric  acid  or  nux  vomica  (R.).  Of  doubtful  efficacy  (Wa.).  Cubebs, 
removes  functional  trouble  (B.).  Nux  Vomica.  Drop  doses  of  tincture  in 
atonic  impotence  (B.).  In  large  doses  when  spermatorrhoea  (R.).  Sanguina- 
ria,  has  decided  aphrodisiac  properties,  but  useful  only  in  functional  form  (B.). 
Serpentaria,  in  relaxation  and  feeble  erections,  will  often  restore  power.  £>ss 
doses  of  tincture  bis  in  die  (B.).  Ergotin,  hypodermically  about  the  dorsal  vein 
of  penis,  when  its  enlargement  and  too  rapid  emptying  is  the  cause  of  impo¬ 
tence  (B.).  Cannabis  Indica,  is  a  useful  remedy  ;  the  best  combination  for 
functional  impotence  would  be  one  of  Cannabis,  Nux  Vomica  and  Ergot  (B.). 
Polygonum  Hydropiperoides,  is  a  useful  remedy  in  the  functional  form,  erections 
feeble,  semen  watery  and  testes  soft  (B.).  Arseniate  of  Iron,  acts  as  a  tonic  to 
the  organs,  and  in  full  doses  often  benefits  cases  of  functional  form  (B.). 
Damiana,  has  been  brought  forward  as  a  genital  stimulant,  and  a  remedy  for 
impotence,  but  there  is  probably  no  ground  for  any  confidence  in  such  claims 
(Stille).  [Compare  Emissions,  Spermatorrhcea,  also  List  of  Aphrodisiacs, 
ante ,  page  47. J 

Prescriptions. 


R 


.  Ferri  Arseniatis, 
Ext.  Ergotse,  . 
Ft.  pil.  no.  xxx. 


Sig. 


.  .  .  gr.  v. 

.  .  .  gr.  xxx. 
-One  twice  daily. 


R .  Sanguinarinae, 
Ext.  Ergotse,  . 
M.  Ft.  pil.  no. 
thrice  daily. 


xx. 


.  .  .  gr.  ij. 

.  .  .  gr.  xx. 
Sig. — One  pill 


R.  Ext.  Cann.  Indicae,  .  .  .  .  gr.  x. 

Ext.  Ergotae, . gr.  xl. 

Ext.  Nucis  Vom.,  .  .  .  .  gr.  x. 

Ft.  pil.  no.  xx.  Sig. — One  pill  night 
and  morning. 


R .  Tinct.  Sanguinariae,  .  . 

Ext.  Stillingiae  FI.,  .  . 

M.  Sig. — 15  to  20  drops  in  water, 
thrice  daily. 


3nJ- 
.0  v- 


R  .  Quininae  Sulpli.,  . 
Strych.  Sulph.,  . 
Ext.  Ergotae,  .  . 
Mas.  Ferri  Carb., 
M.  Ft.  pil.  no.  xxx. 
or  3  times  daily. 


,  .  .  .  gr.  xxx. 

.  .  .  gr.  ss. 

.  .  .  gr.  xv. 

.  .  .  gr.  xlv. 

Sig. — One  pill 


R .  Phosphori, . gr.  ss. 

Ext.  Nucis  Vom.,  .  .  .  .  gr.  vj. 

Mas.  Ferri  Carbonat.,  .  .  .  gr.  xl. 

Ext.  Gentianae, . gr.  xxx. 

M.  Ft.  pil.  no.  xxv.  Sig. — One  2  or  3 
times  daily. 


Inflammation. 

Aconite,  especially  in  inflammation  of  respiratory  organs,  eruptive  fevers,  and 
all  inflammatory  states  of  high  temperature  and  sthenic  reaction.  Not  in  ady¬ 
namic  states,  or  continued  fevers,  except  for  hyperpyrexia.  May  be  advantage¬ 
ously  combined  with  opium  (B.) ;  gives  most  brilliant  results  in  many  forms  (R.). 
Always  indicated  in  early  stages  of  simple  inflammatory  fevers,  in  all  inflam¬ 
mation  of  serous  membranes,  pneumonia,  tonsillitis,  acute  rheumatism,  ery¬ 
sipelas,  etc.  Is  especially  adapted  to  the  uses  for  which  bleeding  was  formerly 
employed  (P.).  Arnica  is  antipyretic,  large  doses  (£ss  of  tinct.)  in  sthenic, 
small  doses  (n\,x)  in  asthenic  inflammation  (B.) ;  in  inflammation  of  serous 
membranes  it  has  given  good  results  (P.).  Belladonna,  in  many  forms  no 
remedy  more  useful,  notably  scarlet  fever,  erysipelas,  low  fevers.  Inflamma¬ 
tion  of  eyes,  boils,  carbuncles,  etc.,  by  atropine  externally,  belladonna  inter¬ 
nally.  When  much  fever,  may  be  combined  with  aconite  (B.);  both  locally 
and  internally  in  inflammation  of  the  eye;  is  effectual  in  inflammation  which 
threatens  to  end  in  abscess  (R.).  In  erysipelas,  inflammatory  sore  throat, 
encephalitis,  gouty  and  rheumatic  inflammation,  cystitis,  pneumonia,  etc.  (P.). 


596 


INFLAMMATION. 


Gelsemium,  especially  inflammation  of  lungs  and  pleurae,  and  in  pneumonia 
(rrpv-x  of  fl.  extr.  every  two  hours)  (B.).  In  acute  stage  of  acute  gonorrhoea  is 
valuable  (P.).  Bryonia,  exceedingly  valuable  in  pleurisy  and  other  serous 
inflammations,  especially  pericarditis.  After  the  aconite  stage  (P.).  Veratrum 
Viride,  when  much  delirium  and  arterial  excitement,  useful  at  beginning  only 
(B.).  In  pneumonia,  Veratrine  is  most  valuable,  also  in  acute  rheumatism  and 
generally  as  an  antipyretic  (P.).  Tartar  Emetic,  in  frequent  minute  doses, 
gr.  ^g,  renders  incontestable  service  (B.).  In  pneumonia,  tonsillitis,  pleurisy, 
bronchitis,  and  other  inflammatory  affections  (R.).  Pulsatilla,  in  acute  and 
subacute  inflammations  with  muco-purulent  discharges,  especially  of  eyes,  ears, 
and  nasal  passages  (P.) ;  also  with  aconite  in  epididymitis  (Pf.).  Mercury,  in 
acute  glandular  inflammation  of  throat  and  neck,  in  ileo-colitis,  iritis,  syphilitic 
inflammations  of  serous  membranes,  laryngitis  (B.,  R.).  Silver  Nitrate,  locally 
in  strong  solution,  gr.  clx  to  §j  of  distilled  water,  painted  over  surface  and 
beyond,  after  thorough  cleansing  and  drying ;  no  agent  so  safe,  powerful  or 
efficacious  in  subduing  external  inflammation  (Higginbotham).  A  strong  solu¬ 
tion  in  nitrous  ether  is  a  most  efficient  application  to  check  inflammation  in 
superficial  parts,  as  boils,  felons,  orchitis,  synovitis,  erysipelas,  erythema, 
eczema,  etc.  (B.).  Iodine,  as  liniment  in  vicinity  of  local  inflammation  to  pro¬ 
duce  vesication  (R.).  Sulphides,  especially  that  of  calcium  (doses  gr.) 
appear  often  to  arrest  suppuration.  After  formation  of  pus  they  hasten  matura¬ 
tion  and  circumscribe  inflammation.  In  boils,  abscesses,  and  deep-seated 
suppuration,  they  improve  the  condition  and  promote  healing  (R.).  Antipyrine, 
Kairine,  and  other  antipyretics.  See  under  the  title  Fever.  Alkalies,  espe¬ 
cially  ammonium  and  potassium  salts,  are  very  valuable  in  the  stage  of  exuda¬ 
tion  (B.).  Astringents,  locally  in  inflammations  of  mucous  membranes  (R.). 
Lead,  the  liquor  plumbi  subacetatis  dilutus  as  a  soothing  and  astringent  appli¬ 
cation  to  inflamed  and  erysipelatous  surfaces  (Wa.)  ;  to  eczema  and  other 
inflammatory  diseases  of  the  skin  (Pf.).  For  Leadwater  and  Opium  formulae 
see  page  460.  Digitalis,  the  German  antipyretic,  is  especially  useful  in  pneu¬ 
monia,  bronchitis,  rheumatic  fever  and  scarlet  fever  (B.).  Aconite  safer  and 
better  (R.)  ;  locally  and  internally  is  useful  in  inflammations,  especially  those 
of  joints,  of  breast,  erysipelatous  and  varicose  :  a  fomentation  of  a  teasp.  of 
the  dried  leaves  in  half  a  pint  of  boiling  water,  or  Sj  of  tincture  to  the  same 
quantity  of  water,  applied  by  flannels  to  the  part,  will  quickly  subdue  (Fair- 
bank).  Quinine,  in  peritonitis  (Tr.).  It  is  indicated  in  most  acute  forms,  unless 
objections  occur  (P.).  Has  power  to  arrest  inflammation  in  formative  stage. 
With  morphine  and  in  full  doses  (gr.  xv-xx)  may  suppress  many  forms  (B.). 
Chloral,  excellent  when  temperature  is  high,  much  delirium ;  gr.  v  every  3 
hours  (B.).  Opium,  is  important  in  most  inflammations,  but  especially  those  of 
serous  membranes  ;  a  full  dose  (gr.  X  of  morphine)  at  first,  smaller  doses  after. 
Is  especially  curative  in  inflammation  of  intestines  and  peritoneum,  and  of 
cerebro-spinal  meningitis,  arachnitis,  etc.  (B.,  R.).  Saline  Purgatives,  valuable 
as  part  of  the  denutrition  treatment,  and  to  diminish  arterial  tension  (B.).  Sali¬ 
cylic  Acid  is  antipyretic,  especially  in  septicemic  inflammation,  and  acute  rheu¬ 
matism,  erysipelas,  pneumonia  (B.).  Salicylate  of  sodium  more  soluble  (R.). 
Colchicum  often  exercises  a  happy  influence  over  certain  acute  inflammations, 
as  bronchitis,  conjunctivitis,  etc.,  especially  if  occurring  in  gouty  subjects  (P.). 
Cocaine,  locally  in  commencing  inflammations  of  mucous  surfaces,  to  con¬ 
strict  the  bloodvessels  of  the  part  (R.).  Pilocarpus  gives  good  results  in  the 
exudative  stage  of  pleuritis,  iritis,  keratitis,  etc.  (B.).  Cold,  by  ice  in  bags,  or 
cold  water,  a  very  useful  agent.  Heat,  by  hot  water,  fomentations,  etc.,  often 
much  better.  Ice,  in  small  pieces  in  a  bladder  applied  to  inflamed  part(R.). 
Water,  cold  and  hot  baths  and  packing  very  useful  in  all  inflammations  (B.). 
Alcohol  is  constantly  prescribed,  and  is  of  value  in  low  states,  if  symptoms 
after  its  administration  are  ameliorated  (B.).  [See  Fever.]  Poultices,  useful 
in  many  inflammatory  states,  but  often  abused  (B.).  To  check  formation  of 
pus  and  assist  in  maturation  (R.).  Venesection,  when  pulse  hard,  strong,  full 
and  frequent,  a  plethoric  state  of  the  system  and  great  intensity  of  morbid 
action  ;  if  required  the  earlier  it  is  done  the  better  (Gross ).  Leeches  very  useful 


INFLUENZA. 


597 


in  many  forms  where  sthenic  reaction  and  plethora.  Value  of  blood-letting 
probably  due  to  derivative  and  counter-irritant  effect  (B.) ;  a  remedy  of  great 
power  for  good  or  evil,  now  much  neglected  (Wa.).  Local  bleeding  by  leeches, 
cups,  scarification,  etc.,  should  generally  be  preceded  by  some  form  of  general 
depletion  (Gross).  Aliment :  when  no  inflammation  of  digestive  tract,  use  milk 
and  beef-tea  alternately  every  3  hours.  No  starches  or  fats.  In  intestinal  inflam¬ 
mation,  milk,  eggs,  animal  broths,  oysters,  fish,  but  must  be  used  with  great 
caution.  Skim-milk  treatment  (B.).  Cod-liver  oil  in  many  chronic  inflamma¬ 
tions,  as  of  heart,  lungs,  kidneys,  etc.  (R.).  [Compare  the  various  titles,  as 
Bronchitis,  Pleuritis,  etc.,  also  the  list  of  Antiphlogistics,  on  page  43.] 


Prescriptions. 


R.  Tinct.  Aconiti, . ^j. 

Tinct.  Belladon.,  ....  ^ij. 

M.  Sig. — Three  or  four  drops  in  water 
every  hour.  (B.) 


R .  Ammonii  Chloridi,  .  .  .  3  v. 

Acidi  Acetici, 

Alcoholis, . aa  3  x. 

Aquae,  ....  q.  s.  ad  3  x. 

M.  et  fiat  lotio.  Evaporating  and  dis- 
cutient  lotion. 


Antim.  et  Pot.  Tart.,  . 

.  .  gr.  ijss. 

Magnesii  Sulph.,  .  . 

•  •  3T 

Morphinae  Sulph.,  .  . 

•  •  ,‘gr-  )lA- 

Ac.  Sulph.  Aromat.,  . 

.  .  sj-ss. 

Tinct.  Verat.  Virid., 

•  •  3JSS. 

Syr.  Zingiberis,  . 

•  •  d'j- 

Aquae  Destill.,  .  .  . 

.  .  sx. 

M.  Sig. —  Tablesp.  every  2,  4,  or  6 
hours.  Antimonial  and  Saline  Mixture. 

( Gross .] 


[See  pages  460  and  461  for  Lotion  and  Liniment  formulae.] 


Influenza. 

Sulphurous  Acid,  by  fumigation  or  inhalation,  a  few  drops  on  boiling  water 
or  as  a  spray,  often  controls  (R.).  Tartar  Emetic  has  been  recommended 
strongly,  but  is  too  depressant  (Wa.).  Quinine  has  been  used  beneficially 
throughout  the  disease,  especially  after  the  acute  stage,  for  neuralgic  pains 
(Wa.).  Ammonium,  the  liquor  ammonii  acetatis,  combined  with  nitric  or 
chloric  ether,  is  often  of  great  service  (Wa.).  Sanguinaria,  used  with  much 
benefit  (Wa.).  Cimicifuga  has  been  given  with  much  success  (R.).  Spiritus 
Etheris  Nitrosi,  in  doses  of  3j-jss,  in  any  convenient  vehicle,  is  a  popular  and 
efficacious  remedy  (Wa.).  Cocaine,  a  4  per  cent,  solution  snuffed  up  nostrils 
or  applied  by  spray-producer,  very  efficacious  in  the  early  stage  (R.).  Cubebs, 
3ss  or  3j  doses  of  the  tincture  in  j^-glass  of  linseed  tea  thrice  daily,  for  the 
subsequent  cough,  often  curing  like  a  charm  (R.).  Opium,  best  avoided  in 
early  stage,  but  later  for  the  cough,  with  ipecac.,  gives  great  ease.  Dover’s 
powder,  with  nitre  and  lobelia  is  a  good  form  (Wa.).  Potassium  Nitrate,  nitre 
largely  diluted,  as  lemonade,  3j-ij  in  the  course  of  the  day,  proves  highly 
useful  (Wa.).  Turkish  Baths  have  been  employed  with  marked  advantage 
(Wa.).  Hot  Fomentations,  for  headache  (R.).  Benzoin,  the  compound  tinc¬ 
ture,  .3ss-j,  inhaled  from  a  pint  of  hot  water  frequently  (Da  Costa).  [Compare 
Bronchitis,  Catarrh,  Hay-Fever.] 


Prescriptions. 


R.  Ext.  Ipecac.  FI.,  .  .  .  .  3  ij. 
Tinct.  Opii  Deod.,  .  .  .  .  3  iv. 

Tinct.  Aconiti, . %j. 

M.  Sig. — Five  to  ten  drops  every  two 
hours.  For  the  bronchitis. 


R.  Ext.  Cimicifugae  FI.,  .  .  .  ^ss. 
Tinct.  Opii  Deod.,  .  .  .  sjj. 

Syr.  Tolutani, . 3  xj. 

M.  Sig. — Teasp.  every  four  hours. 


R.  Ammonii  Chloridi,  .  .  .  3jss. 
Morphinae  Sulph.,  .  .  .  .  gr.  ij. 
Tinct.  Sanguinariae, 

Syr.  Ipecac.,  .  .  .  .  aa  giv. 

Mist.  Glycyrrh.  Co., 

Aquae, . aa  ^jss. 

M.  Sig. — Teasp.  as  required  for  the 
cough.  Each  dose  has  of  Morph.  Sulph. 

gr-  tV 


598 


INSOMNIA - INTERMITTENT  FEVER. 


Insomnia. 


Chloral,  the  best  hypnotic  (gr.  xv-xx),  quite  unrivaled.  Cautiously  in  deli¬ 
rium  tremens,  which  see  (B.).  In  many  forms  of  sleeplessness  (R.) ;  acts  best 
in  cases  which  are  of  purely  nervous  type  (Wa.) ;  in  combination  with  alcoholic 
preparations,  especially  if  potassium  or  sodium  bromides  are  present,  it  is  apt 
to  separate  to  the  top  as  an  alcoholate.  See  a?itey  page  165.  Croton  Chloral, 
3j  may  be  given  (R.).  Potassium  Bromide,  when  from  cerebral  overaction, 
gr.  xv  before  each  meal,  and  gr.  xxx  on  retiring.  Cumulative  effect  (B.).  It 
increases  hypnotic  effect  of  hyoscyamus,  belladonna,  cannabis  indica,  ether 
and  chloroform  (R.).  Hyoscyamus,  an  effective  substitute  for  opium  in  chil¬ 
dren,  o ij— 3J  °f  tinct.  necessary,  and  without  danger  (B.) ;  when  opium  dis¬ 
agrees  (R.).  Belladonna,  hypnotic  in  some  morbid  states,  especially  those 
marked  by  prostration,  low  arterial  tension,  contracted  pupils.  Atropine, 
gr.  to  jj1^  (B.).  Paraldehyde,  in  doses  of  hhxxx-1,  is  an  efficient  hypnotic 
with  little  or  no  depressing  action  on  the  heart  (C.).  Ignatia,  for  sleeplessness 
from  nervous  erethism,  better  than  morphine  (Pf.).  Gelsemium,  in  simple 
wakefulness  (B.) ;  and  in  that  of  drunkards,  mania  and  over  excitement  (R.). 
Coffee,  insomnia  from  lowering  of  nervous  power,  and  chronic  alcoholism  (P.). 
Opium,  Morphine  the  best  form,  gr.  %-gr.  ss,  when  pain  (B.).  Codeine  and 
Narceine,  also  hypnotic,  should  be  given  to  act  at  natural  time  for  sleeping 
(R.).  Sumbul,  hixxx-xl  of  tinct.,  with  a  little  chloric  ether,  very  efficient  in  the 
insomnia  of  chronic  alcoholism  (P.).  Tartar  Emetic,  and  opium,  very  effect¬ 
ive  when  due  to  cerebral  congestion,  and  when  opium  stimulates  (B.).  Ether 
or  Chloroform  in  a  full  dose  (R.).  Phosphorus,  nutrition  inactive.  Insomnia 
of  the  aged  (B.).  Humulus,  a  hop-pillow  effective  (B.,  P.) ;  tinct.  lupulinae, 
3SS-5SS,  as  cerebral  sedative  (B.).  Cocaine  has  been  used  with  some  success 
(Wa.).  Chamomilla,  TT\j  of  the  tinct.  every  quarter-hour,  an  excellent  sedative 
for  children  (A.  A.  Smith).  Cannabin  Tannate,  in  8-grain  doses,  a  good  hyp¬ 
notic  (Fronmliller)  ;  very  inefficient  (W.).  Cannabis  is  very  uncertain  in  its 
action  (R.).  Alcohol,  if  from  cerebral  anaemia,  a  full  dose  of  whiskey  or 
brandy  ;  or  in  some  a  glass  of  ale  or  beer  answers  better  (B.).  Water,  a  tepid 
bath  just  before  retiring  often  effective.  When  head  is  hot,  cold  to  it,  and 
tepid  bath  to  the  body  (B.).  [Compare  Nervousness;  also  the  list  of  Hyp¬ 
notics  on  page  27  ;  also  the  Analogues  of  Chloral,  page  163.] 


R.  Paraldehyde, .  Sdss- 

Alcoholis  (90  per  cent.),  .  ^jss. 

Tinct.  Vanilloe, . ^  ss. 

Adu?e>  . . 3  b 

Syr.  Simplicis,  ...  ad  3  iv. 

M.  Sig. — A  teasp.  or  two  every  hour 
until  sleep  is  obtained. 

(  Yvon's  Hypnotic  Elixir.) 


R.  Chloralis  Hyd., . .3  ij. 

Potassii  Brom., . spij. 

Tinct.  Opii,  . gj. 

Syr.  Aurantii  Cort . g  iij. 

Aquae, . ad  g  ij. 

M.  Sig.  —  Teasp.  dose.  May  be  re¬ 
peated  if  necessary. 


Potassii  Bromidi,  .  .  .  .  g  iv. 

Chloralis  Hydrat.,  .  .  .  .  3  iij. 

Tinct.  Asafoetidae,  .  .  .  .  £iv. 

Syrupi, . gvj. 

Aquae,  .  .  .  .  .  q.  s.  ad  ^vj. 

M.  Sig. — Tablesp.  every  2  hours  until 
sleep  is  induced.  In  the  insomnia  of  hys¬ 
teria. 


R .  Potassii  Bromidi,  .... 

Chloralis  Hydrat.  .  .  aa  ^ss. 

Syr.  Pruni  Virgin.,  .  .  .  .  j§j. 
Aquae, . q.  s.  ad  ij. 

M.  Sig. — Teasp.  in  a  winegl.  of  water. 
Repeat  in  one  hour  if  necessary. 


Prescriptions. 

R. 


Intermittent  Fever. 

Cinchona.  Quinine  as  prophylactic,  gr.  v-x  each  morning  in  black  coffee  ; 
begin  with  gr.  v,  add  gr.  j  each  week  (R.).  In  ordinary  intermittents  give  6  or 
10  grain  doses  up  to  20  or  30  grains,  so  as  to  have  it  all  in  4  or  5  hours  before 
the  expected  paroxysm  ;  give  the  sulphate  and  in  solution  to  get  its  full  action 
(Da  Costa).  For  acute  ague,  gr.  x  in  sweating  stage,  and  same  5  hours  before 
next  paroxysm,  and  gr.  x-xv  at  the  septenary  periods,  until  the  third  has 


INTERMITTENT  FEVER. 


599 


passed.  In  pernicious  form,  gr.  xx-xl  are  required,  by  stomach,  rectum  or 
skin,  to  secure  safety  of  patient.  Best  in  combination  with  morphine,  and  with 
continuous  administration  of  arsenic  during  intermissions.  May  be  given  in 
solution  by  rectum,  or  hypodermically  (B.,  R.).  Is  almost  specific  in  inter- 
mittents  when  uncomplicated,  and  of  recent  origin  (Wa.).  Chinoidine  may 
be  used  as  a  substitute  for  quinine  in  doses  twice  as  large  (B.).  Cinchonine, 
Cinchonidine,  Quinidine,  the  sulphates  of  these  alkaloids  are  scarcely,  if  at  all, 
inferior  to  quinine  as  therapeutical  agents.  (Report  of  the  Madras  Commis¬ 
sion,  1866.)  Average  dose  of  each,  gr.  x  (Wj\.).  Salicylate  of  Cinchonidine, 
promises  well  as  an  antiperiodic  (B.).  Opium,  as  morphine,  gr.  hypo¬ 

dermically,  not  only  lessens  the  chill  but  aids  the  action  of  the  antiperiodic  ;  is 
to  be  strongly  urged  (Da  Costa) ;  is  useful  in  the  pernicious  variety,  in  combi¬ 
nation  with  quinine  (B.).  Arsenic,  the  best  remedy  next  to  quinine,  especially 
useful  in  long-standing  agues,  of  quartan  type  (R.).  Useful  as  adjunct  to  qui¬ 
nine  daily,  to  prevent  relapse.  Most  important  in  chronic  ague,  with  iron  ; 
also  as  prophylactic  small  doses  of  Fowler’s  solution  (B.).  Capsicum,  the 
resins  of  black  and  red  pepper,  as  adjuvants  chiefly  (B.) ;  promotes  action  of 
quinine  (Pf.).  Nux  Vomica,  has  been  used  with  success,  but  now  used  as 
adjunct  to  quinine  (B.)  ;  good  in  convalescence  (P.)  ;  has  antiperiodic  value 
not  inferior  to  quinine.  Strychninae  gr.  equals  gr.  j  of  quininas  sulphas 
(Wa.).  Hydrastine,  stands  next  after  arsenic  ;  same  indications  as  quinine 
(B.)  ;  in  doses  of  gr.  ij-ix  is  strongly  recommended  (P.).  Pilocarpine,  gr.  yi 
of  the  muriate,  in  the  cold  stage,  is  strongly  recommended  by  high  authority, 
to  excite  profuse  perspiration  and  thus  lessen  the  attack  (Da  Costa).  Apiol, 
when  prejudice  exists  against  quinine.  Gtt.  xv  during  an  hour,  in  divided 
doses,  4  hours  before  paroxysm  (B.) ;  is  one  of  the  minor  remedies  which  often 
prove  successful  in  mild  cases  (Wa.).  Salicin,  as  substitute  for  quinine,  but 
inferior  (B.) ;  grs.  x-xl,  in  mild  cases  (P.).  Chloroform,  to  prevent  an  impending 
paroxysm  ;  3j-£ij  (of  spt.)  before  the  chill,  or  by  inhalation  (B.).  Narcotine, 
gr.  ij-v  ter  die,  is  eminently  antiperiodic.  No  drug  (except  quinine)  cures 
intermittents  so  rapidly  and  surely,  or  with  more  freedom  from  disagreeable 
effects  (Wa.)  ;  said  to  be  superior  to  quinine  (R.).  Nitric  Acid,  full  doses 
every  4-6  hours  (B.).  Sodium  Chloride,  in  large  doses  during  the  apyrexia, 
3viij-xij,  may  occasionally  prove  efficacious  (Wa.).  Eucalyptus,  during  con¬ 
valescence  (B.) ;  has  been  successfully  used  in  treatment  of  ague,  £>j-ij  of  a 
tincture  (Wa.).  Carbolic  Acid,  in  4-grain  doses  with  infusion  of  ginger,  cured 
a  series  of  8  cases  which  had  resisted  quinine  (Wa.);  its  value  established; 
TWss-ij  in  mint-water;  or  gr.  ^  in  rr^xx  of  water,  hypodermically  (Tessier) ; 
combined  with  iodine  is  of  great  value  in  chronic  malaria,  and  in  acute  cases 
after  quinine  has  stopped  the  paroxysm  (B.).  Mercury,  uncalled  for  in  ordi¬ 
nary  cases  ;  but  hydrarg.  cum  creta,  quinine  and  rhubarb  of  service  in  obstinate 
intermittents  of  children  in  tropical  regions  (Wa.).  Sodium  Hyposulphite, 
gr.  xv-xx  every  two  hours  is  said  to  cure  (R.).  Cascarilla,  Chamomile,  Quassia, 
used  (R.).  Gentian,  is  valued  chiefly  as  vehicle  (P.).  Ammonium  Picrate, 
proved  wonderfully  effective  in  India,  where  10,000  cases  were  treated  there¬ 
with  (Clark).  Lemon,  in  decoction,  exceedingly  efficient  in  preventing  recur¬ 
rence  of  the  paroxysms  after  they  have  been  broken  up  by  the  use  of  Quinine 
(Crudeli).  Emetics,  may  cure  many  cases  ;  one  each  morning  will  assist  the 
action  of  quinine.  Ipecacuanha  preferred  to  antimony  (R.) ;  only  at  com¬ 
mencement,  inadmissible  if  gastric  irritation  (Wa.).  Antimony,  at  the  onset, 
and  continuously  in  mild,  uncomplicated  cases.  Tartar  Emetic,  gr. 
every  2  hours,  has  been  followed  by  complete  cures  (Moore).  Antipyrine,  is 
useless  (Falkenheim).  Resorcin,  and  similar  agents,  have  no  specific  action, 
merely  controlling  the  pyrexia  (Wa.).  Warburg’s  Tincture  is  a  remedy  of 
great  power,  but  produces  such  severe  diaphoresis  as  to  be  dangerous  to  adyna¬ 
mic  subjects  (Prof.  Maclean).  Purgatives,  in  the  intermission,  before  using  the 
antiperiodic,  is  good  practice  ;  podophyllum,  colocynth  or  jalap  (Da  Costa). 
Iron  is  valuable  in  chronic  cases  ;  the  system  should  be  thoroughly  saturated 
with  it  (Da  C.).  Ergot,  for  the  enlarged  spleen  (Da  C.).  [Compare  the  title 
Malaria  ;  also  the  List  of  Antiperiodics  on  page  43.] 


6oo 


INTERTRIGO - INTUSSUSCEPTION. 


R .  Quininae  Sulph., 

Mucil.  Acaciae, 

Syr.  Eriodyctii  Aromat. 

(Parke,  Davis  &  Co.),  vel 
Mist.  Glycyrrhizae  Co  ,  vel 
Velatine,  .  .  .  .  q.  s.  ad  ^  ij . 

M.  Fiat  emulsio.  Sig. — A  teasp.  con¬ 
tains  gr.  ij  of  Quin.  Sulph.  Suspension  of 
the  quinine  without  dissolving  it  makes  the 
bitter  taste  less  perceptible  (Squire),  and 
the  Syrup  of  Yerba  Santa  covers  the  taste 
wTell.  (Potter.) 

R.  Ac.  Carbolici, . gj. 

Tinct.  Iodi  Comp . 3  iij. 

M.  Sig. — 4  drops  every  4  hours  in  suf¬ 
ficient  water.  (B.) 


R.  Massae  Ferri  Carb.,  .  .  .  £j. 

Ac.  Arseniosi, . gr.  j. 

M.  Ft.  pil.  no.  xx.  Sig. — One  thrice 
daily  in  chronic  ague.  (B.) 


R.  Quininae  Sulph.,  .  .  .  .  gr.  xl. 
Ferri  Sulph.  Exsic.,  .  .  gr.  xx. 

Ac.  Arseniosi, . gr.  j. 

M.  Ft.  pil.  no.  xx.  Sig. — One  thrice 
daily.  (B.) 


Quininae  Sulphat.,  .  .  .  .  gr.  lxxx. 
Ac.  Sulph.  Diluti,  .  .  .  .  q.  s. 

Spt.  Etheris  Nitrosi,  ...  7,  iv. 

Syr.  Tolu,  Aquae,  .  .  .  ad£  ij. 

M.  Sig. — A  teasp.  contains  gr.  v  of 

Quin.  Sulph.  ( Da  Costa.) 


R.  Quininae  Sulphat.,  ....  £j. 

Ac.  Hydrobrom.  Dil.,  .  .  3  ij. 

Aquae, . 3  xiv. 

M.  Sig. — A  teasp.  contains  gr.  iij  3^  of 
Quin.  Sulph.  The  acid  directed  prevents 
the  unpleasant  cerebral  action.  (B.) 


R.  Quininae  Sulph., . gss. 

Pulv.  Acaciae, . 3  ss. 

Syr.  Zingiberis, . 3  iv. 

M.  Sig. — A  teasp.  contains  one  grain  of 
Quin.  Sulph.  A  good  formula  for  children, 
the  quinine  being  suspended,  not  dissolved. 


R  .  Quininae  Sulph.. . gr.  xxx. 

Capsici, . gr.  xv. 

Opii  Pulveris, . gr.  iij. 

M.  Ft.  pil.  no.  xxx.  Sig. — One  to  five 
pills  as  required.  ( Piffard .) 


Prescriptions. 


.  gr.  xxxij. 

3  si¬ 


ft 


Intertrigo. 

Bismuth,  nitrate  or  carbonate,  as  dusting  powder  (R.,  B.).  Tannin,  the 
glycerite,  excellent  (R.,  P.).  Camphor,  added  to  dusting  powders,  to  allay 
heat  and  itching  (R.).  Lime-water,  to  obviate  irritating  urine  (R.).  Soap,  free 
ablution  with,  when  caused  by  acid  secretions;  use  greasy  applications  after¬ 
wards  (R.).  Boracic  Acid,  as  ointment,  £jss  to  §j  of  vaseline,  a  very  useful 
application  (Wa.).  Glycerin,  with  tragacanth,  etc.  [See  under  Herpes  for 
formula.]  Calomel,  as  ointment,  gj  to  3),  is  especially  useful  (Wa.).  Zinc 
Carbonate.  Calamine  is  a  good  dusting  powder ;  so  also  is  the  oxide,  or 
fuller’s  earth. 

Intestinal  Obstruction. 

Opium,  even  yi-g rain  doses  every  4  hours,  for  2-4  days,  arrests  dangerous 
symptoms,  and  brings  a  painless  purgation  (Brinton,  P.).  Morphine,  endermi- 
cally  (Wa.).  Belladonna,  often  successfully  employed  (P.)  :  gr.  yi~Vi  every 
few  hours,  when  from  want  of  tone  and  partial  spasm  (Tr.).  Strychnine,  occa¬ 
sionally  beneficial ;  cautiously  in  acute  cases  (Wa.).  Mercury.  A  full  dose  of 
calomel,  followed  in  a  few  hours  by  castor  oil,  and  a  turpentine  enema,  affords 
relief  (Wa.).  Caffeine  acts  upon  the  muscular  tissue  and  often  proves  of  the 
utmost  value  (Wa.).  Senna,  the  infusion,  in  doses  of  3 j— iij ,  forms  an  efficient 
purgative  (Wa.).  Purgation  to  be  refrained  from  (Brinton).  Enemata,  insuf¬ 
flation  and  surgical  measures  are  often  necessary.  [Compare  Constipation, 
Intussusception,  Hernia.] 


Intussusception. 

Belladonna,  gr.  iv  of  extract  in  an  enema,  has  been  successfully  used  (Wa.). 
Opium,  in  full  doses  carried  to  narcotism,  has  been  successful  in  many  cases 
(Wa.);  must  be  used  freely  to  prevent  inflammation  (Macleod).  Effervescent 
Enemata,  have  been  employed  with  success  (B.).  Tobacco  Enema,  may  over- 


IRRITABILITY - IRITIS - JAUNDICE. 


601 


come,  and  has  proved  exceedingly  effective,  but  is  dangerous.  Produces  most 
depressing  nausea.  Not  safe  to  use  more  than  ^iv  of  the  infusion  ;  3j-Oj  (B.). 
Inflation,  of  intestines  with  air  ( Hippocrates ),  seems  a  most  reasonable  mechan¬ 
ical  remedy.  Irrigation,  by  hydrostatic  pressure  is  resorted  to  with  success. 
Requires  care  and  gentleness  (B.).  Hot  water  (Wa.) ;  ox-gall,  gr.  x-xxx  in  the 
solution  used,  is  especially  efficient  in  cases  arising  from  partial  paresis  of  the 
bowels  (Hawkins).  The  knee-chest  position  is  the  best  during  irrigation  or  in¬ 
flation.  [Compare  Hernia,  Typhlitis.] 


Irritability. 

Ignatia,  in  small  doses  diminishes,  in  large  doses  excites  irritability  of  cerebro¬ 
spinal  axis.  The  remedy  par  excellence  (Pf.).  Chloral  gr.  v,  2  or  3  times  a 
day,  in  irritability  with  nervousness  and  restlessness  (R.).  Chamomilla,  is  an 
excellent  sedative  for  children,  in  doses  of  n\j  of  the  tincture  every  %  hour  (A. 
A.  Smith).  Opium,  gives  calm  to  the  nervous  system  if  used  in  medium  doses. 
Strychnine,  in  functional  irritability  of  the  nervous  system.  [Compare  In¬ 
somnia,  Nervousness.] 

Iritis. 

Belladonna,  locally  and  internally  (R.) ;  rtpv  every  3  hours,  also  lotion  (5j  of 
extract  to  ^iv  aquae),  is  of  great  value  (P.).  Atropine  (solution  gr.  iv  ad  5j) 
has  a  wide  field  of  utility,  as  mydriatic  (B.) ;  should  never  be  omitted  (C.)  ;  is 
essential  in  the  treatment  of  every  form,  should  be  applied  early  in  the  case 
and  persevered  in  throughout  its  continuance  (Lawson).  Mercury,  when  of 
syphilitic  origin,  as  it  usually  is  (B.)  ;  the  bichloride  is  of  great  service  (R.).  In 
plastic  iritis  of  original  severity,  or  in  cases  aggravated  by  improper  treatment, 
mercury  is  imperative,  gr.  ij  of  blue  pill  twice  a  day,  until  blue  line  on  gums 
(C.).  Duboisine,  as  substitute  for  atropine,  is  more  rapid  for  effecting  dilatation, 
less  irritating  to  the  conjunctiva,  and  has  less  permanent  after-effects  (B.). 
Turpentine,  in  so-called  “rheumatic  iritis’’  is  very  successfully  used;  small 
repeated  doses  (P.).  Opium,  when  much  pain,  an  indispensable  adjuvant. 
Morphine,  hypodermically  (C.).  Copaiba,  Z\)  in  mucilage,  thrice  daily,  gives 
excellent  results  in  iritis  and  sclerotitis,  diminishing  pain  in  24  to  48  hours,  and 
restoring  sight  (Hall).  Quinine  and  Iron,  when  the  patient  is  feeble  or  anaemic. 
Irritants,  or  astringents  should  never  be  employed  (C.).  Surgical.  Paracen¬ 
tesis  when  increased  tension.  Corelysis  when  only  one  or  two  adjacent  ad¬ 
hesions.  Iridectomy.  Complete  functional  rest  to  the  eyes,  by  atropine  and  a 
bandage  with  compression-pad,  an  absolute  necessity  during  the  whole  period 
of  treatment  (C.).  [Compare  Syphilis.] 


Prescriptions. 


R.  Hydr.  Chlor.  Corr.,  .  .  .  gr.  j. 

Potassii  Iodidi . zj. 

Tinct.  Calumbae,  .  .  .  .  3  ij. 
Aquae  Destil.,  .  .  .  .  ad  5  vj. 


M.  Sig. — A  dessertspoonful,  in  a  wine¬ 
glass  of  water,  2  or  3  times  daily. 

(Lawson.) 


R.  01.  Terebinth., . ^iij. 

Syr.  Acaciae, . ojss- 


Aquae  Cinnamomi,  ...  5  ss. 

M.  Sig. — A  teaspoonful  4  or  5  times 
daily. 


R.  Extracti  Belladon.,  .  .  .  sjj. 
Ung.  Hydrargyri,  .  .  .  .  =vj 
M.  Sig. — For  inunction  to  brow. 


Jaundice. 

Mercury,  in  attacks  with  depression,  sickness  and  coated  tongue,  gr. 
of  gray  powder  taken  at  onset,  and  repeated  three  or  four  times  a  day,  very 
valuable  (R.).  As  purgative  in  jaundice  from  both  deficiency  and  excess  of 
bile,  singularly  enough  (B.).  Gray  powder  with  ipecac,  followed  next  morning 
by  castor  oil,  is  well  adapted  to  the  jaundice  of  infancy  and  childhood  (Wa.). 


602 


JOINT  AFFECTIONS. 


Mercurials  and  podophyllum  are  better  avoided,  especially  in  obstructive  jaun¬ 
dice,  unless  very  marked  indications  for  them  exist  (Da  Costa).  Celandine,  was 
formerly  employed  as  deobstruent  (P.) ;  energetically  affects  the  liver  (Pf.). 
Hydrastis,  useful  if  continued  for  some  time,  in  jaundice  from  catarrh  of  ducts 
(B.).  Arsenic,  has  been  used  with  success  in  jaundice  from  catarrh  of  bile  ducts 
after  catarrh  of  duodenum.  Better  for  jaundice  of  malarial  origin  (B.).  Nitro- 
Hydrochloric  Acid,  internally,  and  acid  bath  to  right  hypochondrium  ;  tempera¬ 
ture  of  bath  96°,  ^iij-gall.  j  (B.) ;  when  jaundice  depends  on  torpor  of  the  liver, 
or  is  catarrhal  in  origin  (W.) ;  during  convalescence,  tt\,v-x  of  the  dilute  acid 
in  3j  of  a  compound  elixir  of  taraxacum  before  each  meal  (Da  Costa).  Quinine, 
when  due  to  malarial  miasm,  or  when  periodic  (B.).  Euonymin,  an  hepatic 
stimulant  of  especial  power  (B.).  Podophyllum,  in  catarrhal  and  malarial 
jaundice  (B.) ;  when  stools  exhibit  no  trace  of  bile,  one  dose  has  cured  (Wa.). 
Best  avoided,  unless  markedly  indicated  (Da  C.).  Sodium  Phosphate,  no 
remedy  superior  in  jaundice  from  catarrh  of  gall-ducts;  3j  doses  every  four 
hours  for  adults  :  gr.  x-£)j  for  children  (B.).  Manganese,  in  jaundice  from 
malarial  origin,  or  catarrh  of  biliary  passages  (B.).  Aloes,  for  simple  jaundice 
of  an  atonic  kind  (B.) ;  when  hypochondriasis  (P.).  Rhubarb,  for  above  mala¬ 
dies  in  children;  white  or  clay-colored  pasty  stools;  skin  jaundiced  (B.). 
Saline  Purgatives  to  depurate  the  upper  bowel,  as  Rochelle  salt ;  with  alkaline 
baths,  diaphoretics  and  diuretics  (Da  C.).  Ammonium  Iodide,  gr.  j-iij  in  water 
every  2  or  3  hours  in  catarrh  of  bile  ducts  and  jaundice.  Also  Ammonium 
Chloride,  with  fluid  extract  of  taraxacum  (B.).  The  Chloride,  in  20-grain  doses 
every  4  hours,  produces  a  decided  change  (Wa.).  Stillingia,  relieves  jaundice 
and  torpid  liver  following  intermittent  fever  (B.).  Dulcamara,  employed  with 
advantage  (P.).  Iris,  in  malarial  jaundice  and  that  from  duodenal  catarrh  (B.). 
Alkaline  Mineral  Waters,  especially  in  catarrh  of  duodenum  or  bile-ducts  (B.). 
Potassium  Salts.  The  Chlorate  in  chronic  or  asthenic  jaundice.  The  Sulphate 
the  most  useful  saline  purgative  in  jaundice  (Wa.).  Aliment.  No  starches  or 
fats.  Milk,  eggs,  oysters,  beef  broth,  broiled  or  raw  beefsteak,  or  whitefish  (B.). 
Plenty  of  green  vegetables  at  each  meal,  use  cold  water  freely,  avoid  all  high 
seasoning  in  food,  and  all  liquors.  [Compare  Hepatic  Cirrhosis,  Hepatic 
Diseases,  Calculi.] 


Joint  Affections. 

Aconite,  for  pains  in  inflamed  joints  (R.)  ;  the  liniment  locally  in  chronic 
arthritic  swellings  (Wa.).  Mercury,  the  oleate  in  chronic  inflammation  of  the 
knee  (R.).  Diluted  Ung.  Hydrarg.  Ammoniat.  £>j  to  3iv  at  first,  then  gj  to  §j, 
by  gentle  friction  2  or  3  times  daily,  in  chronic  articular  inflammations  by  far 
the  best  application  (P.).  Rhus  Toxicodendron,  internally  and  as  lotion,  is 
invaluable  for  subacute  stiffness  and  aching  of  joints  after  acute  rheumatic 
fever  (P.).  Iodine,  3iij-vj  ad  glycerini  3 i i j ,  aq.  destil.  ifiv,  in  numerous  ob¬ 
stinate  cases  of  joint  affections  consequent  on  rheumatism  (Wa.).  Ferric 
Iodide,  with  Iodine  locally,  in  scrofulous  affections  of  the  bones  and  joints 
(Wa.).  Iodoform  has  been  used  with  satisfactory  results  in  scrofulous  affections 
of  the  joints  and  bones  by  many  continental  authorities  (Wa.).  Salicylic  Acid, 
Sj  with  3iv  of  Lanolin,  and  01.  Olivas,  q.s.  to  make  a  paste,  applied  locally  and 
covered  with  cotton,  or  rubbed  in  once  daily  for  3  or  4  days,  then  omitted  fora 
week,  and  again  renewed,  is  of  proven  value  in  many  obstinate  cases  of  stiff 
knees,  pains  from  so-called  rheumatism,  painful  ankle  and  wrist-joints,  etc. 
(Aulde).  Arsenic,  often  serviceable  in  rheumatoid  arthritis  and  nodosity  of 
joints.  Large  doses  continued  necessary  (R.).  Alcohol,  and  water,  equal  parts, 
an  excellent  evaporating  lotion  (B.).  Silver  Nitrate,  a  strong  solution  in  nitrous 
ether  is  the  most  efficient  application  to  check  inflammation  in  small  joints  if 
applied  early  to  adjacent  vascular  parts  (B.).  Cod-liver  Oil,  in  strumous  subjects 
(R.):  the  remedy  on  which  most  reliance  may  be  placed  in  scrofulous  joint 
affections  (Wa.).  Cold  Douche,  Galvanism,  Turkish  Baths,  for  stiff  joints 
(R.).  Digitalis,  as  fomentation,  3j  of  tincture  to  boiling  water,  applied  on 
flannel,  has  proved  very  efficient  in  acute  inflammations  of  joints  (Fairbank). 


KERATITIS - LABOR. 


603 


Turpentine,  the  liniment  a  serviceable  application  in  chronic  enlargement  of 
the  joints  (Wa.).  Sulphuric  Acid,  as  irritant  ointment,  S]  of  acid  to  §j  of  lard, 
very  beneficial  in  chronic  diseases  of  joints  (Wa.).  [Compare  Bursitis,  Cox- 
algia,  Gout,  Rheumatic  Arthritis,  Rheumatism,  Synovitis.] 


Keratitis. 


Atropine,  renders  great  service  by  contracting  vessels  (B.).  Atropine  by 
instillation,  with  enforced  disuse,  and  a  protective  bandage,  should  be  regarded 
as  measures  of  course  (C.).  Mercuric  and  ferric  perchlorides,  with  cod-liver 
oil,  will  accomplish  all  that  medicine  can  do  for  interstitial  keratitis  in  syphilitic 
subjects  (C.).  Calcium  Sulphide,  proves  most  useful  in  doses  of  gr.  to  X , 
thrice  daily,  in  sugar-of-milk  trituration  (Snell).  Arsenic,  Potassium  Iodide  or 
Bromide,  Iron  or  Quinine,  for  constitutional  effects  in  vascular  keratitis.  Also 
counter-irritation  by  iodine  painted  on  the  temples  till  soreness  (C.).  Ferric 
Perchloride,  successfully  employed  in  panniform  keratitis.  A  large  drop  of  the 
solution  dropped  from  a  quill  every  second  or  third  day  (Wa.).  Eserine,  lowers 
intra-ocular  tension  (B.).  Astringents  or  Irritants  (as  alcohol  in  any  form,  zinc 
sulphate,  silver  nitrate,  etc.),  are  entirely  inadmissible  (C.).  Iridectomy,  is  often 
beneficial  in  severe  vascular  keratitis  (C.).  Pressure-Bandage,  in  severe  sup¬ 
purative  forms,  limits  extent.  Water,  cold  when  inflammatory  symptoms 
marked:  hot  (90-100°  F.)  in  non-inflammatory  form,  to  excite  inflammatory 
reaction  ;  should  be  discontinued  when  marked  injection.  [Compare  Corneal 
Opacities.] 

Prescription. 


R  .  Hydrarg.  Chlor.  Corr.,  .  .  gr.  j. 
Ammonii  Chloridi,  .  .  .  gr.  vj. 
Tinct.  Belladonnae,  .  .  .  3  ij. 
Aquae  Destillatae,  .  ...  g  viij. 
M.  et  fiat,  collyrium. 


Sig. — A  teasp.  in  a  winegl.  of  tepid 
water,  to  be  applied  frequently  with  a 
pledget  of  lint  on  the  closed  lids.  In 
phlyctenular  keratitis  of  children. 

( Turnbull. ) 


Labor. 

Ergot,  when  uterine  inertia,  after  the  first  stage  passed.  Is  dangerous  if  any 
obstacle  in  front.  Danger  to  child  in  paralysis  of  foetal  heart  (B.).  Is  best 
given  when  head  has  passed  the  brim  of  pelvis  (Wa.).  Anaesthetics,  in  pro¬ 
tracted  and  painful  labor;  cautiously  with  primiparae  (B.) ;  increase  the  risk  of 
post-partum  hemorrhage  (W.).  Chloroform,  not  to  complete  anaesthesia,  lest 
uterine  action  be  interrupted.  Usually  begin  when  os  is  dilated  (Simpson). 
Chloral,  of  great  value  to  relieve  pain  ;  does  not  interfere  with  the  exhibition 
of  chloroform  ;  should  be  given  in  15-grain  doses  every  J^-hour  till  effect  pro¬ 
duced  (Wa.) ;  the  best  of  all  remedies  for  rigid,  undilatable  cervix,  gr.  xv  every 
20  minutes  for  3  doses,  perhaps  a  4th  after  an  hour’s  interval  (Playfair). 
Ethyl  Bromide,  a  rapid,  sure  and  safe  anaesthetic,  particularly  suited  to  labor 
cases  (Levis).  Opium,  facilitates  dilatation,  promotes  expulsive  power  of  uterus, 
lessens  hemorrhage,  stimulates  longitudinal  and  oblique  fibres  of  the  os  (Wa.). 
Cimicifuga,  exercises  special  action,  similar  to  that  of  ergot ;  is  less  dangerous 
to  life  of  child  and  soft  parts  of  mother  (Wa.) ;  for  mental  disturbance  and 
suppressed  lochia  (R.) ;  as  partus  accelerator  in  lieu  of  ergot,  also  to  allay  ner¬ 
vous  excitement  after  labor,  and  to  check  post-partum  hemorrhage  (P.).  Opium, 
a  full  dose  of  Morphine,  gr.  in  tedious  labors  with  severe  pains,  will  aid 
patient  greatly  and  promote  progress  of  the  child.  No  bad  results  ensue. 
Morphine,  for  relief  of  pains  and  after-pains,  or  painful  complications  (Wa.). 
Hypodermically  in  rigid  os  and  cervix  (R.).  Belladonna,  topically  to  uterus,  of 
great  service  in  long-protracted  labors  from  rigidity  of  os  and  cervix  (H.). 
Gelsemium,  quiets  the  “  nagging  ”  pains  of  the  first  stage;  requires  physiologi¬ 
cal  doses  (B.) ;  relaxes  spasm  in  rigidity  of  the  os  (Wa.).  Quinine,  to  strengthen 
uterine  contractions  ;  used  by  many  in  place  of  ergot  (R.).  Cannabis  Indica, 
the  tincture  gtt.  xxx,  as  stimulant  to  uterine  contractions,  more  prompt,  less 
lasting,  than  ergot  (Wa.).  Ipecacuanha,  after  delivery  ;  to  promote  natural 


6c>4 


LACTATION - LARYNGISMUS  STRIDULUS. 


functions  (R.).  Cotton-root,  as  excitant  of  uterine  contractions  may  be  more 
energetic  than  ergot  (P.).  Althaea,  the  decoction,  as  vaginal  injection  in  diffi¬ 
cult  labor  (P.).  Sodium  Borate,  excites  activity  of  the  uterus,  and  is  well  em¬ 
ployed  in  tedious  labor,  where  there  is  deficiency  of  uterine  contraction  (Rigby). 
Amyl  Nitrite,  has  acted  admirably  in  a  case  of  hour-glass  contraction  of  the 
uterus  ;  seems  to  antagonize  the  action  of  ergot  (Barnes).  Oil  of  Eucalyptus 
is  very  valuable  in  effecting  antiseptic  midwifery  (Wa.).  Mercury.  The 
bichloride,  gr.  vijss  to  a  quart  of  hot  water  gives  a  2 wo  solution,  probably  the 
worst  of  all  antiseptics  for  this  purpose :  is  too  dangerous  for  obstetrical  use 
(Fleischman).  [Compare  Abortion,  After-pains,  False  Pains,  Hemor¬ 
rhage  Post-partum,  Lactation,  Puerperal  Convulsions, — Mania, — 
Fever, — Disorders.] 

Lactation. 

Pilocarpine,  as  a  galactagogue,  gr.  y%  of  the  muriate  in  brandy  on  retiring, 
the  patient  to  be  covered  well  in  bed.  Is  efficient  in  direct  proportion  to  its 
diaphoretic  and  sialagogue  effects,  these  being  evanescent,  but  its  galactagogue 
power  remaining  for  weeks,  an  occasional  dose  only  being  required  to  spur  up 
the  secretion  when  flagging  (Minges).  Belladonna,  internally  or  externally  or 
both  in  excessive  lactation  (R.).  Atropine  gr.  iv-^j  aquae  rosae  on  lint  around 
the  breast  to  arrest  secretion  of  milk.  Remove  when  fauces  become  dry  and 
pupils  dilated  (B.).  Camphor,  locally  to  arrest  the  secretion  ;  a  saturated  solu¬ 
tion  in  olive  oil  or  glycerin,  is  more  efficient  than  belladonna  (Wa.).  Potassium 
Iodide,  in  25  to  30-grain  doses  internally,  for  the  same  purpose,  is  very  effectual 
(Rousset).  Calcium  Phosphate  and  Hypophosphite,  in  debility  from  over-lacta¬ 
tion  (R.,  Wa.).  Ammonium  Chloride,  for  the  intercostal  neuralgia  of  suckling 
women  ;  gr.  x-xx,  every  3  or  4  hours  (Wa.).  Quinine,  Tannin,  are  used  to 
arrest  the  secretion  (R  ).  Alcohol,  as  beer  or  porter,  often  useful  in  excessive 
lactation — not  always  (R.).  [Compare  Abscess,  Agalactia,  Mastitis,  Nip¬ 
ples,  also  the  List  of  Galactagogues  on  page  49,  ante.] 

Excreted  in  the  milk,  when  taken  by  the  nursing  woman,  are  the  oils  of 
anise,  cumin,  dill,  wormwood  and  garlic, — turpentine,  copaiba, — the  active 
principles  of  rhubarb,  senna,  scammony,  and  castor-oil, — opium,  iodine,  indigo, 
antimony,  arsenic,  bismuth,  iron,  lead,  mercury,  and  zinc.  Acids  given  to  the 
mother  cause  griping  in  the  child.  Natural  salts,  as  a  rule,  and  the  purgative 
agents  above-named,  act  as  purgatives  to  the  child,  and  potassium  salts  as 
diuretics.  Turpentine,  copaiba  and  potassium  iodide  given  to  the  mother,  can 
be  detected  in  the  urine  of  the  child.  Opium  given  to  the  mother  may  narcot¬ 
ize  the  child,  and  mercurials  in  the  same  manner  may  salivate  it  (Br.).  Atro¬ 
pine,  hyoscyamine,  the  salicylates,  and  potassium  sulphide,  have  also  been 
found  in  the  milk  after  their  ingestion  by  the  woman. 


Prescription  for  Milk- Fever. 


$.  Tinct.  Aconiti, . 

Antim.  et  Potass.  Tart.,  . 
Spt.  Etheris  Nitrosi, 

Syr.  Simplicis,  .  .  .  .  ka 
Aquae  Aurantii  Flor.,  .  . 
M. 


rn  xx. 

gr-  ij- 


Sig. — A  teaspoonful  in  a  wineglassful  of 
sweetened  water,  every  two  hours. 

( Fordyce  Barker .) 


Laryngismus  Stridulus. 

Aconite,  checks  the  spasm  and  relieves  the  croupous  breathing  (R.).  Bella¬ 
donna,  promises  to  be  of  value  (Wa.).  Atropine,  gr.  in  a  goblet  of  water 
(60  doses),  of  which  give  a  teasp.  every  hour  or  )^-hour,  will  give  prompt 
relief  (A.  A.  Smith).  Bromides,  when  uncomplicated  except  with  convulsions 
(R.).  Full  doses  will  suspend  an  attack,  and  moderate  doses  steadily  contin¬ 
ued,  will  prevent  recurrence  (B.).  Ipecacuanha,  an  emetic  dose  to  cut  short 
an  attack  (B.).  Lobelia,  has  been  employed  (R.).  Chloroform,  quickly  cures 


LARYNGITIS. 


605 


the  paroxysm,  a  few  drops  on  a  handkerchief  sufficient  (B.) ;  may  often  be 
used  with  advantage  (W.).  Nitroglycerin,  will  speedily  allay  the  spasm  (B.). 
Chloral,  gr.  v-xv  to  prevent  or  arrest  (B.).  Quinine,  given  between  attacks  to 
prevent  (B.) ;  a  most  valuable  remedy,  but  in  small,  repeated  doses  (P.). 
Emetics.  Tartar  emetic ;  mercuric  sulphate  (gr.  iij-v)  safer  and  better  (B.). 
Conium,  is  valuable,  carried  to  a  point  of  physiological  effect  (B.).  Water, 
wet  pack  to  neck  (B.) ;  cold  sponging  twice  or  thrice  daily  more  successful  than 
anything  else,  with  out-of-door  exercise.  Cautiously  if  hoarse  voice  indicates 
laryngitis  (R.).  [Compare  Croup,  Laryngitis.] 

Laryngitis,  Acute  Catarrhal. 

Aconite,  very  valuable  (R.) ;  especially  indicated  in  inflammatory  states  of 
respiratory  parts  ;  gtt.  ss-j  every  half-hour  till  an  impression  is  made  on  the 
fever,  then  every  hour  or  two  (B.).  Antimony.  Tartar  emetic,  gr.  a  very 
excellent  remedy  internally ;  larger  doses  in  oedematous  laryngitis,  gr.  ^  with 
gr.  iij  of  Dover’s  powder  every  2  or  3  hours  (Da Costa).  Iodine,  inhaled; 
also  as  counter-irritant  painted  over  neck  (B.).  Morphine,  small  doses  to  allay 
cough  (A.).  Sulphurous  Acid  Spray,  is  vaunted  (Wa.).  Leeches  to  throat  are 
valuable  auxiliaries  to  general  treatment  in  sthenic  cases  ;  or  cupping  at  the 
nape  of  the  neck(Wa.).  Rumex,  has  selective  action  on  the  laryngeal  mucous 
membrane.  See  page  345.  Zinc  or  Copper  Sulphates,  as  emetics,  in  large 
quantities  of  warm  water,  where  oedema  slight  (A.) ;  a  solution  of  zinc  sulphate, 
gr.  xx  to  §j  on  sponge  to  larynx  with  aid  of  the  laryngoscope  if  possible  to  use 
it  (Da  C.).  Scarification,  by  Mackenzie’s  laryngeal  lancet,  of  great  service  in 
the  oedematous  form  (Da  C.).  A  Purgative  and  Diaphoretic,  with  mucilagi¬ 
nous  drinks,  if  given  at  the  start  may  be  sufficient  (Da  C.).  Iron,  Monsel’s 
solution,  1  part  to  2  or  3  of  water  and  glycerin,  an  excellent  local  application 
(Da  C.).  Heat,  by  poultices  or  fomentations  (A.).  Hot-water  stupes  may 
succeed  (Wa.).  Inhalations  of  hot  steam,  with  benzoin,  the  comp,  tinct.  gtt. 
x-xv  to  3 j ,  with  gtt.  x  tinct.  opii,  or  hops,  or  conium,  of  great  service  (DaC.). 
Tracheotomy  ought  not  to  be  delayed,  if  inhalations,  leeches,  and  fomenta¬ 
tions  fail  (A.,  Wa.) :  is  especially  indicated  in  sudden  attacks  of  oedematous 
laryngitis,  as  those  occurring  in  Bright’s  disease  (DaC.).  Ice,  steadily  applied 
in  bags  over  the  larynx,  if  tracheotomy  refused,  has  succeeded  in  bad  cases. 
Small  pieces  may  be  slowly  swallowed  (Da  C.).  [For  Croupous  Laryngitis, 
see  Croup,  Membranous  ;  for  Spasmodic  Laryngitis,  see  Croup,  Catarrhal; 
for  CEdematous  Laryngitis,  see  Glottis,  CEdema.  Compare  also  Laryngis¬ 
mus  Stridulus,  Pharyngitis.] 

Laryngitis,  Chronic. 

Iodine,  painted  over  neck  as  a  counter-irritant,  and  inhalation  of  its  vapor 
(B.).  Sulphur.  Sulphurous  acid  as  spray  in  syphilitic  or  tubercular  laryn¬ 
gitis,  or  a  solution  of  sodium  sulphite  (£>j  to  the  oz.)  in  water  (B.) ;  by  inha¬ 
lation,  spray,  or  fumigation  (R.).  Carbolic  Acid,  where  long-standing  hyper- 
semia  with  diminished  secretion,  3j-ij  to  the  ,3  of  glycerin  is  a  most  successful 
application  (Morell  Mackenzie).  Silver  Nitrate,  powdered  or  in  solution  to 
chronically  inflamed  larynx,  as  in  phthisis  (R.) ;  a  solution  of  gr.  x  or  xx  ad 
^j,  applied  with  a  brush  by  the  aid  of  the  laryngoscopic  mirror  (W.).  Form¬ 
erly  much  used,  but  is  objectionable  (B.).  Should  be  used  with  great  caution, 
and  only  when  a  particular  point  can  be  seen  for  it  with  the  laryngoscope 
(Da  C.).  Ferric  Perchloride,  solution  gr.  lx-cxx  ad  gj  glycerini  as  local  applica¬ 
tion  (A.).  Zinc  Chloride,  gr.  xx-xxx  ad  3 j ,  in  glycerin.  Alternation  of  topical 
applications,  of  great  value  (A.).  Copper  Sulphate,  gr.  xx  to  5jj  of  water, 
locally  twice  a  week  (Da  C.).  Bismuth,  the  sub-nitrate  by  insufflation,  is  highly 
recommended  in  the  worst  forms  of  laryngitis,  even  in  that  accompanying 
phthisis  (Tr.,  Wa.).  Guaiacum,  as  lozenges,  very  useful  in  mucous  laryngitis 
(A.).  Althaea,  as  pectoral  lozenges  to  relieve  laryngeal  irritation  (P.).  Cubebs, 
the  berries  chewed  are  very  efficient  in  relaxation  of  the  larynx  following  a 


6o6 


LARYNGOTOMY - LEPROSY - LEUCOCYTHSEMIA. 


cold  or  long  speaking  (Wa.).  Cocaine,  a  20  per  cent,  solution  of  the  hydro¬ 
chlorate  by  spray,  mop,  or  brush,  is  very  efficient  in  many  laryngeal  affections 
(Prosser  James).  Benzoin,  in  strumous  laryngitis  (Wa.)  ;  in  chronic,  benzoin 
on  hot  coals,  or  inhaled  from  boiling  water,  of  great  service  (Tr.).  Tannin,  in 
chronic  catarrh  and  ulcerations,  a  solution  (gr.  x-^j-^iv)  applied  by  hand-ball 
or  steam  atomizer  (B.,  A.).  Inhalations,  or  spray,  of  the  best  agents  very 
grateful  (B.) ;  air  loaded  with  vapors  of  ammonium  muriate  by  inhaler,  said  to 
be  used  successfully  (W.) ;  vapors  from  boiling  tar,  turpentine,  etc.,  placed  on 
hot  water,  or  better  by  steam  atomizer  (DaC.);  chloroform,  hops,  benzoin, 
etc.,  by  atomization  (Walker).  Insufflation,  substances  to  be  in  small  quantity, 
mixed  with  bland  powder  (B.).  Functional  Rest  of  voice  often  requisite,  especi¬ 
ally  in  phthisical  and  syphilitic  laryngeal  ulceration  (A.).  Chronic  Laryngitis 
includes  many  disorders  of  the  larynx,  which  of  late  years  have  been  differ¬ 
entiated,  as — thickened  vocal  cords  (chronic  laryngitis  proper),  laryngeal  ulcers, 
polypi,  cysts,  cauliflower  growths,  tubercular  and  syphilitic  laryngitis,  etc.,  in 
all  the  voice  being  similarly  affected.  Dysphagia,  as  a  concomitant  symptom, 
is  constantly  indicative  of  tubercular  laryngitis  (Da  Costa).  [Compare  Cough, 
Phthisis,  Syphilis,  Dysphagia.] 

Laryngotomy. 

Laryngotomy  is  more  quickly  and  easily  performed  on  the  adult  than  trache¬ 
otomy,  being  farther  from  the  lungs  and  less  dangerous.  It  is  usually  directed 
to  be  performed  by  cutting  longitudinally  through  the  skin,  then  horizontally 
through  the  crico-thyroid  membrane,  which  may  be  felt  as  a  soft  depression, 
an  inch  below  the  pomum  Adami.  In  urgent  cases,  however,  Prof.  Wood 
recommends  a  narrow-bladed  knife  to  be  passed  horizontally  through  both 
skin  and  membrane  at  once,  and  then  to  enlarge  the  opening  laterally  to  the 
required  extent.  The  advantage  of  having  a  horizontal  incision  in  the  skin  is 
the  greater  openness  of  the  wound  when  the  patient  throws  up  his  head  under 
a  sense  of  dyspnoea  (D.).  In  Laryngo-Tracheotomy,  the  deep  incision  is  car¬ 
ried  downwards  from  the  crico-thyroid  membrane,  through  the  cricoid  cartilage 
and  one  or  two  of  the  upper  rings  of  the  trachea  (Cl.). 

Leprosy. 

Anacardium  Orientale  (Oil  of  Cashew),  has  been  much  lauded.  Investiga¬ 
tion  established  that  much  of  its  success  was  due  to  hygienic  measures  and 
use  of  fresh  meat  as  food  (P.).  Arsenic,  with  5  or  6  times  the  quantity  of  black 
pepper,  in  est.eem  in  India  (Wa.).  Sarsaparilla,  as  tonic  and  alterative,  valu¬ 
able  (P.).  Gurjun  (Wood  Oil),  as  ointment  and  emulsion,  has  been  used  with 
success  in  alleviating  the  disease,  by  Dr.  Dougall,  Port  Blair,  Andaman  Islands. 
The  ulcers  of  24  lepers  healed  thereby.  Ferri  Arsenias,  gr.  ^  daily,  is  used 
with  success  (Wa.).  Mercury,  the  oint.  of  the  red  iodide,  diluted  1  to  10,  or 
gr.  j  of  the  salt  to  3v  of  unguentum,  gives  very  good  results  (Wa.).  Diet. 
Nutritious  food,  cleanliness,  bath,  will  do  much  to  prevent  the  manifestations 
of  the  disease  (R.).  Chaulmoogra  Oil,  see  page  162,  is  credited  with  a  few 
cures  and  many  cases  improved.  The  oil  is  mixed  with  Psoralea  corylifolia  as  a 
liniment,  and  also  used  internally  (Wa.).  Hoang-Nan,  is  considered  of  utility 
by  a  number  of  writers  on  leprosy,  and  is  given  in  combination  with  Alum  1, 
Realgar  2  or  1,  and  the  drug  2  parts,  the  whole  being  made  into  3-grain  pills, 
one  pill  daily  being  given  at  first  and  gradually  increased  (Pf.).  Argenti 
Nitras,  is  said  to  act  as  a  tonic  and  alterative,  and  to  control  leprosy  for  a 
limited  period  (Pf.). 

Leucocythsemia. 

Alkaline  Hypophosphites,  have  been  used  with  more  or  less  benefit  (Wa.). 
Digitalis,  in  young  subjects  (B.).  Nitro-muriatic  Bath,  should  not  be  neglected, 
with  tonics  and  nutrients  (A.).  Iron,  is  of  little  value  (B.);  large  doses  may  do 


LEUCORRHCEA - LICHEN. 


607 


good  in  early  stage,  with  careful  diet,  and  Ergot  to  contract  the  spleen  (Da 
Costa).  Phosphorus,  gr.  ^  increased  to  gr.  has  proved  successful  in  several 
cases  (Wa.).  Arsenic,  in  as  full  doses  as  can  be  borne,  may  be  of  service 
though  hitherto  ineffectual  (Gowers).  Galvanization  of  the  spleen  causes  im¬ 
provement  of  the  blood,  increasing  the  number  of  its  red  corpuscles  (Gowers) ; 
is  curative  in  uncomplicated  cases  (B.). 


Leucorrhcea. 


Hydrastis,  the  fluid  extract,  undiluted  topically,  quickly  improves  in  uterine 
and  vaginal  leucorrhoea  (B.).  Pulsatilla,  5-drop  doses  ter  die  for  a  few  weeks  ; 
also  a  teasp.  in  a  pint  of  cold  or  tepid  water,  as  vaginal  enema  daily,  when 
pain  in  loins,  depression  of  spirits,  loss  of  appetite,  etc.  (P.).  Silver  Nitrate, 
in  solution  locally,  also  tampon  saturated  with  £j  each  of  alum  and  bismuth, 
when  leucorrhoea  due  to  granular  vaginitis  (Parvin).  Balsam  of  Peru  and 
Tolu,  internally  (P.).  Glycerin,  is  largely  prescribed  for  vaginal  leucorrhoea, 
and  for  erosions  and  ulcerations  of  the  cervix  uteri  (B.) ;  the  best  vehicle  for 
other  agents  (E.).  Borax,  £j  to  Oj  water  as  vaginal  wash  for  the  leucorrhoea 
of  pregnancy  (Parvin).  Cimicifuga,  is  said  to  be  useful  (P.).  Copaiba,  has 
been  used  with  success  (P.).  Cocculus  Indicus,  when  sero-purulent  discharge, 
pain  in  lumbar  region  (P.).  Carbolic  Acid,  diluted,  as  injection  (B.) ;  for 
vaginal  leucorrhoea  (R.).  Bismuth,  with  mucilage,  as  injection  ;  or  with 
cocoa-butter  as  suppository  (B.).  Copper  Sulphate,  in  solution,  as  injection 
(R.).  Tannic  Acid,  in  chronic  cases  serviceable  as  injection,  3  ss  of  tannic 
acid  in  j§viij  of  claret  wine  (B.).  If  os  ulcerated,  a  suppository  of  tannin  and 
cocoa-butter  to  mouth  of  uterus  (R.).  Iodo-Tannin,  an  excellent  application, 
3j  of  iodine  to  §j  of  tannic  acid,  a  sufficient  quantity  to  be  packed  dry  around 
the  cervix  (B.).  Alum  and  Borax,  makes  a  useful  injection  in  vaginal  leu¬ 
corrhcea  (R.).  Belladonna,  with  tannin  as  bolus  where  neuralgia  or  ulceration 
of  os.  When  disease  due  to  over-secretion  of  mucous  glands  about  the  os,  and 
much  pain  present,  inject  sodii  bicarbonas,  3j  ;  tinctura  belladonnae,  3 i j  ; 
aquae,  Oj  (R.).  Potassium  or  Sodium  Bicarbonate,  3j  to  Oj  aquae  as  injection, 
especially  when  discharge  alkaline  and  copious  (R.).  Pareira,  Uva  Ursi,  suc¬ 
cessfully  used  (P.).  Sumbul,  recommended  in  atonic  form  (P.).  Myrrh,  with 
iron  or  aloes,  beneficial  (P.).  Ergot,  said  to  be  useful  in  some  cases  (R.). 
Potassium  Permanganate,  has  no  special  advantage ;  is  used  in  solution  (gr. 
ij  —  3 j  (B.).  Potassium  Chlorate,  £j  to  Oj  of  water  as  injection  in  simple  cases 
(Parvin).  Iron,  the  iodide,  internally  and  externally  has  proven  serviceable  ; 
the  mistura  ferri  composita,  when  anasmia  and  general  debility  (Wa.).  The 
styptic  preparations,  locally  (B.).  Phosphates,  for  the  cachexia  (B.).  The  cal¬ 
cium  phosphate,  gr.  j-ij  several  times  daily,  of  great  value  in  checking  profuse 
discharge  (Wa.).  Injections,  water  at  6o°  F.  to  prevent  recurrence  (R.).  Hot 
water  injections  best  tonic  to  pelvic  vessels,  to  relieve  venous  congestion  ;  use 
with  elevated  hips  (E.).  [Compare  Endo-metritis,  Uterine  Ulceration, 
Vaginitis.] 

Prescriptions. 


R .  Aluminis,  .  .  .  . 

•  •  •  3b 

Zinci  Sulph . 

.  .  .  3SS. 

Sodii  Boratis,  .  . 

.  .  .  .  gr.  iv. 

Aq.  Rosse,  .  .  .  . 

.  .  .  5  viij. 

M.  Sig. — Injection. 

(B- 

R  .  Liq.  Plumbi  Subacet.,  .  .  .  ,5  jss. 

Ac.  Carbolici, . ^ss. 

M.  Sig. — One-fourth  to  be  added  to  a 
pint  of  water  and  used  as  an  injection. 


Lichen. 

Aconite,  sometimes  useful  (R.).  Mercury,  calomel  and  nitrate  of  mercury 
oint.  mixed  (also  tar  oint.  added),  in  patches  of  obstinate  lichen  (R.).  Silver 
Nitrate,  the  nitrous  ether  solution  painted  every  day  or  two  over  patch  (R.). 
Baths,  warm  or  of  sulphides  (R.) ;  sponging  with  alkaline  lotions,  diluted 
lead  water,  fluid  extract  of  grindeha  well  diluted,  or  solution  of  copper  sulphate. 


6o8 


LITH/EMIA - LOCOMOTOR  ATAXIA. 


gr.  x  to  the  3,  in  miliaria,  or  prickly  heat  (lichen  tropicus) ;  with  dusting  pow¬ 
ders  of  lycopodium,  zinc  oxide  or  starch,  singly  or  combined  (Hughes).  Potas¬ 
sium  Citrate,  or  some  other  refrigerant  diuretic,  and  light,  unstimulating  food 
(Da  Co^ta).  [Compare  Eczema.] 


Lithsemia. 


Lithium  Salts,  especially  the  citrate,  gr.  xx  thrice  daily,  is  very  efficient  (Da 
Costa) ;  the  carbonate  invaluable  (Wa.). ;  the  bromide,  in  solution  of  citrate  of 
potassium,  given  after  stomach  digestion  is  completed,  one  of  the  very  best 
agents  (Aulde).  Pichi,  of  great  value  in  lithaemia  with  cystitis  (Wyman). 
Arsenic,  in  small  doses,  is  also  useful  (Da  C.).  Nitric  Acid,  10  minim  doses 
of  the  dilute  acid  in  half-glass  of  water  thrice  daily,  with  an  occasional  dose  of 
pil.  rhei  compos,  at  bedtime,  is  the  most  efficient  treatment  for  the  class  of 
patients  who  will  not  diet  themselves  (Hughes).  Purgatives,  especially  alkaline 
mineral  waters,  to  clear  the  portal  system  (Da  C.).  Sodium  Phosphate,  in  laxa¬ 
tive  doses,  3j  thrice  daily,  gives  good  results.  Alkalies,  in  biliousness ;  also 
the  continued  use  of  alkaline  waters  rich  in  potassium  salts,  for  solution  of 
calculi  (B.).  Acids,  hydrochloric  often  of  great  service  ;  also  lactic  acid,  when 
faulty  digestion  and  assimilation  (Br.).  Potassium  Permanganate,  prevents 
calculi  by  converting  uric  acid  into  urea  (B.).  Buchu,  combined  with  an  alkali, 
has  been  a  beneficial  remedy  (P.).  Colchicum,  15  rt^  doses  of  the  wine,  twice 
or  thrice  daily ;  is  very  useful  (Wa.).  Chimaphila  is  believed  to  check  the 
secretion  of  lithic  acid  (P.).  Aliment,  farinaceous  vegetables  and  acid  fruits 
are  suitable  (B.).  Alcohol  in  any  form  is  poison  to  a  lithasmic  (Da  C.).  Succu¬ 
lent  vegetables  and  fruits,  occasional  abstinence  from  animal  food.  High  living, 
alcoholic  liquors,  and  sedentary  habits  are  injurious.  Milk  diet,  and  frequent 
draughts  of  pure  water  also  recommended.  Removal  to  a  locality  where  pure 
soft  water  can  be  procured,  is  often  curative.  [Compare  Calculi,  Dyspepsia, 
Gout.] 

Prescriptions. 


R.  Lithii  Bromidi, . 5ss~j-  R-  Potas.  Nitratis, . 3]. 

Liq.  Potas.  Citrat.,  .  .  .  5  iv.  Ext.  Pichi  FI., . 3]. 

Syrupi  Simp., . 3  ij.  Elixir  Simpl . 3  iij - 


M.  Sig. — A  teasp.  in  a  wineglassful  or  M.  Sig. — A  teasp.  every  2  hours, 
more  of  water,  2  hours  after  each  meal. 

Reduce  after  a  week. 


R.  Tinct.  Belladon.,  .  .  .  .  rqxviij. 
Vini  Colchici  Rad.,  .  .  .  3  ij. 

Liq.  Potas.  Citrat.,  .  .  ad  3  iv. 

M.  Sig. — A  dessertsp.  well  diluted, 

every  3  hours. 


R.  Vini  Colchici  Rad.,  .  .  .  .  3 ij. 
Ext.  Phytolaccse  FI.,  .  .  .  3]. 

Potas.  Acetatis, . 3  iij. 

Aquae, . q.  s.  ad  J  vj . 


I  M.  Sig. — A  tablesp.  four  times  daily. 


Locomotor  Ataxia. 

Belladonna  and  Ergot  are  highly  recommended  by  Brown-Sequard  (R.). 
Silver  Nitrate,  when  motor  disturbances  are  very  marked.  Improved  1  in  20 
(R.) ;  gives  the  best  results  in  doses  of  gr.  %  to  gr.  yi  thrice  daily,  withholding 
it  after  a  few  weeks  to  prevent  argyria.  The  Oxide  may  be  used  instead  of  the 
nitrate,  in  half-grain  doses  (Da  Costa).  Potassium  Iodide,  Corrosive  Sublimate, 
or  Chloride  of  Gold  and  Sodium,  all  in  full  doses,  often  retard  the  progress  of 
the  disease  (Da  C.).  Physostigma  has  proved  beneficial  (R.).  Phosphorus,  use¬ 
ful,  but  may  not  cure  (B.).  Hyoscyamine,  ameliorative,  gr,  gradually  to  gr. 
TC  (B.).  Electricity,  galvanic,  relieves  pain  ;  faradic  stops  wasting  of  muscles 
(B.) ;  in  stage  of  irritation  the  constant  current  (ascending)  through  spinal 
column  (R.).  Water,  one  of  the  most  efficient  agents  ;  friction  with  a  cloth 
dipped  in  water  of  60-65°  F.,  a  cold  compress  to  head  ;  4-8  minute  bath  of  70- 


LUMBAGO - LUNG  DISEASES. 


609 


750  gradually  lowered  to  6o°,  then  shower-bath,  frictions  (R.).  Rest,  as  com¬ 
plete  as  possible,  must  be  insisted  on  ;  with  good,  nutritious  diet,  milk  being 
desirable  (Da  C.).  Pilocarpine  produces  general  improvement  if  given  in  the 
incipiency,  gr.  j  to  §j  of  water,  of  which  rtpxxx  twice  daily  (B.).  Strychnine, 
gr.  in  3j  of  syr.  hypophosphitum,  thrice  daily,  when  the  system  is  saturated 
with  silver  (Da  C.).  Suspension  daily,  by  head,  has  seemed  to  give  relief  to 
pain  and  improve  condition.  Is  known  as  Charcot’s  treatment,  but  discovered 
by  Matchoukowsky,  of  Odessa,  and  carried  out  systematically  by  Hessing,  of 
Pesth,  before  Charcot  took  it  up.  Antipyrin,  relieves  the  pains  remarkably. 


Lumbago. 

Cimicifuga,  said  to  be  more  effectual  than  any  other  remedy  (R.) ;  has  some¬ 
times  wonderful  success;  no  indications  can  be  given  for  it;  3ss-ij  0f  fluid 
extract  (B.).  Curative  (P.).  Rhus  Toxicodendron,  in  subacute  muscular  or  tendin¬ 
ous  rheumatism,  worse  at  night ;  completely  relieves  some  cases  (Pf.).  Veratrum 
Viride,  the  tincture  useful  (R.).  Aconite  in  doses  of  tincture  every  two 

hours,  with  linim.  aconiti  locally  (Wa.).  Iodides,  if  referable  to  syphilis,  mer¬ 
cury,  copper,  tin,  or  lead  poisoning  (B.).  Ammonium  Muriate,  is  very  efficient 
in  myalgic  lumbago,  gr.  xx  thrice  daily  for  2  days  or  until  signs  of  congestion 
of  the  nasal  mucous  membrane  appear, — then  to  be  replaced  by  Quinine, 
gr.  v,  thrice  daily  for  a  week  (Waugh).  Antipyrine,  gr.  vij,  hypodermically, 
completely  banished  it  in  a  very  bad  case  at  the  Hotel  Dieu,  Paris.  Morphine, 
hypodermically  to  relieve  pain  (B.,  R.) ;  gr.  l/e  with  Atropine  gr.  hypoder¬ 
mically,  will  frequently  cure  lumbago  in  two  or  three  hours  (Da  C.).  Capsicum, 
a  strong  infusion  applied  on  lint,  and  covered  with  oiled  silk,  very  efficient  in 
recent  lumbago  (R.) ;  a  capsicum  plaster  is  a  very  efficient  application.  Potas¬ 
sium  Nitrat.e,  in  ten-grain  doses  hourly  or  every  two  hours,  when  urine  scanty 
and  high-colored  (R.).  Belladonna,  as  plaster,  very  valuable  for  persistent 
lumbago  remaining  in  a  small  spot  (R.).  Turpentine,  in  doses  of  rr\pcx-xxx 
(carefully,  lest  strangury  and  nephritis),  of  greatest  value  when  the  bowels 
regular  and  urine  clear  and  abundant  (Wa.).  Ether  Spray,  externally  as  freez¬ 
ing  mixture  (R.).  Guarana,  xv-xl-gr.  doses  removed  severe  chronic  (Rawson). 
Chloroform  Liniment,  affords  relief  (Wa.).  Canada  Balsam,  gr.  v-xx,  is  useful 
or  Burgundy  Pitch,  as  plaster  (P.).  Acupuncture,  occasionally  gives  instant 
relief  (B.).  Not  when  high  fever  (R.).  Aquapuncture,  has  been  employed 
with  extraordinary  success  (B.).  Heat,  by  hot  douche  to  seat  of  pain  (B.) ;  or 
by  very  hot  poultices  for  three  hours,  then  the  skin  covered  with  flannel  and 
oiled  silk  ;  or  a  hot  flat-iron  (R.).  Galvanism,  the  constant  current  (B.)  ;  is 
highly  useful ;  faradization  almost  as  successful  as  acupuncture  (R.).  Strap¬ 
ping  from  the  thigh  upwards  with  layers  of  adhesive  plaster  which  overlap  each 
other.  Nothing  is  so  instantaneously  beneficial.  Diet,  should  be  generous  and 
nutritive.  Lemon- juice  as  a  beverage.  Absolute  rest  is  of  great  importance. 
[Compare  Rheumatism.] 

Prescriptions. 


R .  Collodii, 

Tinct.  Iodi., 

Spt.  Ammoniae, 

aa  part  aeq. 

Sig. — Paint  over  the  part  with  a  camel’s- 
hair  brush.  ( Burggraeve .) 


R.  Ext.  Cimicif.  FI.,  .  .  .  .  j|ij. 
Ammon.  Chloridi,  .  .  .  .  ijj. 

Aq.  Laurocerasi, 

Syr.  Simplicis,  .  .  aa  .  .  3J*. 

M.  Sig. — A  teasp.  thrice  daily. 

[Potter.) 


Lung  Diseases. 

Aconite,  is  indicated  in  most  acute  congestions  (P.) ;  is  especially  indicated 
in  inflammatory  states  of  respiratory  organs  (R.) ;  Belladonna,  in  rtp  doses  of 
the  tincture  frequently,  is  of  great  benefit  in  pulmonary  oedema,  to  retard  exu¬ 
dation  of  serum  and  to  counteract  the  failure  of  the  heart  (A.  A.  Smith). 
Terebene,  is  very  valuable  in  many  conditions.  Terpine  Hydrate,  is  still  more 

39 


6io 


LUNGS,  GANGRENE  OF - LUPUS. 


efficient  and  more  easily  administered.  [See  under  Bronchitis.]  Ammonium 
Acetate,  serviceable  not  only  in  bronchitis,  but  in  the  whole  range  of  acute  pul¬ 
monary  complaints  as  occurring  in  children  (Dessau).  See  under  Bronchitis, 
for  formula.  Veratrum  Viride  renders  important  service  in  acute  parenchy¬ 
matous  congestions  (B.) ;  gr.  l/e  of  resin  in  pill  when  temperature  and  pulse 
are  high.  It  tends  to  induce  prostration,  collapse,  etc.  (A.).  Blisters.  Flying 
blisters  to  chest,  and  perhaps  along  pneumogastric  nerves  in  hypostatic  con¬ 
gestion  (R.).  Copaiba,  exercises  a  powerful  influence  over  the  pulmonary 
mucous  membrane,  and  is  beneficial  in  lung  diseases  generally,  when  attended 
with  excessive  secretion  (Wa.).  Jaborandi,  is  serviceable  for  the  attacks  of 
breathlessness  attendant  on  lung  affections,  but  must  be  watched  lest  collapse 
ensue  (Berkart).  Liquor  Potassae,  in  doses  of  tr^x-xv  added  to  an  ordinary 
expectorant  mixture,  is  often  attended  with  good  results  in  congestions  of 
bronchi  and  lungs,  chronic  bronchitis,  plastic  bronchitis,  etc.  (Walshe).  Cimi- 
cifuga,  is  a  useful  sedative  in  many  irritative  affections  of  the  lungs  and  bron¬ 
chial  tubes,  relieving  cough,  improving  appetite,  and  ameliorating  the  general 
condition  (Wood).  Croton  Oil,  as  liniment,  is  a  highly  useful  counterirritant  in 
many  chronic  lung  diseases,  and  even  in  the  bronchitis  of  infancy  (Park).  Cubebs, 
in  small  and  oft-repeated  doses,  is  efficient  in  chronic  bronchitis  and  other  lung 
affections  of  old  persons,  checking  the  excessive  secretion  and  gently  stimulat¬ 
ing  the  system  (Wa.).  [Compare  Bronchitis,  Emphysema,  Hemoptysis, 
Phthisis,  Pleuritis,  Pleurodynia,  Pneumonia.] 

Lungs,  Gangrene  of. 

Creasote,  by  inhalation,  to  obviate  the  fetor  (R.).  Carbolic  Acid  inhalations, 
are  used  with  marked  benefit  (Wa.).  Mineral  Acids,  especially  nitro-hydro- 
chloric,  with  Quinine,  the  main  reliances  in  chronic  pulmonary  gangrene  (A.). 
Stimulants,  as  malt  liquors,  with  general  tonic  treatment,  are  necessary  (A.). 
Ammonium  Carbonate,  one  of  the  most  reliable  remedies  ;  is  best  given  in 
decoctum  cinchonge  (Wa.).  Eucalyptus,  the  oil  with  alcohol,  equal  parts  of 
each,  of  which  3j  as  inhalation  by  steam  atomization,  is  useful  (Wa.).  Turpen¬ 
tine,  the  spirit  on  boiling  water  inhaled  for  fifteen  minutes  every  two  hours,  suc¬ 
cessfully  employed  (Skoda).  [Compare  Pneumonia,  Phthisis.] 

Lupus. 

Arsenic,  in  chronic  cases,  not  of  syphilitic  origin  (B.).  Arsenious  acid  as 
caustic  (R.).  The  best  remedy  in  lupus  of  head  and  face  (Wa.).  The  oleate 
of  arsenic,  in  ulcerating  forms,  constantly  applied,  will  destroy  cell-infiltration 
in  a  mild  and  comparatively  painless  manner;  is  also  well  employed  in  the 
tubercular  variety  (Wa.).  Iodine,  useful,  whether  syphilitic  or  scrofulous  ;  the 
tinct.  or  a  glycerin  solution  (B.) ;  as  tincture  or  liniment  to  edges  and  around 
(R.).  Mercury,  as  ointments  in  erythematous  lupus,  calomel  ointment  in 
scrofulous  and  tubercular  lupus  of  children  (R.).  Calomel  int.,  gr.  j-ij  in¬ 
creased  to  iv,  will  quickly  check  (Wa.).  Emplastrum  hydrargyri  very  efficient 
in  lupus  erythematodes  and  allied  affections  (Kohn).  Cod-liver  Oil,  internally 
and  locally  (B.).  Lead,  liq.  plumbi,  with  one  or  two  parts  of  glycerin,  applied 
warm  after  removal  of  crusts,  in  milder  forms  (R.).  Carbolic  Acid,  as  a  mild 
escharotic  (B.).  Zinc  Sulphate,  dried,  as  caustic,  freely  dusted  over  surface, 
and  a  poultice  to  remove  slough  (B.).  Jequirity,  a  most  useful  application 
(Shoemaker).  Sodium  Ethylate  on  absorbent  cotton,  is  the  best  of  all  caustics, 
followed  by  the  Oleopalmitate  of  Bismuth  as  a  soothing  and  astringent  appli¬ 
cation  (Shoemaker).  Chromic  Acid,  an  efficient  local  application,  gr.  c-^j 
aquae  destil.  (B.).  Phosphorus,  as  substitute  for  arsenic  (B.).  Silver  Nitrate, 
a  weak  solution  gradually  strengthened,  in  superficial  forms  (R.).  Cauteriza¬ 
tion,  with  the  actual  cautery  at  white  heat,  after  scraping  out  as  much  as  possible 
of  the  diseased  parts,  so  as  to  destroy  the  lupus  cell.  Seek  to  replace  the  lesion 
by  a  cicatrix,  to  prevent  relapse  in  situ,  and  the  development  of  the  disease 
elsewhere.  Internal  remedies  only  useful  for  the  general  health. 


LYMPHANGEITIS - MALARIA. 


6l  I 


Prescriptions. 


R .  Iodi, 

Potassii  Iodidi,  .  ,  .  .  aa  |  ss. 

Glycerini . ^  j. 

M.  Sig. — Locally  in  Lupus. 

(. McCall  Anderson .) 


R.  Ung.  Arsenici  Oleat.,  .  .  .  ^ij. 

Ung.  Simplicis, . g  j. 

M.  ft.  unguentum.  Sig. — Use  constantly 
over  the  affected  surface.  If  pain  sets  in 
Opium  may  be  added.  ( Shoemaker .) 


R.  Hydrargyri  Bromidi,  .  .  .  gjss. 


Adipis, . ^  v. 

M.  ft.  unguentum.  Sig. — To  cover  the 
part  affected,  using  cod-liver  oil  freely,  and 
the  following  solution  internally.  In  tuber¬ 
cular  lupus  of  the  face.  (Hardy.) 


R  .  Potassii  Iodidi, . gr.  lxxv. 


Sodii  Chloridi,  ...  .  ^  ss. 

Aq.  Destil., . ^viijss. 

M.  Sig. — Tablesp.  before  meals,  night 
and. morning.  (Hardy.) 


Lymphangeitis. 

Belladonna,  the  extract  softened  with  glycerin,  freely  applied,  is  of  great 
service  ;  when  pain  is  severe,  a  poultice  may  be  applied  over  the  extract  for  a 
few  hours  only  (Wa.).  Lead,  liq.  plumbi  subacet.  dil. ,  as  an  external  applica¬ 
tion,  constantly  applied,  to  soothe  and  restrain  the  inflammation  (Wa.).  Iodine, 
in  strong  tincture,  around  glands,  to  prevent  suppuration  (Roberts).  Quinine, 
or  Salicin,  with  alcoholic  stimulants  freely,  in  septic  cases  (Roberts).  [Com¬ 
pare  Bubo.] 


Malaria,  Chronic. 

Quinine  is  less  curative  than  when  the  infection  is  recent,  but  in  periodical 
affections  depending  on  the  malarial  cachexia  it  is  of  specific  value,  large  doses 
being  required  (B.).  Salicylates,  of  quinine  and  cinchonidine  are  especially 
effective  in  chronic  malarial  disease  (B.).  Arsenic  plays  an  important  role  in 
chronic  malarial  disease  (B.) ;  diminishes  splenic  engorgement,  and  com¬ 
bined  with  iron  is  rapidly  curative  of  many  affections  due  to  the  paludal 
miasm  (Boudin) ;  is  a  powerful  prophylactic  against  malaria,  and  in  chronic 
malarial  poisoning,  with  frequent  return  of  fever  and  neuralgia,  the  continued 
use  of  arsenic  is  of  great  benefit  (Fayrer).  Iron,  the  sulphate  has  decided 
antiperiodic  power,  and  is  particularly  successful  in  anaemic  subjects  and  in  those 
with  enlargement  of  the  spleen  (Wa.) ;  it  improves  the  anaemia  of  chronic 
malaria,  and  should  generally  be  combined  with  arsenic  (B.).  Iodide  of  Iron 
and  Manganese,  the  syrup  in  doses  of  rr^xx-xxx,  is  a  successful  remedy  for 
chronic  malarial  infection,  and  the  Sulphate  of  Manganese  gives  excellent  re¬ 
sults  in  jaundice  of  malarial  origin  (B.).  Cornus,  Calumba,  and  other  bitters, 
are  highly  efficient,  especially  the  first-named,  in  chronic  malarial  poisoning, 
and  in  convalescence  after  malarial  fever  (B.).  Carbolic  Acid  and  Iodine  com¬ 
bined  are  of  great  value  in  chronic  malarial  infection  ;  both  are  highly  anti¬ 
periodic,  and  the  latter  is  the  best  substitute  for  quinine  and  the  most  active 
reducer  of  splenic  enlargement  (Gimwell).  Eucalyptus  is  of  high  utility  to 
reconstruct  the  damages  in  the  organs  of  assimilation  (B.).  Baths,  the  vapor- 
bath  and  Turkish  baths  are  efficient  aids  to  medicinal  treatment  in  breaking  up 
chronic  cases,  and  may  of  themselves  cure  such  by  inducing  profuse  perspira¬ 
tion  (Da  Costa).  [Compare  Intermittent  Fever,  Remittent  Fever.] 

Prescriptions. 

R.  Cinchonidinae  Salicylat.,  .  3  ij.  R.  Quininae  Sulph., . gr.  xl. 

Ac.  Arseniosi, . gr.  j.  Ferri  Sulph.  Exsic.,  .  .  .  gr.  xx. 

Ferri  Sulph.  Exsiccat.,  .  .  gr.  xx.  Ac.  Arseniosi, . gr.  j. 

M.  ft.  cachets  no.  xx.  Sig. — One  wafer  M.  ft.  pil.  no.  xx.  Sig. — One  pill  thrice 

thrice  daily.  daily. 


6l2 


MANIA - MASTITIS. 


R .  Cornus, 

Calumbse, 

Liriodendri, 

Pruni  Virgin.,  .  .  .  .  aa  ^  vj. 

Eupatorii, 

Capsici, . aa  ^  iv. 

Pulv.  et  misce.  Sig. — A  teasp.  in  cold 
or  warm  water,  three  or  four  times  daily. 

A  good  tonic  tincture  may  be  made  from 
the  above  combination.  (B.) 

Mania. 

Stramonium,  of  value  ;  allays  irritation  and  induces  tranquil  sleep  ;  wild  and 
furious  delirium,  but  intermittent ;  also  in  nymphomania  (P.).  Many  facts 
seem  to  confirm  its  reported  value  (Tr.).  Daturine,  gr.  Thr~&u  hypodermically 
in  acute  mania,  but  is  less  useful  than  atropine  or  hyoscyamine  (Wa.).  Duboi¬ 
sine,  gr.  3^  hypodermically  in  acute  mania  (Gubler.)  Belladonna,  is  useful, 
especially  in  monomania,  with  fixed  hallucinations,  though  a  large  dose  causes 
a  temporary  insanity  (Tr.)  ;  one  of  the  very  best  remedies  in  all  hyperaemic 
conditions  of  the  brain  (P.).  Hyoscyamus,  in  violent  intermittent  forms,  to 
procure  sleep  and  calm  violent  delirium  (R.) ;  delirium  with  hallucinations  but 
not  congestion  ;  milder  and  less  inflammatory  forms  ;  also  in  hypochondriacal 
monomania  (P.).  Veratrum  Viride,  successfully  combats  the  excitement  in 
acute  mania  (B.).  Camphor,  has  been  used  successfully  ;  its  action  is  uncer¬ 
tain  (P.).  Opium,  and  tartar  emetic  are  satisfactory  for  many  cases ;  also  mor¬ 
phine  hypodermically  to  induce  sleep  (R.) ;  narcotic  effect  of  doubtful  utility  ; 
better  in  insanity  with  depression  (P.) ;  will  not  produce  narcotism  in  many 
cases,  even  in  2-grain  doses.  Cannabis  Indica,  gj  of  tinct.  with  3j  of  potas¬ 
sium  bromide,  is  recommended  (R.).  Bromides  are  used  in  puerperal  mania, 
that  of  pregnancy,  nymphomania  and  other  forms  (R.).  The  combined  use  of 
potassium  bromide  and  tinct.  of  cannabis  indica,  in  equal  parts,  3j  of  each 
thrice  daily  for  weeks  and  months,  has  proved  very  efficient  in  acute  and  peri¬ 
odical  mania,  senile  mania,  and  other  forms  (Clouston).  Chloral,  as  calma¬ 
tive,  hypnotic,  has  induced  mental  improvement,  gr.  v-xx  (B.).  Coniine,  most 
suitable  to  acute  mania,  quiets  muscular  action  or  hypoder.,  com¬ 

mencing  with  b\,To).  Very  successful  with  morphine  conjointly  injected  (B., 
R.).  Digitalis,  3ss-3j  of  tinct.,  valuable  in  acute  and  chronic  mania,  espe¬ 
cially  when  complicated  with  general  paresis  and  epilepsy  (Maudsley).  Cau¬ 
tion  !  watch  the  pulse  for  any  marked  intermittence  (B.).  A  very  valuable 
palliative  in  acute  mania  (Van  der  Kolk).  Ergot,  large  doses,  £ss-j  0f  fluid 
extract,  to  reduce  excitement,  shorten  attacks,  widen  intervals  between  them, 
and  prevent  exhaustion,  hence  is  very  useful  in  recurrent  and  epileptic  forms, 
and  in  chronic  mania  with  lucid  intervals  (Crichton  Browne).  Iron,  as  a  resto¬ 
rative,  is  frequently  used  in  chronic  mania  with  benefit,  the  tincture  of  the  chlo¬ 
ride  in  5-10  minim  doses  (B.).  Gelsemium,  is  more  useful  than  conium  in 
mania  with  great  motor  excitement  and  wakefulness ;  large  doses  required, 
tt^xv-xx  of  tincture.  Croton  Oil,  as  a  purgative,  triX-K  every  hour,  as  revul¬ 
sive  in  mania  from  cerebral  congestion  (R.).  Cimicifuga,  is  often  efficiently 
used  in  cases  of  mania  occurring  during  the  puerperal  or  pregnant  condition 
(R.).  Galvanism,  of  the  head  and  cervical  sympathetic,  has  produced  distinct 
improvement  (B.).  Paraldehyde,  as  a  hypnotic,  in  doses  of  rrbxxx-1,  is  often 
decidedly  useful  (R.).  Cold  Douche,  in  maniacal  delirium,  the  patient  being 
in  a  warm  bath  during  the  application  of  the  douche  to  the  head  (R.).  Re¬ 
moval  from  home,  from  sympathetic  friends,  and  from  surroundings  connected 
with  the  origin  of  the  malady,  is  a  prime  necessity  to  a  cure.  [Compare  De¬ 
lirium,  Puerperal  Mania.] 

Mastitis. 

Belladonna,  Atropine  locally  (see  Lactation),  or  combined  with  morphine 
and  chloral,  when  much  pain  (B.).  Especially  as  liniment  to  check  secretion 


R.  Tinct.  Iodi,  .......  ^ij. 

Ac.  Carbolici, .  ^j. 

M.  Sig. — Two  to  three  drops  three  or 
four  times  a  day  in  water. 


R .  Ac.  Arseniosi, . gr.  j. 

Mas.  Ferri  Carb.,  ....  ^j. 

M.  ft.  pil.  no.  xx.  Sig. — One  pill  thrice 
dailv. 


MASTODYNIA - MEASLES. 


613 


of  milk  when  inflammation  is  imminent  (R.) ;  or  when  distended  by  milk  (P.). 
When  inflammation  has  set  in,  continuous  application  of  Belladonna  for  24 
hours  often  arrests  it.  It  is  also  useful  when  an  abscess  has  formed.  Fomen¬ 
tations  useful  in  addition,  but  skin  must  be  dried  well  before  the  belladonna 
is  rubbed  in  (R.) ;  rr^v-x  of  tinpt.  internally  as  well  (P.).  Camphor,  a  saturated 
solution  in  glycerin,  locally,  in  mammary  congestion  threatening  abscess 
(Wa.).  Phytolacca,  has  power  to  arrest  inflammation  of  the  mammae  and  to 
prevent  suppuration  ;  the  fluid  extract  in  10-minim  doses  internally,  and  the 
solid  extract  on  a  cloth  to  the  inflamed  breast  (B.).  Conium,  the  extract  in 
small  doses  several  times  a  day,  of  striking  benefit  in  mastitis  and  impending 
abscess  of  breast  (Wa.').  Calcium  Sulphide,  internally  in  abscess,  occasionally 
increases  pain  (R.).  Hyoscyamus,  as  plaster,  to  relieve  painful  distention  from 
milk  (P.).  Stramonium,  fresh  leaves  as  cataplasm  to  discuss  indurated  milk 
(P.).  Iodine,  tinct.  and  ointments  to  remove  indurations  of  breasts  after  inflam¬ 
mation  (B.).  Mercury  and  Morphine,  the  oleate  locally  in  mammary  abscess 
(R.).  Tobacco,  leaves  as  poultice  in  abscess  (R.).  Digitalis,  the  infusion 
locally  as  fomentation  in  severe  inflammation  of  the  breasts,  causes  it  to  yield 
speedily  (Fairbank).  Ammonium  Chloride,  3j  ad  Oj  spt.  rosmarini,  as  lotion 
on  linen  rags,  kept  constantly  to  the  part,  especially  in  induration,  after  abscess 
has  suppurated  (Wa.).  Tartar  Emetic,  in  small  and  frequent  doses,  given 
early,  is  beneficial  (Wa.).  Oil  frictions  in  first  stage  of  inflammation  of  breasts, 
from  circumference  toward  the  nipple  (L.).  Rest,  by  supporting  mammas  with 
strips  of  plaster,  and  bandaging  the  arm  to  the  side,  to  prevent  motion  (T.). 
Sponging,  with  alcohol  (over  proof)  until  part  is  cold  ;  renewed  if  heat  return. 
Heat,  applied  by  a  basin  lined  with  flannel  saturated  with  hot  water,  to  relieve 
pain  and  prevent  suppuration.  [Compare  Abscess,  Lactation.] 

Mastodynia. 

Dr.  Tanner  advises  non-interference  in  simple  cases  of  enlargement  and 
tenderness,  which  will  spontaneously  subside  if  let  alone.  In  severe  cases  sup¬ 
port  by  strips  or  bandage,  if  breast  pendulous;  belladonna  ointment  or  lini¬ 
ments;  amputation  of  mamma  has  been  necessary.  Conium,  has  specific 
anodyne  action  on  the  mammae  and  generative  organs.  Cimicifuga,  relieves 
infra-mammary  pains  of  uterine  origin  in  spinsters.  Olive  Oil,  2  parts,  to  1  of 
tinct.  opii,  may  be  used  by  gentle  friction  to  painful  breasts  after  parturition 
(Parvin). 

Measles. 

Aconite,  for  febrile  symptoms,  and  especially  to  arrest  the  catarrhal  pneu¬ 
monia  (R.) ;  a  valuable  remedy  (P.) ;  the  best  drug  when  fever  is  very  high, 
)4-drop  doses  of  the  tincture  every  2  hours  (Da  Costa).  Jaborandi,  with  a  hot 
bath,  as  diaphoretics,  in  cases  of  delayed  eruption  (Da  C.).  Asclepias,  an 
infusion  or  decoction  freely  as  a  diaphoretic,  to  promote  the  eruption  (W.). 
Veratrum  Viride,  has  been  employed  (R.).  Pulsatilla,  for  the  catarrhal  oph¬ 
thalmia,  nasal  and  intestinal  catarrh;  ,3j-ij  of  tincture  to  ^iv  water  as  wash 
(P.).  Ammonium  Carbonate,  dissolved  in  a  solution  of  the  acetate,  is  much 
vaunted.  When  feeble  circulation,  cyanosis,  delirium,  gr.  v-x  to  5SS-5J’  liq. 
ammonii  acetatis  (B.) ;  gr.  iij-vj  or  vij,  every  hour  or  two,  in  cinnamon-water 
or  milk  ;  one  of  the  reliable  remedies  (W.).  Camphor,  the  mixture,  with  liq. 
ammon.  acetatis,  excellent  when  cough  and  catarrh  the  most  urgent  symp¬ 
toms  (A.).  Ipecacuanha,  for  cough  and  catarrh,  gr.  j-ij  every  4  or  6  hours  (A.). 
Antimony,  preferred  to  ipecac  by  some  (A.).  Quinine,  in  small  doses  for  the 
adynamia  (gr.  j — i ij ) ,  or  large  (gr.  xv)  for  hyperpyrexia,  and  catarrhal  pneumo¬ 
nia,  etc.  (B.).  Carbolic  Acid,  has  been  employed  in  several  hundred  cases  with 
decided  advantage;  most  useful  at  early  stage  (Wa.).  Cod-liver  Oil  and  Iron, 
to  scrofulous  children,  a  long  course  of  such  medication  after  convalescence 
(Da  C.).  Purgatives,  must  be  given  with  caution  (R.)  ;  the  milder  purging  salts, 
as  magnesium  sulphate,  to  be  preferred  (A.).  Mustard,  as  bath  on  sudden  retro¬ 
cession  of  rash  (R.) ;  often  increases  the  fever  without  benefiting  the  pneumonia 


614 


MELANCHOLIA - MENINGITIS. 


and  other  complications  (A.).  Water,  cold  affusion  at  commencement;  pack¬ 
ing,  especially  when  retrocedent  (R.) ;  hot  foot-baths  for  convulsions  (A.)  ;  tepid 
bath  with  cold  douche  to  head,  if  cerebral  symptoms  are  severe  (Da  C.).  Oil 
Inunctions,  cocoa-butter  very  grateful,  and  reduces  temperature.  Also  in 
roseola  (B.).  Hands  and  feet  to  be  rubbed  with  a  firm  fat  to  remove  heat  and 
tightness  produced  by  rash  (R.).  Aliment,  low  diet  and  slops ;  no  animal  food 
during  whole  course  (A.).  Hygiene,  dark  room,  complete  disuse  of  eyes,  strict 
cleanliness  (A.).  [For  Sequelae  see  Bronchitis,  Cough,  Ophthalmia,  Otor- 
rhcea,  Pneumonia,  etc.] 

Prescriptions. 


R .  Ac.  Carbolici, 

Ac.  Acetici, . aa  ^j-^jss. 

Tinct.  Opii  Deod.,  .  .  .  ^j. 

Spt.  Chloroformi,  .  .  .  .  £j. 

Aquae, . q.  s.  ad  $  viij. 

M.  Sig. — A  tablespoonful  every  4  hours, 
until  fever  abates.  (Jfri/h.) 


R. 

Tinct.  Tolutanas,  .  .  .  .  g  ij. 

Syr.  Senegae, . ^ss. 

Ac.  Acetici, . 3jjss. 

Syr.  Pruni  Virg.,  .  .  .  ad  £  iv. 

M.  Sig. — A  teaspoonful  as  required  for 
cough  after  convalescence. 


Melancholia. 

Aurum,  gives  excellent  results ;  gr.  2V  to  ¥0  °f  chloride  ter  die,  especially 
when  cerebral  anaemia  coexists  (B.).  Bromides,  sometimes  afford  relief  which 
no  other  agent  will;  no  indications  (B.).  Potassium  Bromide  for  townspeople, 
especially  women  with  unendurable  despondency  (R.).  Cocaine,  a  useful  tonic, 
especially  beneficial  in  nervous  affections  accompanied  by  depression  (Br.). 
Cimicifuga,  in  puerperal  or  uterine  despondency,  of  singular  value  (P.).  Ig- 
natia,  has  soothing  effect  in  great  mental  depression  (P.).  Arsenic,  in  melan¬ 
choly  of  aged  persons  gives  great  comfort.  Best  with  small  doses  of  opium. 
Fowler’s  solution,  gtt.  ij ;  tinctura  opii,  gt.  iij-v,  ter  die  (B.).  Opium,  in  stimulant 
doses  of  tincture,  gives  good  effects  (B.) ;  especially  when  paroxysms  of  acute 
anguish  and  despair,  or  when  suicidal  impulse  (Wa.).  Morphine  hypodermi¬ 
cally  is  of  great  benefit  in  some  persons  who  have  a  peculiar  idiosyncrasy 
therefor  (R.).  Camphor  has  been  highly  recommended  (R.).  Musk  and 
Castoreum  are  employed  in  melancholia  with  benefit  (R.).  Cannabis  Indica, 
sometimes  relieves  (B.).  Phosphorus,  depression  from  over-work  (R.).  Chloral, 
as  hypnotic,  has  been  followed  by  marked  amelioration  and  cure  (Wa.). 
Valerian,  in  hysterical  or  suicidal  melancholia,  is  often  beneficial  (Wa.). 
Caffeine  has  been  useful  (B.).  Iron,  as  restorative.  Tincture  of  chloride  (B.). 
Water-cure,  shower-bath,  15-20  seconds,  or  warm-bath,  950  Fah.  for  30  min¬ 
utes  ;  the  shower  or  cold  douche  may  be  usefully  employed  in  certain  cases 
where  reaction  takes  place  after  it  (Wa.).  [Compare  Hypochondriasis, 
Hysteria.] 

Meningitis,  Cerebral. 

Aconite,  is  as  serviceable  in  this  as  in  the  other  acute  inflammations ;  during 
the  stage  of  excitation,  the  tincture,  gtt.  ij  with  gtt.  v  of  deodorized  tincture 
of  opium,  every  2  hours,  gives  admirable  results  (B.).  Belladonna,  in  all 
hyperaemic  conditions  of  brain  and  spinal  cord  one  of  the  very  best  remedies, 
especially  during  the  period  of  excitement  (P.).  Hyoscyamus,  valuable  in  sub¬ 
acute  form  (P.)  ;  for  nervous  irritability  during  convalescence  (A.).  Gelsemium, 
extremely  useful ;  rr^v  of  fluid  extract  every  2  hours  (B.).  Mercury,  as  ointment 
gives  good  results  in  children  (A.) ;  Calomel  in  small,  frequent  doses,  so  as  to 
bring  the  system  under  it  quickly,  a  most  valuable  remedy  apart  from  its  purga¬ 
tive  effects  (Wa.).  Potassium  Iodide,  has  cured  (Niemeyer),  especially  valuable 
in  the  tubercular  form  (B.).  Ergot,  the  fluid  extract  in  $ss  doses,  with  3ss  of 
potassium  bromide,  every  4  hours,  to  diminish  the  vascular  excitement  (B.). 
Potassium  Bromide,  in  the  convulsions  following  simple  meningitis  (R.).  Opium, 
in  small  doses;  by  clinical  evidence  proved  to  be  the  best  treatment,  especially 
for  the  acute  stage  before  exudation,  or  during  the  stage  of  excitation  (B.). 


MENINGITIS. 


615 


When  collapse,  may  sustain  powers  of  life  ;  with  tartar  emetic  has  proved 
most  beneficial,  but  should  be  used  with  great  caution,  as  it  may  do  great  harm 
(Wa.).  Bryonia,  exceedingly  valuable  for  serous  inflammations  in  stage  of 
effusion  (P.).  Pulsatilla,  valuable  in  the  acute  form  (B.).  Purgatives,  as  soon 
as  possible,  unless  exhaustion.  Calomel  and  jalap  the  most  active  and  search¬ 
ing  (A.).  Croton  oil  as  a  derivative  and  revulsive  ;  also  locally  to  the  shaven 
scalp,  productive  of  the  best  results  in  tubercular  meningitis  (Wa.).  Venesection, 
or  arteriotomy  (temporal  artery)  gives  good  results  (B.) ;  when  high  cerebral 
excitement  and  vascular  action  (A.).  Blisters,  on  nape  of  neck  if  coma,  after 
active  symptoms  are  subdued  (A.).  Water.  Cold  water  for  hyperpyrexia 
(C.) ;  pounded  ice  in  bag  or  bladder,  as  a  cap  to  the  head  (R.).  [Compare 
Hydrocephalus.] 

Meningitis,  Cerebro-Spinal. 

Opium,  no  remedy  so  effective  in  small  doses.  Utility  ends  when  effusion, 
stupor,  and  coma  ensue  (B.)  ;  large  doses  (Valleix),  gr.  j  every  hour  in  very 
severe  cases  (S.) ;  has  been  used  in  France  and  Germany  with  much  success 
(Tr.)  ;  is  the  best  remedy  of  all,  gr.  j  every  hour  for  4  days  ;  even  such  doses 
will  not  narcotize  (Da  Costa).  Aconite,  useful  combined  with  opium  (B.)  ; 
affects  the  cranio-spinal  axis  from  3d  nerve  to  phrenics,  the  region  where  this 
disease  is  most  manifest  (Harley).  Gelsemium,  extremely  valuable,  rr^v  of 
fluid  extract  every  2  hours,  to  maintain  constant  physiological  effect  (B.) ; 
efficient  for  the  delirium.  Belladonna,  in  all  hyperaemic  conditions  of  brain 
and  spinal  cord,  especially  during  stage  of  excitement  (P.).  Iron,  the  tincture 
of  the  chloride,  in  20-30  minim  doses,  every  2  hours,  suggested  by  the  simi¬ 
larity  of  the  disease  to  erysipelas,  has  made  many  successful  cures  without 
leaving  any  sequelae  (Klapp).  Bromides  to  guard  the  opium  and  enable  the 
latter  to  be  pushed,  20-grain  doses  every  4  hours  (Da  C.).  Hydrocyanic  Acid, 
dilute,  n\j-ij,  with  gr-  iij— v  °f  sodium  bicarbonate,  every  3  or  4  hours,  for 
severe  vomiting  (Delafield).  Quinine  in  large  doses  at  the  commencement 
(B.) ;  has  been  exhaustively  tried  in  this  disease  and  failed  (Da  C.).  Potassium 
Iodide  for  the  sequelae,  a  long  course  of  iodides  during  convalescence  is  the 
best  .treatment  (Da  C.).  Cold  to  the  spine,  the  most  satisfactory  treatment 
(Radcliffe) ;  to  head  and  upper  spine  for  5  minutes  only  at  a  time,  for  the 
headache  and  tetanic  symptoms  (Da  Costa).  Venesection,  or  arteriotomy 
(temporal  artery),  probably  of  service,  but  cautiously  (B.) ;  leeches  at  back  of 
neck  and  on  temples,  to  relieve  the  terrible  headache,  if  patient  is  strong  and 
vigorous  (Da  C.).  Digitalis,  in  early  stage  (Rummel).  Ergot,  one  of  the  best 
remedies  (B.).  Turpentine,  enema,  as  derivative  (B.).  Stimulants,  in  small 
quantities  (A.).  Counter-irritation,  by  actual  cautery  freely  applied  to  back, 
alleviates  pain  (A.).  Water,  cold  baths  or  wet  pack  for  hyperpyrexia  ;  warm 
bath  in  uraemia  (B.) ;  hot-water  bottles  or  sand-bags  to  trunk  and  extremities 
to  keep  up  warmth.  Bath  of  102-106°  for  short  time  only,  then  wrapped  in 
blankets  (A.).  Heat  to  the  body,  except  the  head  and  neck  (Da  C.).  Aliment, 
nutritious  and  suitable  food  at  short  intervals,  day  and  night  (A.) ;  tonics  with 
fresh  air  and  good  diet  during  convalescence  (A.).  Ventilation,  of  dwellings, 
the  best  sanitary  precaution  when  the  disease  is  epidemic  (Simon). 


Prescriptions. 


R .  Morphinae  Sulph.,  .  .  .  .  gr.  ss. 

Ac.  Sulph.  Aromat.,  .  .  .  ^j. 

Tinct.  Cinchonae  Co.,  .  ad  ^vj. 

\I.  Sig. — Tablesp.  every  2  hours,  for  a 
boy  of  12  years  old. 

( Meigs  &=  Pepper.') 


R  .  Potass.  Iodidi, . 3  iv. 

Tinct.  Gentian.  Comp., 

Syr.  Sarsae  Co., . aa  5  ij. 


M.  Sig. — Teasp.  thrice  daily,  to  pro¬ 
mote  absorption  during  convalescence. 


Meningitis,  Spinal. 

Aconite,  is  very  useful  (B.) ;  with  Ergot  and  an  Opium  impression  to  reduce 
the  amount  of  blood  in  the  vessels  of  the  cord  (Da  Costa).  Potassium  Iodide 


6 16 


MENORRHAGIA. 


see  below.  In  the  chronic  form,  with  the  bichloride  of  mercury  when  a  specific 
history  present  (Hammond).  Belladonna,  strongly  to  be  relied  on,  even  when 
brought  on  by  external  violence  (P.).  Bryonia,  in  serous  inflammations,  when 
effusion,  is  extremely  valuable  (P.).  Purging,  by  magnesium  sulphate,  combined 
with  tinct.  hyoscyami  (A.).  Quinine,  when  paralysis  occurs,  in  3-grain  doses  thrice 
daily,  with  X -grain  doses  of  extract,  belladonnas,  or  20-30  grain  doses  of  potas¬ 
sium  iodide,  and  flying  blisters  along  the  spine  (Da  Costa).  Opium,  in  some 
form  must  be  used  for  pain  (Bastian).  Mercury,  gr.  of  the  bichloride,  with 
increasing  doses  of  potassium  iodide,  to  promote  absorption  of  inflammatory 
products,  if  the  inflammation  subsides  (Bastian)  ;  a  mercurial  impression  often 
benefits  the  paralysis  (Da  C  ).  Cold,  by  ice  to  spine  is  deemed  necessary,  and 
no  doubt  alleviates  the  pain,  though  heat  would  be  a  more  rational  application 
for  the  inflammation  (Bastian).  . 


Menorrhagia. 

Opium, has  specific  action  in  reducing  the  uterine  circulation, should  be  pushed, 
even  to  inducing  habit,  in  severe  cases  (Lutaud).  Ipecacuanha,  in  full  emetic 
doses  (Wa.) ;  is  excellent  (B.) ;  Ergot  is  better  (P.).  Savine,  enlarged,  relaxed, 
and  passively  congested  uterus  (B.).  In  5-10  drop  doses  of  tinct.  in  water  every 
half-hour  to  three  hours,  has  proved  useful  (P.) ;  when  due  to  want  of  tone  in 
uterus  (R.).  Ergot,  large  spongy  uterus  ;  bromides  better  (B.).  Ergotin  gr.  j 
or  ij  in  glycerin  and  water,  undoubtedly  efficacious  as  hypodermic  injection 
(P.) ;  all  forms  (R.)  ;  minim  doses  of  the  fluid  extract  are  very  beneficial  (A.  A. 
Smith).  Hamamelis,  has  decided  influence  on  venous  system  ;  of  high  repute 
(Pf.).  Arsenic  and  Iron,  when  from  anaemia  (B.).  Cannabis  Indica,  often  suc¬ 
cessful  (R.) ;  gtt.  v-x  of  tinct.,  thrice  daily,  productive  of  extraordinary  success 
(Wa.)  ;  has  a  stimulant  action  on  the  uterine  muscular  fibre,  and  may  be  given 
in  combination  with  Ergot  (B.).  Iron,  when  dependent  on  anaemia  (B.).  Rue, 
low  vascular  tonus ;  should  never  be  used  in  the  pregnant  state  (B.).  Oil  of 
Erigeron,  in  io-drop  doses,  is  efficient  (Wa.).  Gossypium,  a  favorite  uterine 
hemostatic  in  many  hospitals,  in  30-minim  doses  of  the  fluid  extract  every  four 
hours  (Parvin).  Quinine,  has  been  recommended  (R.)  ;  after  Ergot  it  is  the 
very  best  agent,  in  6-grain  doses  every  3  hours  (Parvin).  Digitalis,  very  useful, 
especially  when  from  heart  disease,  in  plethoric  subjects  (B.,  R.) ;  3j-jss  of  infu¬ 
sion  as  dose  will  arrest  menorrhagia  when  unconnected  with  any  disease  (P., 
R.).  Aloes,  debilitated  and  relaxed  subjects,  with  Iron  (B.).  Cimicifuga,  pas¬ 
sive,  coagulated  and  dark(P.)  ;  for  accompanying  headache  (R.).  Gallic  Acid, 
is  very  efficient  (R.).  Potassium  Chlorate  or  Bromide,  in  doses  of  gr.  xv  thrice 
daily,  combined  with  Ergot,  has  an  almost  infallible  influence  over  uterine 
hemorrhage,  unless  caused  by  cancer,  polypi,  adherent  placenta,  or  other  similar 
affections  (Tait).  Bromides,  usually  arrest  promptly  (B.).  That  of  potassium 
most  useful  in  young  women  if  loss  occurs  at  natural  period  only  ;  commence 
bromide  a  week  before  and  discontinue  when  discharge  ceases  till  a  week  before 
next  time.  If  loss  occurs  every  two  or  three  weeks  give  bromide  continuously, 
10-grain  doses,  but  more  when  organic  changes  in  womb  (R.,  Wa.).  Ammonium 
Chloride,  for  headaches  (R.).  Calcium  Phosphate,  in  anaemia  from  excessive 
menstruation  (R.).  Magnesium  Sulphate,  very  small  doses  with  a  little  dilute 
sulphuric  acid  and  syrup,  is  exceedingly  useful  (Wa.).  Oil  of  Cinnamon,  in 
drachm  doses  (R.).  Water,  hot-water  bag  to  lower  dorsal  and  lumbar  verte¬ 
brae  (R.) ;  cold  sitz-bath,  feet  in  warm  water,  especially  valuable.  6o°-65°  Fahr. 
for  5-15  minutes,  patient  then  quickly  dried  and  put  to  bed.  [Compare 
Metrorrhagia.] 


Prescriptions. 


R.  Ext.  Tpecac.  FI.,  .  .  . 

•  •  •  3'F 

R  .  Ext.  Ergots  (Squibb’s),  .  .  gr.  xij. 

Ext.  Ergotae  FI.,  .  .  . 

Ext.  Opii  Aquosi,  .  .  .  .  gr.  vj. 

Ext.  Digitalis  FI.,  .  . 

•  -  •  7>  ij- 

M.  et  div.  in  pil.  no.  xij. 

M.  Sig. — A  half  teasp. 

to  a  teasp.  as 

Sig. — One  pill  every  hour,  in  profuse 

required  until  emesis. 

(B.) 

menstruation  of  atonic  type. 

MENSTRUAL  DISORDERS - METRORRHAGIA. 


617 


Menstrual  Disorders. 

Aconite,  gtt.  j  every  half-hour  to  hour  promptly  restores  discharge  when 
sudden  suppression  from  chill  (P.,  B.,  R.,  Wa.) ;  as  emmenagogue  (Tr.).  Pul¬ 
satilla,  often  of  the  greatest  value  when  menses  scanty  or  delayed,  or  suppressed 
by  fright  or  chill  (P.,  B.).  Ignatia,  in  suppression  of  hysteria  (P.).  Savine,  a 
powerful  uterine  tonic  ;  as  emmenagogue  certain,  powerful,  safe  (P.).  Ferrum, 
in  anaemic  subjects  (B.).  Aloes,  as  emmenagogue  [vide  Amenorrhcea]  . 
Cocculus  Indicus,  for  irregular  menstruation  with  colicky  pains  and  scanty  dis¬ 
charge.  Should  be  given  for  a  few  days  prior  to  and  during  period  (P.) ;  TT\jj-iij 
of  a  saturated  tincture  thrice  daily.  Opium,  in  suppression  from  violent  mental 
emotions,  a  valuable  remedy  (Wa.).  In  many  menstrual  disorders  opium 
proves  invaluable,  but  must  be  cautiously  administered  lest  the  habit  be  formed. 
Cimicifuga,  relieves  heat  and  pains  in  the  head,  flushings  in  the  face,  pains  in 
back  and  limbs,  etc.,  when  occurring  as  the  result  of  menstrual  perversion 
(Wa.).  [Compare  Amenorrhcea,  Dysmenorrhcea,  Menorrhagia,  Climac¬ 
teric  Disorders.] 

Mentagra. 

Mercury,  the  oleate,  or  the  bichloride,  gr.  ij  to  3j  water,  applied  as  lotion  after 
each  epilation  (R.).  Citrine  oint.  extensively  employed  (Wa.).  Sulphurous 
Acid,  with  an  equal  part  of  glycerin,  is  an  efficient  application  (Jenner).  Arsenic 
has  a  more  or  less  powerful  influence,  used  internally  in  doses  of  \\v  of  liquor 
arsenicalis  thrice  daily  (Wa.)  ;  the  oleate  of  arsenic  is  an  efficient  local  applica¬ 
tion.  Sulphur  Iodide,  as  ointment  gj  to  Sjjss,  is  efficient,  with  Donovan’s  solu¬ 
tion  internally  (Sir  E.  Wjlson).  Copper  Sulphate,  as  lotion,  £j  to  5xvj  of  water, 
with  ^ss  of  zinc  sulphate,  and  3jss  of  aquae  laurocerasi  (B.). 

Metritis,  Acute. 

Opium,  locally,  in  suppositories  or  enema  is  more  effectual  than  if  admin¬ 
istered  internally  (Wa.).  Aconite,  is  invaluable  in  early  stage  of  simple  in¬ 
flammatory  fevers  (P.).  [Compare  Puerperal  Fever.]  Heat,  to  the  feetT 
and  by  large  poultice  to  the  abdomen.  Also  hot  water  vaginal  injection 
literally  for  hours,  if  possible ;  repeated  at  short  intervals,  from  a  Davidson 
syringe.  The  only  means  of  aborting  an  attack  of  cellulitis  (E.),  which  is  the 
condition  generally  present  in  cases  which  are  usually  supposed  to  be  ones  of 
acute  metritis  (Playfair).  Turpentine,  as  hot  epithems  ;  few  measures  are  more 
generally  serviceable  (Wa.).  Linseed  Poultices,  produce  great  relief  to  pain 
and  favorably  affect  the  course  of  the  disease  (Duncan).  Leeches,  to  the  hypo¬ 
gastric  region,  may  be  required  in  patients  of  full  habit.  [Compare  Puerperal 
Fever,  Puerperal  Metritis.] 

Metrorrhagia. 

Ipecacuanha,  possesses  considerable  energy  in  arresting  flooding  (P.) ;  in 
full  emetic  doses,  gr.  xx  in  evening,  followed  by  an  acidulated  draught  in  the 
morning  (Wa.).  Hamamelis,  when  persistent  oozing  (R.).  Ergot,  the  most 
valuable;  full  doses,  repeated  every  hour  or  so  (R.,  P.).  [See  Menorrhagia 
for  formula.  ]  Savine,  5  to  io-drop  doses  of  tincture  in  cold  water  every  yz  hour 
to  3  hours  (P.).  Iron,  styptic  preparations  as  injections  (B.).  |See  Hemor¬ 
rhage,  Post-Pa rtum.]  Opium,  has  specific  action  on  the  uterine  circulation 
(see  a7ite,  page  296),  and  should  be  given  freely  in  intractable  cases  of  metror¬ 
rhagia  from  uterine  fibroids  or  cancer,  in  which  the  establishment  of  the  opium- 
habit  is  often  advisable  (Lutaud).  Cannabis  Indica,  often  arrests,  especially  when 
at  climacteric;  tincture  gtt.  v-xx  ter  die  (P.) ;  has  had  extraordinary  success  in 
number  and  rapidity  of  cures  (Wa.).  Sulphuric  Acid,  sometimes  very  effective, 
especially  when  due  to  fibroid  or  polypus.  Ac.  sulph.  dil. ,  gtt.  v-xx,  well 
diluted  (13.)  ;  long  extensively  prescribed  (Wa.).  Cinnamon,  is  used  with  good 
effect  (P.) ;  has  a  specific  action  of  the  uterus  (T.).  Digitalis,  in  plethoric  sub- 


6 1 8 


MILIARY  FEVER - MUSCLE - MYELITIS. 


jects.  The  infusion  best,  a  tablesp.  bis  die  (B.,  P.) ;  the  effect  is  prompt  and 
decided  (\Va.).  Magnesium  Sulphate,  often  succeeds  (B.).  Senegin,  in  2-grain 
doses,  successfully  employed  (P.).  [Compare  Amenorrhcea.]  Ice,  to  abdo¬ 
men,  or  within  the  uterus  (B.) ;  ice  in  every  form  first  thing  to  try  (Wa.).  Rest, 
absolutely  necessary.  Dry  cupping  over  sacrum  is  found  useful  (R.).  [Com¬ 
pare  Menorrhagia,  Uterine  Tumors.] 


Prescription. 


R.  Ext.  Ergotse  FI., . ^ss. 

Ext.  Senec.  Aur.  FI.,  .  .  pt]. 
Ext.  Viburn.  Prunif.  FL,  .  %]. 

01.  Myristicae, . rr^xx. 

Syr.  Simplicis,  .  .  .  ad  j. 


M.  Sig. — A  dessertsp.  every  %  hour 
until  relieved,  then  reduce  dose.  Keep 
the  head  low,  and  apply  cold  over  hypo- 
gastrium. 


Miliary  Fever. 

Aconite,  for  the  hyperpyrexia  (R.,  P.).  Cooling  Drinks,  purgatives  and  anti- 
phlogistics,  in  mild  cases  ;  malignant  ones  sometimes  occur,  and  are  dangerous 
(A.).  Lime-water  applied  by  sponging,  is  very  useful;  or  a  lotion  of  zinc 
oxide  suspended  in  lime-water,  gr.  xl  to  gj,  painted  on  the  affected  parts  of  the 
skin,  and  permitted  to  dry  thereon  (E.  Wilson). 

Muscse  Volitantes. 

Potassium  Iodide,  very  effectual  in  curing  muscae  depending  upon  hepatic 
derangement  (Wa.).  Valerian,  often  found  curative  (Wa.).  Muscae  Volitantes 
are  due  to  shadows  cast  on  the  retina  by  fibrillae  floating  in  the  vitreous  body, 
and  are  most  visible  to  myopic  persons.  They  do  not  merit  attention  unless 
very  abundant,  or  steadily  increasing  (C.).  Rest  of  the  eye  necessary.  Neu¬ 
tral-tint  glasses  may  be  worn  to  render  the  muscae  less  visible,  if  troublesome. 

Myalgia. 

Arnica,  the  best  agent  for  contused  muscular  fibre ;  also  for  shake,  concus¬ 
sion,  shock,  npv-x  every  2  or  3  hours  in  water  (P.)  ;  a  few  drops  of  tincture 
internally  removes  stiffness,  after  packing  with  cold,  wet  sheet  (R.).  Cimici- 
fuga,  often  succeeds  wonderfully,  as  often  fails  ;  no  indications  for  its  use  (B.) ; 
general  bruised  sensation  (R.).  Ammonium  Chloride,  in  10  to  20-grain  doses, 
the  most  efficient  remedy  (Anstie) ;  is  effective  (R.).  Veratrine,  the  ointment 
externally  may  control  (B.).  Belladonna,  as  liniment,  is  often  successful  (R.). 
Gelsemium,  frequently  cures  but  large  doses  are  necessary,  rrbv-xx  of  the  fluid 
extract  every  3  hours  (B.).  Coca,  to  relieve  the  sense  of  fatigue  (P.).  Opium, 
by  frictions  or  poultices  (R.).  Iodine,  ointment  for  pain  and  tender  muscles  of 
the  chest,  when  skin  may  be  pinched  without  pain  (R.).  Ammonium  Muriate, 
is  very  efficient.  (See  Lumbago.)  Xanthoxylum,  externally  and  internally, 
has  a  deserved  reputation  (B.).  Chloroform  Liniment,  with  friction,  often  affords 
great  relief  (Wa.).  Firing,  sometimes  very  beneficial  (B.).  Packing,  with 
dripping  wet  sheet  (R.).  Counter-irritation,  by  firing,  aquapuncture,  acupunc¬ 
ture  (B.).  Electricity,  the  constant  current  (B.).  Baths,  Turkish,  in  aching 
muscles,  from  over-exertion  (R.).  Poultices,  very  hot,  followed  by  applications 
of  lint  and  oilskin  (R.).  Rest,  is  the  remedy  of  course  (Wa.).  Rest  and  support 
to  weak  muscles  important  till  they  regain  their  tone  ;  especially  in  painful 
muscular  affections  following  prolonged  or  excessive  exertion,  or  in  the  sore¬ 
ness  or  stiffness  which  occur  during  convalescence  from  any  long  illness,  or 
accompanying  general  debility.  These  are  generally  better  after  repose,  but 
increase  with  fatigue.  [Compare  Pleurodynia,  Lumbago.] 

Myelitis. 

Belladonna,  is  decidedly  effective,  especially  when  brought  on  by  external 
violence  (P.).  Ergot,  most  successful ;  large  doses  are  necessary  (B.).  Elec¬ 
tricity,  in  chronic,  not  in  recent  form  (B.).  Silver  Nitrate,  in  chronic  inflam- 


MYOPIA - Ni'EVUS — NAILS - NASAL  AFFECTIONS. 


619 

mations  of  the  cord,  one  of  the  few  remedies  which  are  ever  of  service  ;  gr. 

(W.).  Phosphorus,  of  marked  benefit  in  myelitic  paraplegia  from 
excessive  venery  (W.).  Water-cure,  ice-bag  to  spine,  feet  in  hot-water ;  or 
better,  hot  douche  to  spine  (B.).  Cold,  externally,  by  ice-bags,  along  the  spine, 
with  cupping  or  leeching  if  much  localized  pain  or  tenderness  ;  spoon  diet 
and  a  sparing  amount  of  stimulants,  also  copious  warm  enemata  to  relieve  the 
bowels  and  act  as  derivatives.  Little,  if  anything,  is  to  be  done  with  mere 
drugs.  Posture  should  be  prone,  or  on  side  ;  absolute  rest  (Bastian).  [Com¬ 
pare  Meningitis,  Spinal.] 


Myopia. 

Atropine,  by  daily  instillation,  systematically,  for  the  purpose  of  sacrificing 
either  the  convergence  or  the  accommodation,  in  cases  where  failure  of  the 
internal  recti  occurs,  the  disability  assuming  the  form  of  muscular  asthenopia 
(C.).  Glasses,  properly  adjusted,  should  be  worn  from  the  commencement. 


Naevus. 

Ferrum  Perchloride,  injected,  is  effectual;  but  dangerous  when  applied  thus 
to  naevi  about  the  head  (Wa.).  Creasote,  pencilled  over  twice  a  day,  may  re¬ 
move  naevi  (Wa.).  Chromic  Acid,  as  escharotic,  or  local  application,  gr.  c  ad 
3j  aquae  destil.  (B.).  Electrolysis,  or  galvano-cautery,  to  remove  naevi  (B.). 
Nitric  Acid,  strong,  as  eschaiotic  for  small  superficial  naevi,  followed  by  ol. 
olivae  (B.).  Zinc  Chloride,  Iodide  and  Nitrate,  locally,  especially  the  first 
named  (R.).  Setons,  threads  passed  across  the  growth  in  various  directions,  to 
produce  suppuration  ;  when  pus  appears  the  threads  should  be  removed.  So¬ 
dium  Ethylate,  prepared  by  adding  the  metal  sodium,  piece  by  piece,  to  abso¬ 
lute  alcohol  in  a  wide-mouthed  bottle  ;  the  crystalline  substance  found  deposited 
after  effervescence  ceases  is  an  excellent  caustic  for  naevi ;  painted  over  them  it 
causes  a  rapid  eschar,  and  usually  gives  but  little  pain  (Richardson).  Mercury, 
the  Acid  Nitrate  an  excellent  caustic  for  removing  moles  from  the  face  (Thomas). 


Nails,  Ingrowing. 

Liquor  Potassae,  a  solution  (3ij~Sj)  on  cotton-wool  in  ingrowing  toenail,  to 
margin  of  nail  at  ulcerated  surface,  to  soften  the  nail  (B.).  Glycerin,  or  Silver 
Nitrate,  on  a  fold  of  lint,  to  the  ulcerated  surface  (C.).  Lead  Carbonate,  a 
piece  softened  between  the  fingers,  and  applied  as  plaster  beneath  the  fungous 
cushion,  cures  in  a  few  days  (Tr.).  Paring  the  nail,  after  softening  in  warm 
water,  and  cutting  a  V-shaped  incision  in  centre  of  nail ;  the  ingrowing  portion 
should  not  be  cut. 


Nasal  Affections. 

Ammonia,  by  inhalation,  in  pain  and  inflammations  of  nose  and  frontal  bones 
(R.).  Potassium  Iodide,  large  doses  (gr.  xxx-lxxv  daily),  valuable  in  syphilitic 
affections  of  the  nose  (Wa.).  Glycerite  of  Tannin,  to  excoriations  of  inside  of 
nose,  after  measles,  scarlatina,  etc.  Also  for  impetiginous  eruptions  of  inside, 
most  severe  where  hair  grows,  epilation  sometimes  needful.  Also  in  discharge 
of  greenish,  black,  stinking  mucus  (R.).  Glycerin  of  Starch,  or  Zinc  Ointment, 
applied  often,  a  good  supplementary  application  (R.).  Hydrastis,  in  chronic 
catarrhal  conditions  and  nasal  ulcers,  used  internally  and  externally,  with  great 
benefit  (P.).  Pulsatilla,  may  be  employed  both  internally  and  externally  in 
nasal  inflammations  (P.),  and  in  acute  inflammation  of  nose  (B.).  Cod-liver 
Oil  for  chronic  discharge  (R.).  Injections,  by  nasal  douche,  are  used  with 
benefit  in  catarrhal  states  (Wa.).  Zinc  Chloride,  gr.  ij  to  the  3,  or  the  Sulpho- 
carbolate,  gr.  v  to  the  3,  as  solutions  locally  by  cotton-wrapped  probe  to  dimin¬ 
ish  sensibility  of  the  nasal  mucous  membrane  (Sajous).  Cocaine,  has  many 
applications  in  treatment  of  nasal  affections;  a  4  per  cent,  solution  by  mop  or 


620 


NAUSEA - NECROSIS - NERVOUS  AFFECTIONS. 


spray  will  empty  the  engorged  venous  sinuses,  and  is  very  useful  in  acute 
catarrh,  hay  fever,  etc.,  also  in  posterior  and  anterior  rhinoscopy  (R.).  [Com¬ 
pare  Acne,  Catarrh,  Epistaxis,  Hay  Fever,  Influenza,  Oz^na,  Polypus, 
Sneezing.] 


Nausea. 

Ipecacuanha,  has  no  rival  in  sickness  of  pregnancy,  scarcely  less  useful  in 
that  of  chronic  alcoholism.  Very  small  doses,  gr.  g1^  equals  n\j  of  wine  (P.). 
Pulsatilla,  in  dyspeptic  nausea,  with  coated  tongue,  flatulence,  sick-headache, 
(P.).  Cocculus  Indicus,  in  cephalic  nausea,  violent  but  ineffectual  efforts  at 
vomiting  (P.).  Calumba,  in  nausea  of  languid  stomach  with  flatulence,  has 
considerable  reputation  (P.).  Cinnamon  or  Cloves,  will  check  nausea  (P.). 
Nutmeg,  the  simple  powder  in  wine  (P.).  Pimenta,  Pepper,  Peppermint,  relieve 
(P.).  Tartaric  Acid,  as  effervescing  draught,  with  a  few  drops  of  tinct.  opii, 
tinct.  calumbse,  or  hydrocyanic  acid  added,  when  from  morbid  gastric  irritation 
(Wa.).  Cold  Compress  or  Ice-bag,  over  the  stomach  very  useful.  Bismuth  Sub¬ 
nitrate,  or  the  Liquor  Bismuthi,  when  the  salt  in  substance  disagrees,  is  a  rem¬ 
edy  of  established  value  in  nausea  and  vomiting  arising  from  gastric  disorders  ; 
may  be  combined  with  Hydrocyanic  Acid  (Wa.).  [Compare  Vomiting,  Vom¬ 
iting  of  Pregnancy,  Seasickness.] 

Necrosis. 

Sarsaparilla,  a  very  useful  medicine  in  diseases  of  the  bones  (P.).  Rest,  in 
a  “Salter’s  swing,”  with  poultices,  water-dressing,  or  stimulating  lotions,  to  aid 
work  of  repair  (Cl.,  Hilton).  Tonics,  nutritious  food,  baths,  good  hygiene,  all 
are  necessary  adjuncts  to  local  treatment  (Andrews).  Acid  Solutions,  of  no  use 
as  solvents,  may  be  employed  with  benefit  for  detergent  and  alterative  effects 
to  expedite  the  sloughing  and  restorative  processes  (Gross).  Operation  to  re¬ 
move  sequestrum  is  generally  necessary;  or  resection  of  the  devitalized  bone, 
the  latter  in  young  subjects  greatly  exhausted,  where  delay  would  endanger  life. 
(Gross).  Potassa  cum  Calce  introduced  into  fistulas,  to  convert  them  into  large 
openings,  permitting  the  removal  of  diseased  bone  (Kirkpatrick).  [Compare 
Caries,  Bone  Diseases,  Syphilis,  Scrofulosis.] 

Nervous  Affections. 

Arsenic,  of  especial  value  in  nervous  affections  resulting  from  malaria,  in 
which  large  doses  are  required  ;  v^x  of  Liq.  Arsenicalis,  increased  to  rt\,xxx 
thrice  daily  (Wa.).  Asafcetida,  is  a  remedy  of  much  value  in  nervous  affec¬ 
tions  connected  with  uterine  derangement,  also  in  dyspeptic  hypochondriasis 
and  other  nervous  affections ;  may  be  combined  with  bitter  tonics  and  mild 
aperients  (Wa.).  Potassium  Bromide,  takes  precedence  in  epilepsy,  epilep¬ 
tiform  convulsions,  hysterical  convulsions  and  spasms,  tetanus,  etc.,  is  of 
great  value  in  chorea,  insanity,  acute  mania,  insomnia,  delirium  tremens,  some 
forms  of  neuralgia,  and  the  numerous  symptoms  of  vaso-motor  disturbance, 
such  as — numbness,  coldness,  deadness,  pricking  sensations,  indefinable  but 
distressing  sensations  in  abdomen,  hypogastrium  or  epigastrium ;  feelings 
similar  to  rigors,  with  anxiety,  palpitation  or  fluttering  of  the  heart, — all  due 
to  interference  with  the  local  circulation  (Reynolds).  Valerian  and  Valerian¬ 
ates,  are  thought  to  exercise  some  special  influence  over  nervous  affections, 
especially  the  Valerianate  of  Zinc,  in  half-grain  to  grain  doses  in  pill,  or  the 
Ammoniated  Tincture  of  Valerian,  from  which  every  good  that  can  be  expected 
from  the  valerianates  will  be  more  certainly  obtained  (Wa.).  Sumbul,  acts  as 
a  nervous  stimulant,  and  is  especially  efficacious  in  neurotic  migraine,  also  in 
hysteria  and  the  obscure  paralytic  affections  associated  therewith  (Wa.).  Caf¬ 
feine,  is  of  signal  value  in  neuralgia,  hemicrania  and  other  nervous  affections 
(Shaffer);  grain -doses  in  solution  hypodermically,  afford  great  relief  in 
dorso-intercostal  neuralgia  attending  shingles,  insomnia,  etc.  (Anstie).  Cocaine 


NERVOUS  EXHAUSTION - NERVOUSNESS. 


621 


is  a  powerful  nerve  stimulant,  destroying  the  sense  of  fatigue,  and  often 
evincing  marked  analgesic  power  in  neuralgias.  Is  effective  in  melancholia, 
hypochondriasis,  etc.,  as  well  as  locally  in  nerve  pain  over  a  limited  area.  It 
acts  as  an  excitant  upon  the  central  nervous  system  (R.)  Opium,  is  a  remedy 
of  marked  value  in  insanity,  melancholia,  mania,  and  all  nervous  affections 
accompanied  by  pain  (Wa.) ;  gives  general  repose  to  both  body  and  mind,  is 
of  decided  value  in  diabetes,  and  produces  marked  improvement  in  melan¬ 
cholia  and  despondency  (R.).  Lupulin,  is  peculiarly  useful  in  nervous  affec¬ 
tions  when  Opium  cannot  be  tolerated,  especially  in  chronic  hysteria  attended 
with  morbid  vigilance,  10-grain  doses  every  6  hours  afford  great  relief,  without 
causing  any  unpleasant  symptoms  (Eberle).  Santonin,  in  convulsions,  epilepti¬ 
form  seizures,  and  affections  regarded  as  choreic,  etc.,  the  result  of  reflex  irrita¬ 
tion  from  worms  (Wa.).  Phosphorus,  of  occasional  utility  in  affections  of  the 
nervous  system  induced  by  mental  exertion  or  over-excitement.  Danger  from 
its  use  is  its  liability  to  produce  fatty  degeneration  of  the  internal  organs  (Wa.). 
Phosphate  of  Silver  is  regarded  as  of  special  value  in  myelitis  with  disturbance 
of  bladder  and  rectum,  and  in  sclerosis  of  the  nervous  substance  (Wa.). 
Nitrate  of  Silver,  the  only  remedy  which  has  done  good  in  progressive  locomo¬ 
tor  ataxia ;  gr.  two  or  three  times  daily,  with  Hypophosphite  of  Sodium, 
both  to  be  discontinued  when  blue  line  appears  on  gums  (Althaus).  Cold 
Shower  Baths,  are  often  beneficial  in  nervous  diseases  unconnected  with  disease 
of  the  brain.  [Compare  Hysteria,  Melancholia,  Mania,  Diabetes,  Loco¬ 
motor  Ataxia,  Hemicrania,  Neuralgia,  Nervousness,  Insomnia,  Hemi¬ 
plegia,  Paralysis,  Spinal  Paralysis,  etc.] 


Nervous  Exhaustion. 


Ammonia,  the  Aromatic  Spirit  proves  very  serviceable;  Sss-j  in  water 
thrice  daily  (Wa.).  Hypophosphites  of  lime  or  sodium,  or  iron,  are  actively 
tonic  in  cases  of  nervous  depression  and  torpor,  with  occasional  shooting 
pains  (Wa.).  Strychnine  Acetate,  a  remedv  of  great  promise,  when  com¬ 
bined  with  a  rigid  system  of  diet,  mental  discipline,  etc.  (Marshall  Hall). 
Oxide  of  Zinc,  often  excellent  as  a  tonic  and  sedative,  in  nervous  irritability 
and  depression  from  anxiety,  over-study,  etc.,  (Wa.).  Phosphorus,  of  occasional 
utility  in  nervous  breakdown  from  over-study,  etc.,  (Wa!).  Caffeine,  gr.  j  or 
more  in  a  cup  of  coffee,  to  relieve  brain  weariness  and  nervous  exhaustion 
(Wa.).  Cocaine,  in  l/z  -grain  doses  proves  serviceable  in  nervous  exhaustion 
(R.). 


Prescriptions. 


R  .  Strychninae  Acetatis,  .  .  .  gr.  j. 

Ac.  Acetici  Diluti,  ....  rrpxx. 

Alcohol  is, . spj. 

Aquae  destill., . ^vj. 

M.  Sig. — Ten  drops  thrice  daily. 

(. Marshall  Hall.) 


R.  Ac.  Phosphorici  Dil . ,  .  .  .  £j. 
Elixir  Calisayae  (U.  S.  Disp.),  3  vj. 
Elix.  Ammonii  Valerian,  .  .  f^ij. 

Glycerini, . J  iij. 

Vini  Xerici,  .  .  .  .  q.  s.  ad  Oj. 
M.  Sig. —  Jj  thrice  daily. 


Nervousness. 

Aconite,  gtt.  j  of  tinct.  at  bedtime,  repeated  if  needful,  for  restlessness  and 
fidgets  ”  of  men  as  well  as  women  (R.).  Ignatia,  in  small  doses  better  than 
morphine  for  mental  excitement  and  nervous  erethism  (P.) ;  for  the  nervous 
exaltation  of  cinchonism  (Pf.).  Caffeine,  for  restlessness  due  to  great  lowering 
of  nervous  power  (P.).  Chamomile,  lowers  reflex  excitability  (P) ;  minim  doses 
of  the  tincture  every  15  minutes  an  excellent  sedative  for  children  (A.  A. 
Smith).  Potassium  Bromide,  especially  for  women  who  are  despondent,  irrita¬ 
ble,  and  sleepless,  from  overwork,  grief,  worry,  etc. ;  often  connected  with 
migraine  (R.) ;  gr.  ss-j  of  any  bromide  every  34! -hour,  is  very  efficient  for  the 
nervous  disturbances  of  children  (A.  A.  Smith).  Conium,  where  a  great  deal 
•of  motor  agitation,  especially  in  the  typhoid-like  condition  often  resulting  from 


622 


NEURALGIA. 


mental  overwork,  with  insomnia,  exaggerated  nervousness  and  delirium, — it 
acts  charmingly  in  securing  sleep,  by  removing  the  motor  agitation  ;  rrpx  of  a 
fluid  extract  of  the  unripe  fruit,  every  y2  hour,  carefully  watched  (Madigan). 
Strychnine,  affords  relief  in  functional  irritability  of  the  nervous  system,  mani¬ 
fested  by  restlessness  and  wandering  neuralgic  pains  (B.) ;  especially  useful  as 
a  tonic  in  nervousness  from  over-use  of  tobacco  (H.).  Valerian,  extremely 
useful  as  a  sedative  to  reflex  excitability,  calms  nervousness,  does  much  good 
in  fevers  where  restlessness,  fidgets,  anxiety,  etc.  (P.).  Musk,  serviceable  in 
nervous  affections  when  from  uterine  derangement  (Wa.).  Opium,  calms  the 
nervous  system  and  gives  general  repose  to  both  body  and  mind  (R.).  Sumbul, 
often  invaluable  in  restlessness  of  pregnancy ;  rrpxxx-xl  0f  tinct.  with  a  little 
Chloric  Ether  as  draught  (P.).  Camphor,  a  powerful  subduer  of  reflex  excita¬ 
bility  (P.).  Chloral,  where  restlessness,  debility  (R.).  Chloroform,  the  spirit 
of  chloroform  internally  (R.).  Hops,  the  hop-pillow  is  deserving  of  trial.  Lu- 
pulin,  peculiarly  useful  when  opium  cannot  be  tolerated  (Wa.).  Water,  warm 
sponging  to  induce  sleep  and  calm  restlessness  in  convalescence.  Also,  cold 
sponging  (R.).  [Compare  Insomnia,  Irritability.] 


Prescriptions. 


R.  Strychninse  Sulphatis,  .  .  gr.j. 
Quinine  Sulphatis,  .  .  .  gj. 

Tinct.  Ferri  Chloridi,  .  .  .  ^v. 

Ac.  Phosphor.  Dil., 

Syrupi  Limonis,  .  .  .  .  aa  ^ij. 

M.  Sig. — A  teasp.  in  water  thrice  daily. 

(M.) 


R.  Potassii  Bromidi,  .  .  .  .  ^j. 

Ext.  Guaranoe  FI.,  ....  Ajss. 

Syr.  Tolutani, . ^iij. 

Aquae, . q.  s.  ad  %  vj. 

M.  Sig. — Teasp.  to  a  dessertsp.  three  or 
four  times  daily.  To  relieve  nervousness. 


Neuralgia. 

Phenacetine,  Antipyrine  and  Acetanilide,  are  giving  great  satisfaction  in 
many  forms.  Of  the  three,  Phenacetine  in  io-grain  doses,  is  the  safest  and 
most  efficient.  Morphine,  hypoder.  in  the  neighborhood  of  the  affected  nerve, 
the  best  treatment.  Caution  ;  morphine-habit  (B.) ;  gr.  y1^  to  y  often  relieves 
and  frequently  cures  after  a  few  repetitions  (P.).  No  remedy  promises  more 
speedy  and  permanent  relief  than  morphine  by  subcutaneous  injection  in 
sciatica,  lumbago,  tic  douloureux  and  other  neuralgic  affections  (Wa.).  Aconite, 
when  arterial  excitement  (B.) ;  in  congestive  neuralgias,  and  acrodynic,  at 
extremities  ;  has  important,  role  (P.) ;  as  ointment  or  liniment,  especially  when 
fifth  nerve  affected  ;  also  in  neuralgic  headache  (R.).  A  remedy  of  great  value 
(Wa.) ;  a  perfect  physiological  remedy  against  neuralgia,  especially  those  forms 
which  are  based  on  congestive  or  sub-inflammatory  affections  ;  but  its  action  is 
often  slow,  so  that  Morphine  must  be  given  with  it  as  a  palliative.  Aconitine, 
with  Veratrine  as  an  ointment  locally,  a  good  application  (Da  Costa)  ;  inter¬ 
nally  the  best  agent  of  all  in  essential  neuralgia;  should  be  combined  with 
quinine  in  intermittent  forms  and  those  which  resist  quinine  alone.  (See 
formula  below).  Belladonna,  must  be  persisted  in  with  full  doses  ;  gr.  of  atro¬ 
pine,  or  gr.  to  hypodermically,  in  vicinity  of  nerve,  has  special  utility  in 
tic  douloureux  and  sciatica;  also  in  peri-uterine  and  dysmenorrhceal  neuralgias 
(B.).  n\j  of  solution  of  gr.  j-Sij  of  water  hypodermically  (P.).  Spinal  irrita¬ 
tion,  intercostal  neuralgia.  The  liniment  or  ointment  of  atropine  in  facial  (R.). 
Gr.  0.15  of  the  extract  every  hour  till  giddiness,  then  lessen  doses.  Continue 
for  several  days  (Tr.).  Veratrum  Viride,  tincture,  said  to  be  very  useful  (R.). 
Veratrine,  ointment  for  facial  and  sciatica  (R.).  Oint.  (gr.  viij-Jj)  frequently 
of  much  benefit  (P.).  Nux  Vomica,  is  most  useful  in  visceral  neuralgiae,  as 
gastralgia,  hepatalgia,  etc.,  the  tincture  with  carminatives  in  the  former  affec¬ 
tion  ;  or  strychnine,  gr.  y^y  to  twice  or  thrice  daily.  In  all  forms  of  neu¬ 
ralgia  this  remedy  should  be  used  in  small  doses  (P.).  Arsenic,  cures  by  its 
influence  on  bodily  nutrition ;  directly  so  in  neuralgias  of  malarial  origin, 
though  inferior  to  quinine  (B.)  In  various  neuralgias,  also  in  angina  pectoris 
(R.).  Phosphorus,  gr.  y1^  every  few  hours,  has  made  very  effective  cures  (B.). 


NEURALGIA. 


623 


Gr.  x^o  t°  tV  every  3  hours.  Very  useful  in  all  forms,  especially  when  uncom¬ 
plicated  (R.) ;  always  a  good  remedy  except  for  cases  due  to  cold  or  inflamma¬ 
tion,  and  those  not  depending  on  depraved  nutrition  (H.).  Quinine,  large 
doses  (gr.  v-xx,  in  sherry),  just  before  attack  in  periodical  neuralgia,  whether 
malarial  or  not.  Useful  also  in  small,  frequently  repeated  doses  in  other  types, 
especially  of  supra-orbital  nerve  (P.) ;  has  selective  action  upon  supra-orbital 
form  (Spender).  Salicylates  in  large  doses  cured  a  case  of  tic  doul.  of  12  years’ 
standing  (Dercum).  Sumbul,  for  certain  types,  of  more  value  than  any  other 
remedy.  Facial,  sciatic,  or  ovarian,  in  women  of  nervous  constitution,  often 
yield  to  it  at  once  (P.).  Cimicifuga,  in  neuralgia  of  the  5th  from  cold,  and  in 
ovarian  neuralgia  (B.)  Gelsemium,  successful  in  neuralgia  of  5th  (B.)  ;  espe¬ 
cially  dental  branches  (R.) ;  of  value  in  trigeminal,  ovarian,  etc.  (W.)  ;  in  suita¬ 
ble  cases  small  doses  answer  as  well  if  not  better  than  large  ones  (Pf.) ;  rtpfij  of 
the  tincture  every  hour  often  succeed  miraculously  with  no  ill  results  in  neu¬ 
ralgias  about  the  head  and  face  (A.  A.  Smith) ;  no  better  remedy  in  tic  doulou¬ 
reux,  but  must  be  given  in  large  doses,  rrpx-xv  of  a  strong  tincture  or  fluid 
extract  (H.).  Zinc  Valerianate,  extremely  beneficial  in  neuralgia  from  reflex 
irritation  of  female  pelvic  organs  (B.).  Spigelia  Anthelmia,  useful  in  facial  (P.). 
Ammonium  Valerianate,  or  Zinc  Val.  in  neuralgia  of  face  or  head  (R.);  the 
latter  in  nervous  cases,  and  uterine  (Wa.).  Chamomile,  in  neuralgia  of  5th 
nerve  (R.)*  Staphisagria,  internally  and  externally  often  curative  in  obstinate 
facial  and  cervical  neuralgia  (P.).  Ignatia,  in  hysterical  and  intercostal  neu¬ 
ralgia,  with  nervous  erethism,  is  valuable  (P.).  Ergot,  much  employed  in 
visceral  forms,  especially  gastralgia  (P.) ;  said  to  be  useful  (R.).  Ammoniated 
Copper,  in  neuralgia  of  the  5th,  lately  used  by  Fereol  with  remarkable  success; 
Yz  -grain  doses  pushed.  Eserine,  very  efficient  in  neuralgia  of  the  eye-ball,  a 
solution  of  gr.  ij  to  the  3  by  instillation.  Cannabis  Indica,  %-%  gr.  doses  of 
extract  2  or  3  times  a  day  ;  especially  for  neuralgic  headache  (P.) ;  found  useful 
(R.).  Cod-Liver  Oil,  when  low  nutrition,  faulty  assimilation  (W.).  Iron,  when 
from  anaemia.  Tincture  of  chloride  (np  xxx-xl  ter  die),  also  chalybeate  waters 
(B.).  Moderate  doses  only  required  (R.).  In  chlorotic  subjects,  of  whom 
nearly  all  will  have  neuralgia  (Tr.).  Iodides,  for  neuralgia  of  fifth,  dependent 
on  syphiloma  of  the  nervous  system,  pain  nocturnal  chiefly  (B.).  Bromides, 
benefit  some  kinds,  especially  ovarian  (B.);  potassium  bromide  occasionally 
relieves  (R.).  Ammonium  Chloride,  half-drachm  doses  in  facial  and  other 
neuralgias,  is  much  used  (R.) ;  a  very  efficient  and  diffusible  stimulant,  gr.  xx 
-3j  at  first,  repeated  every  hour  during  the  attack  (H.).  Chloroform,  as  anaes¬ 
thetic  to  relieve  pain,  is  occasionally  useful  locally,  also  as  spray  for  uterine 
neuralgia  (R.) ;  by  deep  injection  into  vicinity  of  affected  nerve  rtp  v-xv  of  pure 
chloroform,  a  very  efficient  method  of  dealing  with  long-standing  cases  (B.) ; 
used  in  one  case  it  caused  symptoms  so  severe  as  to  imperil  the  life  of  the 
patient  (W.).  Theine,  hypodermically,  is  promptly  analgesic,  and  has  pro¬ 
longed  influence,  but  must  be  aided  by  remedies  to  improve  the  nutritive  state  of 
the  affected  nerves,  or  which  are  capable  of  removing  the  diathesis  upon  which 
the  neuralgise  depend  (Mays).  See  Formula  below.  Caffeine,  hypodermically 
has  been  found  useful,  especially  in  cervico-brachial  neuralgia  (P.).  Cocaine, 
as  a  hypodermic  injection,  a  4  or  5  per  cent,  solution  is  very  effective  if  admin¬ 
istered  in  the  vicinity  of  the  aching  nerve  (R.) ;  also  by  instillation  in  neuralgia 
of  the  eyeball,  and  whenever  it  can  be  applied  to  the  mucous  surface  in  the 
vicinity  of  the  pain.  Croton  Chloral,  very  effective,  especially  in  tic  douloureux 
and  sciatica,  gr.  ij-v  every  hour  till  gr.  xv  are  taken  (B.)  ;  in  facial,  that  from 
carious  teeth,  that  of  neck  and  back  of  head,  tic  douloureux,  etc.  (R.).  Gr.  j 
every  y  hour  is  a  very  efficient  dose  (A.  A.  Smith) ;  rarely  of  any  value,  but 
when  used  is  best  given  in  20-grain  doses  twice  daily  (FI.).  Chloral  and  Cam¬ 
phor,  parts  tequales,  triturated  together,  and  painted  over  surface  (B.,  R.) ; 
also  with  morphine  (B.).  Aquapuncture,  strangely  relieves  pain  in  a  superfi¬ 
cial  nerve,  so  much  so,  that  some  hold  the  curative  effects  of  morphine  injection 
to  be  due  to  the  water  (B.).  Counter-irritation.  Mustard  poultices  in  neuralgic 
pains  (P.).  Blisters  to  a  posterior  branch  of  the  spinal  nerve-trunk  from  which 
painful  nerve  issues  (Anstie).  Amyl  Nitrite,  inhaled  in  dysmenorrhoeal  neu- 


624 


NEURALGIA. 


ralgia  (B.) ;  and  when  of  5th  nerve  (R.)  Nitro-glycerin,  has  often  afforded  great 
relief  (Wa.).  Carbonic  Acid  Gas,  injected  into  vagina  for  neuralgia  of  uterus 
(R.).  Digitalis,  is  strongly  recommended  in  sciatica,  also  locally  in  earache 
(P.).  Valerian,  serviceable  in  facial  neuralgia  of  hysterical  type  *(P.).  Bibiru 
Bark,  in  intermittent  forms  (P.).  Pyrethrum,  root,  is  chewed  with  benefit  in 
facial  neuralgia  (P.).  Capsicum,  a  strong  infusion  on  lint  covered  with  gutta¬ 
percha  (R.).  Coccus  Cacti,  has  been  very  successful  in  20-30  minim  doses  of  a 
th  tincture  twice  daily,  the  larger  dose  in  the  paroxysm  (W.).  Peppermint,  Oil 
of,  painted  over  the  part  in  facial  neuralgia  (R.);  especially  the  Chinese  oil, 
which  contains  a  large  excess  of  Menthol,  a  very  useful  application  in  superfi¬ 
cial  neuralgiae  (W.).  Turpentine,  has  cured  tic  douloureux  and  sciatica  (B.)  ; 
often  of  wonderful  service  (P.).  Potassium  Chlorate,  for  facial  neuralgia  (B.). 
Alcohol,  with  much  volatile  ether;  care  must  be  taken  in  prescribing  it  (R.). 
Piscidia,  almost  specific  in  many  forms,  useless  in  many  cases  (W.)  Tonga, 
is  efficient  in  facial  neuralgia,  rrpx-xx  every  two  hours  (H.).  Osmic  Acid,  a  one 
per  cent,  aqueous  solution  with  glycerin  to  prevent  change,  of  which  5  to  10 
drops  hypodermically,  has  made  striking  cures  of  inveterate  neuralgiae,  with 
no  ill  effects  resulting  (Shapiro).  Wet  Pack,  is  of  great  benefit,  especially  in 
sciatica.  Intense  Cold,  produced  by  a  spray  of  Chloride  of  Methyl, or  concentrated 
carbonic  acid  gas,  directed  along  the  nerve  from  special  apparatus,  immediately 
relieves  the  pain,  and  usually  cures  (Jacoby).  Compressed  Air,  by  insufflation 
into  the  middle  ear,  in  cases  of  persistent  and  paroxysmal  temporo-occipital 
neuralgia,  due  to  chronic  follicular  pharyngitis  and  inflammation  of  middle 
ear  (Legal’s  Disease).  If  these  insufflations  result  in  diminution  of  the  pain, 
treatment  should  be  directed  to  the  naso-pharynx  and  Eustachian  tubes 
(Masucci).  Galvanism  of  the  affected  nerve,  one  of  the  most  important  cura¬ 
tive  measures ;  a  continuous  current  of  4  to  8  cells  down  the  nerve  generally 
answers  best,  though  some  cases  are  helped  more  by  a  rapidly  interrupted 
faradic  current.  Electricity  is  of  no  value  in  cases  dependent  upon  organic 
lesions,  and  in  any  individual  case  is  purely  experimental  (W.).  Diet.  Animal 
fats  necessary,  as  cod-liver  oil,  butter,  cream,  etc.,  in  as  large  quantity  as  can 
be  digested.  Rest  often  needed,  with  protection  from  cold  and  damp,  flannel 
clothing,  bathing  and  shampooing.  [Compare  Gastralgia,  Hepatalgia, 
Sciatica,  Tic  Douloureux,  Hemicrania,  etc.] 


Prescriptions. 


Local  Use. 

R.  Chloroformi, 

Tinct.  Aconiti,  .  .  .  aa  3SS. 

Linim.  Saponis, . 3 j. 

M.  Sig. — Apply  on  flannel  and  cover 
with  oiled  silk  for  superficial  neuralgia. 


Internal  Use. 

R .  Phosphori, . gr.  ss-jss. 

Alcoholis,  q.  s.  ad  solv. 

Spt.  Menthae  Piperitae,  q.  s. 
Glycerini,  .  .  .  .  q.  s.  ad  ^  iv. 

M.  Sig. — A  teasp.  after  each  meal. 

(H.) 


R.  Aconitinae  (Duquesnel),  .  gr.  iv. 

Veratrinae, . gr.  xv. 

Glycerini,  ....  ,  .  3  ij. 

Cerati, . 3  vj. 

M.  Sig. — To  be  rubbed  over  the  part, 
avoiding  any  abraded  surface  carefully. 

(Da  Costa.) 


R  .  Cupri  Ammonio-sulphat.,  .  gr.  j-iv. 
Syr.  Aurantii  Flor.,  .  .  .  gj. 

Aquae  Destil., . 3  iij 

M.  Sig. — One-third  as  a  dose,  thrice 
daily.  ( Prof.  Fereol.) 


R .  Mentholi, . gr.  xlv. 

Cocainae, . gr.  xv. 

Chloralis, . gr.  x. 

Vaselini, . 3  v. 

M.  ft.  ung.  Sig. — For  local  use. 

(Potter.) 


R  .  Quininae  Sulphatis,  . 
Ferri  Pyrophosphatis, 
Strychninae  Sulphat., 
Ac.  Phosphor.  Diluti, 
Syr.  Zingiberis,  .  . 
Aquae, . q.  s 


.  3b 

•  3b 

.  gr.  ss. 

.  7)  ij* 

•  *lb 

ad  3  iv. 


M.‘  Sig. — A  tablespoonful  twice  daily. 


NIGHT-MARE - NYMPHOMANIA. 


625 


R  .  Veratrinae, . gr.  xl. 

Adipis,  zWUnguenti,  .  .  .  %j. 

M.  Sig. — Local  use.  ( Da  Costa.') 


R .  Theinae, 

Sodii  Benzoatis,  .  .  .  .  aa^j. 

Sodii  Chloridi, . gr.  x. 

Aquae  Destil., . Jj. 

M.  Sig. — 3  to  20  drops  hypodermically 
at  central  seat  of  disturbance.  ( Mays .) 

TT\vj  =  gr.  ss  of  Theine. 


R.  Aconitinae  Crystal.,  .  .  .  .  gr. 

Quininae  Hydrobrom.,  .  .  .  gr.  xx. 
M.  ft.  massa,  et  div.  in  pil.  no.  xij. 

Sig. — One  every  4  or  5  hours.  {Potter.) 


R .  Tinct.  Aconiti, 

Tinct.  Colchici  Sem., 

Tinct.  Cimicifugae, 

Tinct.  Belladonnae,  aa  part  aeq. 
M.  Sig. — 6  drops  every  hour  until  re¬ 
lieved.  [Metcalf.) 


Night-Mare. 

Potassium  Bromide,  in  night-mare  of  adults  :  and  children’s  attacks  of  night- 
screaming  often  associated  with  squinting.  Digestive  organs  may  also  require 
attention  (R.).  Camphor-water,  a  teaspoonful  or  two  the  most  suitable  medi¬ 
cine  (H.).  Sleep,  in  abundance,  may  prevent  (H.).  Diet,  light;  avoid  late 
meals. 


Nipples,  Sore,  Fissured. 


Benzoin,  an  admirable  local  application  (P.) ;  the  tincture  locally  for  slight 
erosions  (Parvin).  Arnica,  the  cerate,  or  Glycerin  of  Starch,  or  glycerin,  1  to  2 
of  eau  de  cologne  (R.).  Silver  Nitrate,  touched  lightly;  effectual  (Wa.). 
Sulphurous  Acid,  solution  neat  or  diluted,  constantly  applied,  or  with  equal 
quantity  of  glycerin  as  lotion  (R.).  Collodion,  sometimes  used  (R.)  ;  useful  for 
protection  (P.) ;  as  coating  (B.).  Alcohol,  brandy  and  water  as  lotion  before 
delivery  and  after  each  suckling  to  prevent  cracking  (R.).  Borax,  saturated 
solution,  beneficial  (Wa.).  Iron,  the  solution  of  the  subsulphate  diluted  with 
3  parts  of  glycerin,  and  applied  with  a  camel’s-hair  brush,  an  effective  applica¬ 
tion  for  fissured  nipples  (B.).  Tannin,  the  glycerite,  one  of  the  best  applica¬ 
tions  to  fissured  nipples  (B.).  Lead  Nitrate,  in  glycerin,  or  ointment 
in  fissured  nipples  (B.).  Zinc  Shield,  constantly  worn  (R.).  Balsam  of  Peru 
or  Tolu,  valuable  as  application,  with  oil  of  almonds,  gum  arabic,  and  rose¬ 
water  (P.).  Rhatany,  as  wash  or  cerate,  has  had  great  success  in  fissure 
(Tr.) ;  1  part  of  extract  to  15  of  cocoa  butter  (Wa.).  Nipple-shield,  to  give  the 
nipple  rest  while  the  child  sucks,  gives  great  comfort.  [Compare  Lactation, 
Mastitis.] 


Prescriptions. 


R.  Balsam.  Peruvian.,  .  .  .  3  ij. 

Olei  Amygdalae,  ....  gjss. 

Mucil.  Acaciae, . ^  ij. 

Aquae  Rosae, . q.  s. 

M.  Sig. — Apply  to  the  nipples  after 

each  nursing.  [Phillips.) 


R  .  Liq.  Plumbi.  Subacet.  Dil.,  3  ss. 

Ext.  Opii  Aquosi,  ....  ^j. 

Aquae  Rosae, . %  iijss. 

M.  Sig. — Lotion,  to  be  used  after  a 
bread-and-milk  poultice,  for  inflamed  nip¬ 
ples.  [F.  Barker.) 


Nodes. 

Mercury.  The  oleate  of  mercury  and  morphine  externally,  is  very  valuable 
(R.).  Potassium  Iodide,  as  ointment  in  conjunction  with  internal  use,  in  syph¬ 
ilitic  nodes  of  children  ;  also  in  non-syphilitic  periosteal  thickenings  (R.).  In 
syphilitic  nodes  it  holds  the  first  place,  especially  when  pains  are  worse  at 
night,  and  by  heat  of  bed  (Wa.).  Stramonium  leaves,  locally,  relieve  (Wa.). 
[Compare  Exostosis,  Periostitis.] 


Nymphomania. 

Potassium  Bromide,  when  from  plethora  ;  not  useful  when  relaxation,  or 
from  cerebral  lesion  (B.)  ;  large  doses  required,  at  least  gr.  xx  ter  die  (R.) ;  an 
40 


626 


OBESITY - ODONTALGIA. 


abundance  of  evidence  testifies  to  its  value  (W.).  Tobacco,  to  nausea,  effect¬ 
ually  cures,  but  is  horribly  depressing  (B.).  Camphor,  in  considerable  doses 
said  to  control  inordinate  sexual  desire  (R.);  at  present  not  much  relied  on 
(Wa.)  Lupulin,  seems  worthy  of  fair  trial  (Wa.).  Sulphur,  or  dilute  sul¬ 
phuric  acid,  internally,  when  arising  from  hemorrhoidal  congestion,  not  an 
infrequent  cause  (Wa.). 

Obesity. 

Banting  Dietary  is  alone  sufficient  to  improve  the  condition.  Its  chief  fea¬ 
ture  is  the  exclusion  of  two  elements — starch  and  sugar — from  the  food.  There¬ 
fore  bread  (except  toast,  or  the  crust  of  a  common  loaf),  potatoes,  sweet  roots, 
butter,  sugar,  cream,  beer,  porter,  and  champagne,  should  be  avoided.  In  one 
year,  on  this  diet,  Mr.  Banting  reduced  his  weight  46  pounds,  and  his  girth 
about  12  inches;  at  the  same  time,  his  numerous  corporeal  infirmities  were 
greatly  mitigated  or  altogether  removed.  Cannot  be  recommended  indiscrimi¬ 
nately.  This  was  the  method  of  Hippocrates,  avoiding  all  fats,  starches,  and 
sugars  ;  in  fact,  all  roots  or  vegetables  grown  underground  (B.).  Meat  Diet, 
very  successful  in  42  cases,  the  diet  being  confined  to  rump-steak,  hot  water 
and  codfish,  for  14  days,  absolutely  excluding  everything  else.  (Dr.  Smith  in 
Brit.  Med.  Jour.,  Nov.  20th,  1888).  The  Schweninger  or  CErtel  method  is 
similar,  using  chiefly  albuminous  food,  excluding  fat  and  carbohydrates,  limit¬ 
ing  the  fluids  drank,  especially  at  meals,  and  enforcing  exercise.  Iodoform,  is 
highly  efficient,  but  causes  wasting,  and  anaemia  by  injuring  red  blood  cor¬ 
puscles  (B.)  Iodol,  in  2-grain  doses  thrice  daily,  is  equally  effective  (B  ).  Al¬ 
kalies.  Solutions  of  oxides  or  bicarbonates  (R.);  alkaline  mineral  waters, 
with  exercise  and  dietary  (B.) ;  serviceable  (Wa.).  Liquor  potassae  5ss  in 
milk,  thrice  daily,  of  established  value  (Wa.) ;  generally  fails  (R.).  Ammo¬ 
nium  Bromide,  sets  up  gastric  catarrh  (B.)  ;  but  lessens  corpulency  (Wa.). 
Sulphurous  Waters,  especially  Blue  Lick,  ijiv  before  each  meal  (B.)  Potas¬ 
sium  Permanganate,  for  attendant  dyspepsia  and  flatulence  ;  also  useful  for  the 
obesity  ;  gr.  %-j  ter  die,  in  aq.  dest.  (B.).  Vinegar,  only  successful  at  expense 
of  serious  injury  to  the  body  (R.).  Fucus  Vesiculosus,  has  power  to  reduce 
adipose  tissue.  An  extract  is  sold  under  the  title  “Antifat”  as  a  proprietary 
medicine  (W.).  Exercise,  daily,  in  the  open  air  is  necessary,  and  if  carried  on 
systematically  is  the  most  efficient  and  least  injurious  method  of  reducing  an 
excess  of  adipose  tissue. 

Odontalgia. 

Aconite  ointment  or  liniment  for  facial  neuralgia  due  to  diseased  teeth,  will 
succeed  quickly  if  at  all  (R.,  Wa.).  Arsenic,  gr.  as  escharotic  to  destroy 
pulp,  when  used  for  pain  may  be  mixed  with  opium.  It  sometimes  at  first 
aggravates  pain  (R.,  W.).  Staphisagria,  the  alcoholic  solution  dropped  into 
the  cavity  (P.).  Alum,  a  solution  of  nitric  ether  (3ij~3vij)  is  said  to  be  an 
effectual  application  (B.).  Alum  and  salt  powdered  and  placed  in  the  cavity, 
excellent  when  nerve  exposed.  Chloral,  rubbed  up  with  equal  weight  of 
camphor,  rubbed  or  put  into  cavity  (R.).  Chloroform  or  Croton-Chloral,  equal 
parts  of  the  former  and  creasote,  a  good  application  (R.).  Tannin,  a  solution 
in  ether  is  a  good  application  to  a  carious  tooth  (B.).  Creasote,  with  tannin  or 
opium  or  chloroform,  placed  in  the  cavity  of  a  decayed  tooth,  often  gives 
relief  (R.).  Cocaine,  a  5  per  cent,  solution  of  the  hydrochlorate  on  cotton  ap¬ 
plied  to  a  cavity  will  often  bring  instant  relief.  Coniine,  solution  in  alcohol 
placed  into  a  hollow  painful  tooth  (R.).  Collodion  and  Carbolic  Acid,  equal 
parts  as  jelly  for  stopping  carious  teeth  (R.).  Opium,  mixed  with  tannin  or 
creasote  inserted  in  cavity  of  painful  tooth  (R.).  Morphine,  hypodermically 
for  severe  toothache  (R.).  Oil  of  Cloves,  inserted  into  cavity  (B.,  P.).  Camphor, 
with  morphine  and  flaxseed,  as  a  cataplasm  to  the  cheek  (B.).  Xanthoxylum, 
a  domestic  remedy  (B.).  Capsicum,  a  strong  infusion  on  lint  (R.).  Gelse- 
mium,  useful  in  some  forms  (R.).  Zinc  Chloride,  to  destroy  exposed  painful 
pulp  (R.).  Ginger,  Mezereon,  Pyrethrum,  are  useful  masticatories  in  tooth¬ 
ache  (P.). 


CESOPHAGUS - OPHTHALMIA. 


627 


Prescriptions. 


R  .  Linim.  Aconiti  (B.  P.), 


Chloroformi, . aa^iij. 

Tinct.  Capsici, . gj. 


Tinct.  Pyrethri, 

Olei  Caryophylli, 

Pulv.  Camphorae,  .  .  .  aa^ss. 

M.  Sig. — A  few  drops  to  be  placed  on 
a  pellet  of  cotton  and  applied  to  the  cavity. 

[Mason.) 


&  .  Ac.  Tannici, . gr.  xx. 

Mastiches, . gr.  x. 

Athens, . ^  ss. 

M.  Sig. — On  cotton  to  cavity.  (D.) 


R.  Creasoti, . 3  ij. 

Ol.  Caryophylli,  .  .  .  .  5  iv. 
01.  Menth.  Piperit.,  .  .  .  5j. 

Camphorae, . 3  ijss. 

Alcoholis,  .  .  .  q.  s.  ad  Oj. 

M.  Sig. — “  Toothache  Drops.” 


R.  Morphinae  Sulph.,  .  .  .  .  gr.  iv. 
Atropinae  Sulph.,  .  .  .  .  gr.  j. 

Aquae  Destill., . 3 j. 

M.  Sig. — A  few  drops  on  cotton,  placed 
in  the  cavity.  (B.) 


CEsophagus,  Affections  of. 

Belladonna,  the  liniment  with  frictions  to  the  sternum,  often  very  useful  as  a 
palliative  in  stricture  of  the  oesophagus  (Wa.).  Conium,  in  spasmodic  contrac¬ 
tions,  with  crampy  pains  of  stomach,  flatulence,  and  globus  hystericus,  has 
proved  very  serviceable  (Wa.).  Hyoscyamus,  or  Conium,  in  stricture  of  oesoph¬ 
agus,  if  much  irritability  ;  with  occasional  leeching  to  relieve  exacerbations 
of  pain  or  spasm  (D.).  Silver  Nitrate,  in  stricture  of  the  oesophagus,  a  weak 
solution  on  sponge  probang  (D.).  Anaesthetics,  should  be  used  only  to  meet 
temporary  indications  (W.).  Nutrient  Enemata,  in  stricture  of  the  oesophagus, 
when  swallowing  impossible  (R.) ;  may,  in  some  cases,  even  preserve  life  (Wa.). 
[See  Enemata. J  Bougie  Dilatation,  in  non-spasmodic  (structural)  stricture, 
the  only  appropriate  treatment  (H.).  [Compare  Dysphagia,  Choking.] 

Onychia  and  Paronychia. 

Silver  Nitrate,  a  strong  solution  in  nitrous  ether,  painted  over  the  adjacent 
tissue,  will  abort  if  applied  early  (B.)  ;  frequently  causes  resolution  of  the 
inflammation  (Wa.).  Lead  Nitrate,  dusted  over  night  and  morning  (R.)  ; 
relieves  pain,  and  hastens  healing  process  (B.).  Turpentine,  applied  on  a  piece 
of  lint  or  other  absorbent  material,  stops  the  pain  at  once,  and  seems  to  kill  the 
felon.  Mercury,  as  ointment,  for  10  minutes  in  every  hour ;  poultices  in  interim 
(R.).  Arsenic,  gr.  ij.  ad  Adipis,  as  ointment,  almost  specific  in  onychia 
maligna  (Wa.).  Tartar  Emetic,  will  shorten  course,  and  render  it  milder  (R.). 
Iodoform,  oint.  or  powder  dusted  on  (B.)  ;  or  1  part  to  9  of  Ether  applied  by  a 
dropper  in  syphilitic  onychia  (Fox).  Iodine,  a  strong  alcoholic  solution  locally 
will  often  subdue  the  disorder  (Wa.).  Chloral,  a  solution  locally,  as  antiseptic, 
and  to  promote  healing  (B.).  Sodium  Chloride,  common  salt  roasted  until 
chlorine  is  driven  off,  equal  parts  of  this,  castile  soap  and  Venice  turpentine, 
as  a  poultice,  is  a  very  efficient  application.  Carbolic  Acid,  to  benumb  surface 
during  incision  (R.) ;  which  should  be  carried  down  to  the  bone,  especially  in 
.tendinous  whitlow  (D.).  Cocaine,  hypodermically,  will  accomplish  the  local 
anaesthesia  more  thoroughly,  if  delivered  deeply  into  the  tissue.  Morphine, 
powdered,  as  local  application  to  relieve  pain.  Heat,  by  poultices,  is  very  use¬ 
ful.  In  Opening  a  felon  avoid  the  lines  of  the  arteries,  on  the  sides  of  the 
fingers,  and  that  of  the  flexor  tendons  which  is  the  median  line  on  the  palmar 
surface.  The  incision  should  be  made  midway  between  these  lines.  If  the 
sheath  of  the  tendon  be  opened  the  tendon  may  slough,  and  the  finger  be  ren¬ 
dered  useless  (Ashhurst). 

Ophthalmia. 

Silver  Nitrate,  a  strong  solution  (gr.  xx  ad  3j)  in  granular  lids;  cautiously 
when  corneal  ulcers  exist  (B.) ;  solid  stick  diluted  with  2  to  4  parts  of  potassium 
nitrate,  applied  lightly  and  quickly,  or  a  solution  (gr.  ij-x  ad  3j)  painted  over 


628 


OPIUM  HABIT. 


everted  lids,  which  should  be  washed  with  a  solution  of  common  salt,  and  then 
with  water  before  being  replaced  (C.) ;  in  solution,  gr.  v  ad  gj  aquae  destillatae, 
locally  once  a  day  in  purulent  ophthalmia  of  the  new-born,  washed  off  with  a 
weak  solution  of  common  salt  (Noyes);  in  solution,  gr.  iij  to  the  g  to  abort  the 
discharge  in  catarrhal  ophthalmia  (Fox).  Boro-Glyceride,  in  many  catarrhal 
affections,  especially  ophthalmia  neonatorum,  is  a  most  efficacious  application, 
the  solutions  used  being  of  io,  25  and  50  per  cent,  strength  (Fox).  Alum,  gr. 
viij  ad  3j  aquae,  applied  every  y  or  y  hour  in  purulent  ophthalmia  of  children ; 
success  depends  on  the  frequency  of  the  application  (R.) ;  a  crayon  formed  of 
a  crystal  of  alum,  a  mild  and  occasionally  useful  application  (C.).  Mercury. 
Calomel  dusted  over  membrane  in  phlyctenular  ophthalmia;  or  after  detaching 
scales  rub  in  brown  citrine  ointment  every  night  for  eczema  of  margin  of  lids 
(B.).  Pulsatilla,  as  lotion  to  conjunctiva  8  or  10  times  in  24  hours,  also  inter¬ 
nally  (P.) ;  much  used  by  homoeopaths  (B.).  Spigelia,  useful  in  rheumatic 
ophthalmia  (P.).  Antimony.  Tartar  emetic,  gr.  to  three  or  four  times  a 
day  in  strumous  ophthalmia,  with  sharp  purgation  at  commencement  (R.). 
Belladonna,  or  Atropine,  locally,  of  great  service  in  strumous  ophthalmia  to 
relieve  pain  ;  constitutional  treatment  also  required  (Wa.).  Atropine,  gr.  ij  of 
neutral  sulphate  to  the  5  of  aqua  destillata,  twice  or  thrice  daily,  as  soothing 
application  (C.).  Arsenic,  invaluable  in  inveterate  cases  of  strumous  ophthal¬ 
mia,  especially  when  complicated  with  cutaneous  eruptions  (Wa.).  Copper 
Sulphate,  gr.  j  ad  5j  aquas  camphorae  as  collyrium  in  purulent  ophthalmia  of 
infants;  in  substance  to  inner  part  of  lids  in  granular  conjunctivitis  (Wa.). 
Tannin,  powdered  (or  in  solution  gr.  j-x  ad  3j)  produces  remarkable  results 
(B.).  Lead  Acetate,  gr.  j  ad  3j  aquae  destillatae,  applied  by  camel’s-hair  pencil 
to  surfaces  of  everted  lids,  washed  away  before  the  lid  is  replaced.  Or  the 
Tannate  of  Lead  \l/2  ad  3  parts  fine  oil,  and  1  of  fresh  lard,  a  very  small  piece 
as  ointment  to  lid  (C.).  Carbonic  Acid  Gas,  said  to  relieve  the  pain  and  photo¬ 
phobia  of  strumous  ophthalmia  when  locally  used  (R.).  Physostigma,  to  reduce 
pupil  and  shut  out  the  light  (P.).  Iodine,  is  employed  in  scrofulous  ophthalmia, 
locally  for  its  alterative  stimulation  (W.).  Iodoform,  in  gonorrhoeal  ophthalmia, 
and  purulent  conjunctivitis,  of  very  great  value  locally,  but  should  be  pulver¬ 
ized  very  finely  (Grossmann) ;  does  not  bear  out  the  claims  made  for  it  (Keyser). 
Zinc  Chloride,  gr.  j  ad  §j  aquae  as  collyrium,  in  gonorrhoeal  ophthalmia,  used 
with  marked  benefit;  also  a  stronger  solution  (gr.  ij-iv  ad  ^j),  effectually 
arrests  the  muco-purulent  discharge  remaining  after  subsidence  of  purulent 
ophthalmia,  and  has  succeeded  admirably  in  diphtheritic  conjunctivitis  and 
pustular  ophthalmia  (Wa.).  Zinc  Sulphate,  as  collyrium,  gr.  j-iv  ad  §j,  is  very 
serviceable  in  ophthalmia  of  infants  or  adults ;  liquor  plumbi  added  improves 
(Wa.).  Staphisagria,  especially  in  tarsal  ophthalmia  (P.).  Colchicum,  when 
gouty  diathesis  (P.).  Cod-liver  Oil,  in  strumous  subjects,  tends  to  remove  the 
manifestations  of  the  disease  (R.).  Cold  Wet  Compresses,  or  iced,  are  held  to 
be  essential  in  early  stage  of  acute  purulent  and  gonorrhoeal  ophthalmia  (C.). 
[Compare  Blepharitis,  Conjunctivitis,  Keratitis.] 

Opium  Habit. 

Capsicum,  very  serviceable  from  its  power  as  a  stimulant  to  the  stomach,  and 
its  sedative  action  on  the  cerebrum  (B.) ;  removes  the  sinking  sensation  at  the 
pit  of  the  stomach  experienced  by  alcoholics,  when  trying  to  break  off  that  habit 
(R.).  Bromide  of  Sodium,  in  large  and  increasing  doses,  3j  twice  daily, 
increased  by  20  grains  each  day,  to  a  maximum  of  100  to  120  grains  twice  in 
twenty-four  hours,  with  simultaneous  gradual  reduction  of  the  opiate  dose,  so 
that  from  the  8th  to  the  10th  day  it  is  entirely  abandoned.  Each  dose  of  the  salt 
should  be  given  in  6  or  8  fluid  ounces  of  cold  water  (Mattison).  A  combination 
of  bromides  (see  formula  below),  commencing  with  40  grains  twice  daily, 
increasing  to  100  grains  twice  daily,  at  10  A.  m.  and  4  p.  m.,  freely  diluted  with 
water,  does  not  depress  vitality,  or  produce  the  injurious  results  of  the  bromides 
as  commonly  administered.  This,  with  3j  of  Warburg’s  tincture  before  break¬ 
fast  each  morning,  with  the  use  of  Spt.  Etheris  Nitrosi  to  eliminate  the  bromides 


OPIUM  HABIT. 


629 


rapidly,  electricity,  a  mixture  of  iron  and  strychnine,  and  an  occasional  hypo¬ 
dermic  of  5  or  10  minims  of  a  4  per  cent,  solution  of  Cocaine  for  nervous  rest¬ 
lessness,  is  the  general  line  of  my  treatment  (Mann).  Bromides  may  do  great 
harm,  if  recklessly  administered,  paralyzing  the  muscular  system  and  causing 
prolonged  delirium.  Cocaine,  or  the  fluid  extract  of  Coca  (Erythroxylon),  has 
been  used  to  relieve  the  depression  caused  by  the  withdrawal  of  the  drug  (B.) ; 
has  been,  by  many  careful  observers,  pronounced  of  great  benefit,  restoring 
appetite,  inducing  sleep,  promoting  digestion,  while  soothing  the  brain  and 
inducing  a  feeling  of  contentment  and  calm  (R.).  Should  never  be  entrusted 
to  the  patient,  lest  he  jump  out  of  the  frying-pan  into  the  fire.  Gelsemium 
subdues  the  restlessness  and  motor  excitement ;  proved  of  great  value  in  one 
case  where  30  grains  of  morphine  were  used  daily  ;  tt\j  of  tincture  every  % 
hour  (Pennoyer).  Conium,  in  io-drop  doses  of  a  good  fluid  extract,  to  check 
motor  activity  and  relieve  the  wandering  pains.  Sparteine,  in  doses  of  gr.  1/3 
to  hypodermically,  at  moment  of  systolic  cardiac  depression  which  answers 
to  the  period  of  craving,  and  corresponds  to  the  truncated  curve  of  the  sphyg- 
mographic  trace,  which  is  characteristic  of  the  period  when  the  stimulant  effect 
of  morphine  has  passed  (Jennings).  Nitroglycerin  acts  in  the  same  manner, 
but  its  effect  is  more  rapid  and  more  ephemeral  (Idem).  Cannabis  Indica,  may 
be  required  in  full  doses,  for  restlessness  after  withdrawal  of  the  opiate,  ,5-doses 
of  Squibb’s  fluid  extract,  repeated  every  hour  or  two,  as  required  (M.).  Galvan¬ 
ism,  is  very  efficient  for  the  neuralgic  pains  in  various  parts  ;  a  strong  faradic 
current  sometimes  acting  better  (M.).  Baths,  if  hot,  105°  to  1120  F.,  are  of 
great  value  to  relieve  disquiet ;  warm  baths  are  worthless  (M.).  Chloral,  as  a 
hypnotic,  fails  in  the  first  few  days  of  abstinence ;  later  in  full  doses,  45  grains 
at  once,  rather  than  three  1 5-grain  doses,  alone  or  with  a  bromide,  it  can  be 
relied  on  (M.).  Hyoscyamine,  Merck’s  amorphous,  gr.  ^  to  tr  hypodermically, 
or  more,  is  useful  as  a  hypnotic,  and  perfectly  safe,  in  patients  of  good  general 
condition,  in  whom  the  disuse  of  Opium  produces  unusual  insomnia  and  motor 
activity  (M.).  Lupulin,  with  Phosphoric  Acid  (see  formula  below),  helps  to 
sustain  the  patient,  lessens  the  force  of  his  suffering,  and  shortens  its  duration 
(Fleming).  Zinc  and  Iron  as  blood  tonics,  given  for  a  month  at  least,  are 
valuable,  and  are  best  given  on  alternate  days  (see  formula  below)  (Fleming). 
Piscidia  Erythrina,  has  been  proposed  as  a  substitute,  and  highly  commended, 
but  is  worthless,  as  are  also  Avena  sativa  and  many  other  falsely  termed  sub¬ 
stitutes  (M.);  there  is  no  remedy  for  the  opium-habit  (Da  Costa).  Zinc  Oxide, 
for  the  vomiting  and  diarrhoea,  beginning  with  gr.  j  once  daily  and  increasing 
to  tolerance  (Da  C.).  Withdrawal  of  the  drug  suddenly  and  completely,  is 
the  method  of  Levinstein  and  other  Germans,  and  is  preferred  when  we  can 
have  absolute  control  and  surveillance  of  the  patient  (Da  C.) ;  entails  horrible 
suffering,  and  is  utterly  inexcusable  (M.).  A  more  gradual  reduction  is  the 
method  usually  employed,  taking  off  one-third  the  first  day,  one-fourth  the 
second  day,  and  then  gradually  reducing  the  amount  until  the  sixth  or  seventh 
day,  when  it  is  entirely  withdrawn.  No  agent  is  of  any  value  unless  strengthened 
by  moral  courage  and  perseverance  on  the  part  of  the  patient  (Squibb).  Use¬ 
less  to  try  to  cure  a  patient  while  he  is  pursuing  his  ordinary  avocations. 
Failure  will  result  unless  there  is  complete  seclusion  and  entire  giving  up  to 
the  treatment  (Mann). 


Prescriptions. 


R.  Tinct.  Capsici, . 5  iv. 

Potassii  Bromidi,  .  .  .  .  5  iv. 

Spt.  Ammoniae  Aromat.,  .  ^  hj- 
Aquae  Camphorae,  .  .ad  ^vj. 

M.  Sig. — A  dessertsp.  several  times 
daily,  in  the  depression  of  alcoholism  and 
opium-habit.  Instead  of  the  bromide,  Fow¬ 
ler’s  Solution  (Liq.  Potass.  Arsenitis),  tt\J, 
may  be  added;  or  Tinct.  Nucis  Vomicae 
5  ij,  or  Tinct.  Aurantii  Amari  5  v. 

( Ringer. ) 


R .  Strychninae  Sulphatis,  .  .  gr.  ss. 
Tinct.  Belladonnae, 

Tinct.  Capsici,  .  .  .  aa  giij. 

M.  Sig. — Ten  drops  every  three  hours, 
increasing  three  drops  daily. 


R .  Tinct.  Cannabis  Ind.,  .  .  rr^xl-lx. 

Spt.  Aitheris, . 51- 

Aquae,  .  .  .  .  .  q.  s  .ad  5  j. 

M.  Sig. — One  dose,  if  insomnia  is  very 
protracted.  ( Fleming .) 


630 


ORCHITIS - OTALGIA - OTITIS. 


Combination  of  Bromides. 

R .  Animonii  Bromidi, 

Sodii  Bromidi,  .  .  .  aa  5ss. 
Potassii  Bromidi,  .  .  .  .  ^j. 

Liq.  Potass.  Arsenit.,  .  .  .  %]. 

Syr.  Tolutan.,  . j|j. 

Aqum  Menthse  Piper.,  .  .  ;jjss. 

Syr.  Hypophos.  Comp.,  .  .  3  iij . 

M.  Sig. —  ^ j  to  3  ij  in  water  thrice 
daily.  Has  a  total  of  Bromides,  gr.  21 
in  each  3  .  [Mann.) 


R.  Strychnine  Sulph.,  .  .  .  .  gr.  ss-j. 
Tinct.  Gentianae  Co., 

Tinct.  Cinchonae  Co.,  .  aa  3  ij. 

M.  Sig. — Teasp.  before  each  meal,  as  a 
stimulant  to  the  appetite  and  nervous  sys¬ 
tem. 

R  .  Tinct.  Nucis  Vomicae,  .  .  3  iij. 

Ac.  Phosphor.  Diluti,  .  .  ^v. 

Syr.  Pruni  Virg.,  ,  .  .  .  3  ij. 


Aquae, . q.  s.  ad  ^  iv. 

M.  Sig. —  3  ij  twice  daily  as  a  nerve- 
tonic.  ( Potter .) 

I 


Orchitis. 

Pulsatilla,  rr\J  or  less,  every  hour,  relieves  pain  rapidly,  though  not  the 
oedema  (St.).  Belladonna,  int.,  and  as  oint.  (extract  j  ad  iij  adipis)  when  in¬ 
flammation  has  subsided  (Wa.).  Sodium  Salicylate,  in  gonorrhoeal  orchitis, 
subdues  pain  in  a  few  hours.  Iodine,  tinct.  locally  to  remove  swelling  after  the 
acute  stage  has  passed  (B.).  Mercury,  the  oieate  locally  (B.) ;  Calomel  gr.  iij 
with  Ipecac,  gr.  x  at  once,  followed  by  a  saline  next  morning,  and  smaller 
doses  of  calomel  and  ipecac,  every  6  hours,  with  morphine  hypodermically,  gr. 

into  cellular  tissue  of  scrotum  (McElroy).  Ammonium  Chloride,  makes  a 
good  evaporating  lotion,  in  solution  with  alcohol  and  water  (R.).  Silver  Nitrate, 
a  strong  solution  to  the  scrotum,  with  gentle  pressure  (Wa.).  Tartar  Emetic, 
in  acute  orchitis  (R.).  Digitalis,  locally,  is  found  most  useful  (P.).  Alcohol, 
with  equal  quantity  of  water,  as  evaporating  lotion  (B.).  Ice,  benefits  and 
relieves  pain  (B.).  [Compare  Epididymitis.] 


Prescriptions. 


R .  Ammonii  Chloridi,  .  .  .  gr.  xl. 
Alcoholis,  Aquae,  .  .  aa  ^  ij. 

M.  Sig.  —  Lotion,  to  be  applied  on 
cloths  to  the  part. 


R.  Hydrarg.  Ammoniat.,  .  .  7,). 

Cerati  Simplicis,  .  .  .  .  £j. 

M.  ft.  unguent.  Sig.  —  Apply  locally, 
with  gentle  friction. 


Otalgia. 

Aconite  and  Opium,  equal  parts  of  the  tinctures,  a  few  drops  well  down  the 
external  meatus,  will  often  subdue  the  pain.  Blistering  Fluid,  or  Croton  Oil 
Liniment,  behind  the  ear  often  relieves  earache  (R.).  Glycerin,  for  dryness 
of  meatus  (R.) ;  or  oil  for  accumulation  of  wax  in  external  meatus  dropped  in 
every  night,  gentle  syringing  in  the  morning  with  warm  water  (CL).  Opium, 
Morphine  in  solution,  gr.  iv  to  the  5,  with  gr.  j-ij  of  Atropine,  is  an  excellent 
application  (B.).  Atropine,  gr.  g1^  in  £>xx  of  water,  a  teasp.  every  three  hours 
for  a  child  in  the  acute  otitis  media  of  children  from  coryza,  very  successfully 
used  to  abort  the  otitis,  and  relieve  the  earache  (Miot).  Pulsatilla,  internally 
and  externally,  is  often  used  with  advantage  (P.).  Cocaine,  a  4  per  cent,  solu¬ 
tion  sprayed  over  the  tympanic  membrane  through  the  external  meatus,  and 
forced  into  the  Eustachian  tubes  by  inhaling  the  vapor  and  then  expanding  the 
tubes  by  Valsalva’s  method  ;  this  repeated  every  three  minutes,  is  a  very  sure 
method  of  curing  otalgia  (R.). 


Otitis. 

Pulsatilla,  in  inflammation  of  external  auditory  canal ;  in  otitis,  as  lotion 
warmed  and  applied  by  syringe,  three  or  four  times  a  day  (P.).  Aconite, 
quickly  relieves  the  pain  (R.) ;  should  be  used  internally  and  locally.  Carbolic 
Acid,  a  20  per  cent,  solution  instilled  into  ear  in  moderate  otitis,  relieves 


OTORRHCEA - OVARIAN  NEURALGIA — OVARITIS. 


631 


pain  at  once  and  checks  progress.  A  solution  in  glycerin  is  best  (Rohrer).  Atro¬ 
pine,  in  the  acute  otitis  media  of  children,  is  very  efficient.  See  Otalgia,  above. 
Blisters,  behind  ears,  either  kept  discharging  or  repeated,  often  very  useful 
(Wa.).  Leeches,  behind  the  ear,  afterwards  a  small  blister  upon  the  same 
place,  when  leech-bites  have  healed  (H.).  Warm  Douche  frequently,  to  the 
ear,  to  secure  cleanliness,  then  drying  the  parts  (Roosa). 


Otorrhcea. 

Mercury,  in  chronic  cases,  the  brown  citrine  ointment  (B.).  Lead  lotions 
much  employed  (B.).  [See  Gonorrhoea,  for  formula.]  Potassium  Perman¬ 
ganate,  as  injection  or  spray,  gr.  j-^j  aq.  destil.  (B.).  Silver  Nitrate,  locally, 
a  solution  of  gr.  iv  to  the  3  (B.) ;  gr.  x  to  the  3  (Roosa).  Copper  Sulphate, 
gr.  j-v  to  the  3  (Roosa).  Tannin,  the  glycerite,  locally,  is  successful  (B.) ; 
especially  in  children  (Wa.).  Zinc  Sulphate,  locally,  in  solutions  of  gr.  ij-viij 
to  the  3  (B.)  ;  gr.  j-v  to  the  3  (Roosa).  Cadmium,  gr.  ij-^j  rose-water  (B.). 
Liquor  Sodae  Chloratae,  ltpxv-xxx  ad  3j  aquas  when  discharge  fetid :  is  highly 
useful  as  injection  (Wa.).  Quinine,  with  sulphuric  acid,  advisable  in  otorrhcea 
after  scarlatina  (Wa.).  Boracic  Acid,  finely  pulverized,  as  astringent  and  dis¬ 
infectant  application  ;  may  be  mixed  with  pulv.  Alum,  and  just  enough  pow¬ 
dered  Lycopodium  to  keep  it  dry ; — this  packed  carefully  through  speculum, 
after  washing  with  a  weak  and  tepid  alkaline  solution.  Absorbent  Cotton,  on 
holder,  may  be  used  every  few  hours  by  patient  to  keep  pus  removed  from  the 
canal.  Syringing  with  warm  salt  water,  once  daily,  as  absolute  cleanliness  is 
essential  in  the  treatment.  Politzer  Bag  is  a  useful  adjunct  in  keeping  secre¬ 
tions  out  of  tympanum  and  breaking  up  adhesions  (Roosa).  [Compare  Otitis.] 

Ovarian  Neuralgia. 

Atropine,  subcutaneously,  the  best  remedy  for  pain  in  the  pelvic  viscera 
(Wa.).  Ammonium  Chloride,  gr.  xxx  with  gtt.  ij-v  tinct.  aconiti,  repeated  in 
^-hour  if  necessary  to  remove  pain  (W.).  Camphor,  with  Cannabis  Indica,  of 
great  service  in  relieving  ovarian  pain,  especially  when  spasmodic  in  character 
(Wa.).  Opium,  often  the  cause ;  if  use  stopped  entirely  improvement  may 
ensue  (E.) ;  one  of  the  best  remedies  in  ovarian  pain  of  non- inflammatory 
character  (Graily  Hewitt).  Hot  Water,  vaginal  injections,  night  and  morning; 
sunlight  baths,  fresh  air  (E.).  Ether,  the  compound  spirit,  in  doses  of  rrpxxx-xl 
as  a  palliative  (Anstie).  Gelsemium,  deserves  a  trial;  its  power  is  great  but 
not  certain  (Wa.).  Leeches  over  the  groin,  or  inside  the  thigh,  where  ovarian 
pain  persistent,  or  tenderness  and  aching  (Wa.).  Surgical,  Battey’s  operation 
as  a  last  resort  (E.).  [Compare  Dysmenorrhcea.] 

Ovaritis. 

Turpentine  Epithems,  may  be  applied  hot  over  the  seat  of  the  disease  (Wa.). 
Tartar  Emetic,  as  ointment  for  counter-irritation  over  seat  of  disease,  in  sub¬ 
acute  ovaritis ;  at  same  time  a  pill  of  opium,  hemp  and  camphor.  See  for¬ 
mula  below  (Hewitt).  Opium,  in  suppository  or  enema,  more  effectual  than 
internally  (Tilt).  Mercurial  Ointment,  combined  with  camphor  and  bella¬ 
donna,  over  the  seat  of  the  disease  by  friction  (West).  Blisters,  in  subacute 
ovaritis  are  often  of  great  service,  placed  over  the  region  or  to  the  cervix  uteri 
(Wa.).  Enemas,  of  warm  water,  simple  or  medicated,  in  subacute  ovaritis, 
are  warmly  recommended;  they  should  be  retained  as  long  as  possible  (Wa.). 
Salix  Nigra,  the  “pussy  willow,”  in  doses  of  rt\,xxx  of  the  fluid  extract  thrice 
daily,  of  decided  benefit  in  ovarian  hyperaesthesia,  etc.,  of  highly  nervous 
women.  Ergot,  is  valuable  in  chronic  ovaritis,  with  rest  and  Pota'ssium  Bro¬ 
mide  (Tait).  Ice,  in  bag,  over  seat  of  pain,  when  intolerable,  and  patient  too 
much  reduced  to  bear  leeches ;  is  often  of  benefit  (Wa.).  Poultices  of  Linseed 
meal,  as  light  as  possible,  often  produce  great  benefit  in  ovarian  inflammation. 


632 


OXALURIA - OZzENA - PAIN. 


Prescriptions. 


R  .  Ext.  Opii,  . . gr.  iij. 

Ext.  Cannabis  Ind., 

Camphorae, . aa  gr.  vj. 

M.  ft.  pil.  no.  vj.  Sig. — One  pill  twice 

daily.  (Graily  Hezvitt.) 


R.  Ung.  Hydrargyri,  .  .  .  .  £vj. 

Camphorae, . gr.  xl. 

Ext.  Belladonnae,  .  .  .  gij. 

M.  ft.  unguent.  Sig. — To  be  rubbed  in 
twice  daily.  ( West.) 


Oxaluria. 

Mineral  Acids,  when  eructations  of  sulphuretted  hydrogen  (R.).  Nitro- 
muriatic  Acid,  is  of  important  service  (B.)  ;  especially  in  the  condition  show¬ 
ing  general  malaise,  weakness,  and  depression  of  spirits,  with  oxalate  crystals 
in  the  urine  (W.) ;  also  in  sciatica  and  other  forms  of  neuralgic  rheumatism 
accompanied  with  oxaluria,  full  doses  (ff\,vj-x)  of  this  acid,  with  an  occasional 
brisk  purgative,  and  cold  douche,  followed  by  friction  (Wa.).  Zinc  Sulphate, 
often  very  serviceable  in  irritability  of  the  nervous  system,  associated  with  dys¬ 
pepsia  and  oxaluria  (Bird).  Lactic  Acid,  aids  imperfect  digestion  (B.). 


Ozsena. 

Gold,  the  auric  salts  are  very  serviceable  in  syphilitic  ozaena  (B.).  Mercury, 
ointment  of  the  nitrate  in  syphilitic  form  ;  the  white  or  red  precipitate  with  58 
times  its  weight  of  sugar  snuffed  after  clearing  the  nose  in  non-syphilitic  forms 
(R.).  Potassium  Permanganate,  3j~Oj  solution  as  an  injection  or  spray  (B.). 
Hydrastis,  the  fluid  extract  locally  (B.) ;  5j-^viij  solution  as  lotion  with  trpv 
of  the  tincture  thrice  daily  internally  (P.).  Bromine,  as  inhalation  (see  form¬ 
ula  below) ;  or  Iodine  with  Carbolic  Acid,  or  the  latter  in  one  per  cent,  solution, 
as  inhalations  (B.).  Carbolic  Acid,  inhaled,  1  per  cent,  solution  (B.).  Silver 
Nitrate,  applied  behind  veil  of  palate; — gr.  v-xx  ad  gj  (B.).  Alum,  solution 
(3j-Oj)  for  irrigation  (R.).  Glycerite  of  Tannin,  by  irrigation  (R.).  Salicylic 
Acid,  in  very  weak  solution  (1  to  500),  as  cleansing,  astringent,  and  disinfectant 
wash,  used  by  retro-pharyngeal  syringe,  and  followed  by  applications  of  Calo¬ 
mel,  in  powder,  to  the  ulcerated  portions  of  the  mucous  membrane  (Massei). 
Cubeba,  the  oleo-resin,  gtt.  xv-xx  on  sugar  after  each  meal,  to  restrain  the 
secretion  and  perhaps  modify  its  character  (Cohen).  Chloride  of  Lime, 
gr.  xxx-lx  with  jfj  decocti  kramerise  ;  of  which  3ij-iij,  diluted  with  an  equal 
quantity  of  water,  should  be  injected  twice  daily  after  cleansing  with  salt  and 
water  (Cohen).  [Compare  Catarrh,  Chronic  Nasal.] 


Prescriptions. 


R  .  Tinct.  Iodi, . 3  iv. 

Ac.  Carbolici, . ^j-ij. 


M.  Sig. — Use  on  sponge  in  a  wide¬ 
mouthed  bottle  as  inhalation. 

(Potter.) 


R  .  Bromi, . 3  ss. 

Alcoholis, . ^  ss. 


M.  Sig. — Inhalation  when  vaporized  by 
heat  of  the  hand. 


R.  Sodii  Carbonatis, 

Sodii  Boratis,  .  .  .  .  aa  t^ij. 

Liq.  Sodse  Chloratse,  .  .  .  ^ss-gij. 

Glycerini . p)). 

Aquae, . q.  s.  ad  3  vj. 

M.  Sig. — Apply  by  means  of  a  hand- 
spray  apparatus.  ( Thornton .) 


R .  Acidi  Carbolici, . rrpxx. 

Aquae  Calcis, . Oj. 

M.  Sig. — Use  as  wash  or  spray. 


Pain. 

Opium,  is  universally  used  to  quiet  pain.  Morphine,  hypodermically,  in 
vicinity  of  nerve,  is  curative  when  not  so  by  stomach.  Morphinae  acetas  vel 
sulphas  gr.  with  atropinae  gr.  y^  to  y^.  Caution,  morphine  habit  (B.). 

Sometimes  a  single  injection  curative  of  sciatica  and  neuralgia.  Poultices  con¬ 
taining  laudanum  useful  in  inflammation.  Linimentum  opii  by  friction,  relieves 


PARALYSIS. 


633 


pleurodynia,  neuralgias,  etc.  Opiates  soon  lose  their  influence  in  any  certain 
dose,  requiring  increased  quantities  to  keep  up  analgesic  influence,  so  in  chronic 
cases  it  is  best  to  exhaust  all  other  means  before  resorting  to  it  (R.).  Chloral, 
has  no  direct  pain-relieving  power,  except  in  dangerous  doses.  To  relieve  pain 
and  promote  sleep,  the  best  agent  is  a  combination  of  chloral  and  morphine, 
cautiously,  if  heart  trouble,  or  to  old  drunkards ;  gr.  xv-xxx  -f-  gr.  %  (B.). 
Sometimes  relieves  neuralgia,  chronic  rheumatism,  gall-stones,  colic,  gastralgia, 
and  even  cancer  (R.).  Aconitine,  locally  over  seat  of  pain  ;  one  of  the  most 
certain  and  powerful  palliatives  in  neuralgic,  rheumatic,  and  gouty  affections 
(Wa.) ;  especially  serviceable  in  neuralgia  of  5th  nerve  (B.).  Belladonna,  the 
best  remedy  for  every  kind  of  pain  in  pelvic  viscera  (Anstie).  Atropine  hypo¬ 
dermically  in  local  pain,  neuralgia,  sciatica,  glaucoma,  etc.  When  it  succeeds, 
has  more  lasting  effect  than  morphine  (R.) ;  sciatica,  tic  douloureux,  etc.  (B.). 
Iodides,  are  magical  in  syphilitic  nocturnal  pains  of  head  (B.).  The  iodide  of 
ammonium,  gr.  iij  ad  5 j  ol.  olivae,  with  friction  ;  causes  the  disappearance  of 
nocturnal  syphilitic  pains  (W.).  Cimicifuga,  relieves  many  kinds  ;  neuralgia 
of  5th,  rheumatic  headache,  ovarian  neuralgia,  dysmenorrhcea.  Inferior  to 
ergot  in  labor-pains  or  after-pains.  3j  doses  (B.).  Conium,  in  cancer,  rheu¬ 
matism,  neuralgia,  etc.  (R.)  ;  also  for  the  fulgurant  pains  of  locomotor  ataxia, 
chronic  alcoholism,  sciatica,  phthisis,  etc.,  doses  of  tr^x  of  a  fluid  extr.  of  the 
unripe  fruit,  every  y2  hour,  well  watched  (Madigan).  Iron,  with  Belladonna, 
for  the  wandering  pains  of  anaemia,  in  which  morphine  is  dangerous  and 
bromides  useless  (Waugh).  Antipyrina,  a  most  efficient  analgesic,  may  be  ad¬ 
ministered  hypodermically.  Is  especially  adapted  to  neuralgias,  migraine,  and 
gouty  pains.  (See  ante,  page  106.)  Theine,  of  very  great  value  for  neuralgic 
pain,  affects  the  nerve  outwardly  along  its  course  from  the  site  of  the  injection 
(Mays).  Chloroform,  locally,  inferior  to  other  local  anaesthetics,  two  or  there 
drops  on  cotton  into  the  ear  for  faceache  or  toothache  ;  vapor  on  raw  surface 
of  cancers,  neuralgia  of  uterus,  photophobic  eye,  etc.,  by  inhalation  in  renal 
and  biliary  colic,  and  to  produce  general  anaesthesia,  which  see  (R.).  Ether, 
syray  for  local  anaesthesia  ;  inhaled  for  general  anaesthesia  (R.).  Carbolic  Acid, 
as  local  anaesthetic  (R.).  Cocaine,  as  a  local  anaesthetic  to  mucous  surfaces,  or 
hypodermically  for  minor  operations  involving  a  small  area,  as  circumcision, 
eye  operations,  etc.,  has  no  equal  ;  a  4  per  cent,  solution  of  the  hydrochlorate 
is  generally  employed  (R.) ;  has  many  applications,  as  odontalgia,  otalgia,  neu¬ 
ralgia  of  superficial  nerves,  etc.,  etc.  Iodoform,  as  suppository  in  painful  dis¬ 
eases  of  the  rectum  or  bladder  (R.).  Stramonium,  is  used  as  ointment  (R.). 
Duboisine,  used  instead  of  atropine  (B.).  Rhatany,  relieves  the  pain  of  ulcera¬ 
tive  disease  of  mucous  membranes,  pain  of  burns,  ulcers,  and  especially  of 
blisters  (Tr.)  Cannabis  Indica,  formerly  used  (B.).  Aquapuncture  (B.).  [See 
Neuralgia.]  Galvanism,  of  an  affected  nerve  gives  certain  relief.  Positive 
pole  on  point  of  emergence  ;  negative  over  superior  ganglion  of  cervical  sym¬ 
pathetic  (B.).  Heat,  if  pain  is  without  fever  or  inflammation  (B.) ;  warm  injec¬ 
tions  soothe  the  pain  of  cystitis,  prostatitis  and  abdominal  pains  generally  (B.). 
Cold,  when  pain  is  inflammatory  (B.).  [See  After-pains,  Anaesthesia, 
Boils,  Chest-pains,  Colic,  Gastralgia,  Headache,  Hepatalgia,  Inflam¬ 
mation,  Lumbago,  Myalgia,  Neuralgia,  Odontalgia,  Otalgia,  Rheuma¬ 
tism,  etc.] 

Prescriptions. 


R .  Antipyrinse, . gr.  xv. 

Aquae  Destil., . rr^xv. 

Cocainae  Hydroch.,  .  .  .  gr.  ss. 


M.  Sig. — One-half  as  hypodermic  in¬ 
jection,  or  the  whole  when  rapid  action  de¬ 
sired.  [See.) 


Paralysis. 

Strychnine,  gr.  to  [gr.  ^  to  ^  (R.)]  ;  also  hypodermically  into 
the  affected  muscles, — for  hemiplegia,  paraplegia,  local,  mercurial,  paludal, 
rheumatismal,  facial,  infantile,  and  diphtheritic  paralyses ;  in  that  of  spinal 


634 


PAROTITIS. 


muscles,  of  bladder  and  all  local  forms  (B.) ;  often  of  use  in  hysterical  (P.) ;  all 
forms,  except,  according  to  Barwell,  in  cerebral  and  spinal  paralyses  (R.).  Nux 
Vomica,  in  hysterical,  and  in  that  from  lead-poisoning  ;  only  in  chronic  cases 
(P.)  ;  in  paraplegia  from  softening  and  wasting  of  cord  (Brown-Sequard). 
Hyoscyamine,  gr.  gradually  increased  to  TC  in  par.  agitans,  locomotor  ataxia 
(B.).  Rhus  Toxicodendron,  certainly  efficacious  in  cases  depending  on  rheu¬ 
matism  (P.).  Ammonium,  the  iodide  and  carbonate  to  aid  in  absorption  of 
thrombi  and  thus  promote  cerebral  nutrition  in  cases  of  incipient  hemiplegia, 
due  to  endarteritis  deformans  reducing  the  lumen  of  the  vessels  in  the  brain 
(B.).  [See  formula  below.]  Arnica,  paralysis  of  the  bladder,  and  many  forms 
(P.).  Phosphorus,  with  cod-liver  oil  in  paralysis  agitans,  small  doses  ;  also  in 
the  paralysis  of  white  softening  of  the  brain  (B.)  ;  in  hysterical  paralysis  (R.)  ; 
in  myelitic  paraplegia  from  excessive  venery ;  the  only  drug  which  really 
affects  the  nerve-centres  (W.).  Belladonna,  when  depending  on  chronic 
inflammation  of  the  cord  (R.) ;  externally  as  ointment  along  spine,  with  Ergot 
internally  (Brown-Sequard).  Physostigma,  into  the  eye  in  ocular  paralyses 
(B.) ;  in  general  paralysis  of  the  insane,  also  in  progressive  muscular  atrophy 
without  much  mental  disorder,  long-standing  hemiplegia,  paraplegia,  loco¬ 
motor  ataxia  (R.).  Coniine,  in  some  cases  of  paralysis  agitans  (B.). 
Ergot,  in  paralysis  of  bladder  from  over-distention  (B.) ;  paralytic  dy- 
suria,  sensation  of  but  partial  emptying  of  bladder  (P.)  ;  said  to  be  useful  in 
paraplegia  (R.) ;  in  paraplegia  complicated  with  menstrual  irregularity  and 
forms  of  paralysis  arising  from  spinal  congestion  (Wa.) ;  has  cured 
cases  of  constipation  of  the  paralytic  when  all  the  most  powerful  cathartics 
failed  (Curran).  Cocculus  Indicus,  valuable  in  hemiplegia,  paraplegia,  and 
paralytic  stiffness  (P.).  Ignatia,  in  paralysis  of  lower  extremities  (P.)  Can¬ 
nabis  Indica,  for  retention  of  urine  from  spinal  disease  (R.).  Capsicum,  in  ]/2 
to  2-grain  doses  every  4  hours  as  general  stimulant  (P.).  Colocynth,  in  cere¬ 
bral  paralyses,  sometimes  seems  to  act  favorably  upon  principles  of  revulsion 
or  counter-irritation  (P.).  Mustard,  as  an  emetic  to  stimulate  failing  heart  in 
certain  forms  of  paralysis  (P.).  Senega,  in  rheumatic,  is  a  powerful  help  (P.). 
Nutmeg,  the  oil  as  external  stimulant  (P.).  Oil  of  Bay,  has  been  given  ;  is 
obsolete  (P.).  Cajuput  Oil,  efficacious  in  palsy  (P.).  Counter-irritation,  by 
blistering  fluid  in  peripheral  paralysis  of  the  7th  nerve  (R.).  Cod-liver  Oil, 
Anstie  insists  on  it  when  low  nutritition  and  faulty  assimilation  (B.).  Galvan¬ 
ism,  in  hemiplegia  and  many  forms  (B.).  Electricity,  faradization  of  the  muscles 
affected.  Localized  electricity  probably  of  more  importance  in  confirmed  spi¬ 
nal  paralysis  than  medicinal  treatment.  Massage,  in  infantile  paralysis,  given 
with  lacto-phosphate  of  calcium  and  cod-liver  oil.  Strychnine  injected  into  the 
muscles  (B.).  [Compare  Hemiplegia,  Locomotor  Ataxia,  Tongue.] 


Prescriptions. 


R.  Strychnine  Sulph.,  .  .  .  .  gr.  ij. 
Aquae  Destillatae,  .  .  .  .  i|j. 

M.  Sig. — For  hypodermic  administra¬ 
tion  :  rr\v  =  gr.  of  strychnine  sulphate. 


R.  Ammonii  Iodidi,  .  .  .  .  %j. 
Ammonii  Carbonatis,  .  .  %  ij. 

Liq.  Ammonii  Acetatis,  .  ^vj. 

M.  Sig. — A  tablesp.  thrice  daily.  See 
Ammonium ,  above.  (B.) 


Parotitis. 

Aconite,  in  febrile  conditions  (R.).  Mercury,  ^  grain  of  gray  powder,  3 
or  4  times  a  day,  very  useful,  relieving  pain  and  swelling  (R.).  Poultice  of 
flaxseed  meal,  a  good  local  application  for  gland.  Leeching,  often  gives  speedy 
relief,  when  pain  is  great  and  resists  hot  fomentations  (Wa.).  Care  to  avoid 
chilling,  important.  Incision,  when  suppuration  occurs.  Stimulants  and  Ton¬ 
ics  internally  are  very  necessary  in  symptomatic  parotitis,  occurring  as  a  com¬ 
plication  or  sequel  of  other  diseases,  with  adynamic  symptoms. 


PEDICULI - PEMPHIGUS - PERICARDITIS. 


635 


Pediculi. 


Mercury.  Citrine  ointment  or  wash  of  corrosive  sublimate,  for  lice  on  all 
parts  of  body.  The  oleate  destroys  lice  immediately,  and  also  kills  the  ova  (R.). 
For  crab-lice  the  ordinary  blue  oint.  is  very  disagreeable,  and  often  toxic  in  its 
effect  on  the  patient.  A  better  preparation  is  Calomel  in  5  per  cent,  oint.,  or  the 
Bichloride,  a  1  per  cent,  solution  in  alcohol,  of  which  a  teasp.  to  a  pint  of  water, 
as  a  bath  to  parts  twice  daily.  Cocculus  Indicus,  destroys  pediculi  (P.) ;  the  tinc¬ 
ture  undiluted  as  a  wash.  Staphisagria,  as  oil  or  ointment  of  the  powder  (R.); 
“  lice-bane  ”  (P.)  ;  the  tincture  a  very  efficient  application,  and  much  more 
cleanly  than  an  oil  or  an  ointment.  Acetum.  Vinegar  will  kill  the  nits,  as  it 
softens  the  adhesive  chitin  by  which  the  ova  are  glued  to  the  hairs.  Ether, 
washed  over  the  parts,  effectually  destroys  crab-lice.  Tobacco,  a  decoction  of 
the  leaf  is  an  efficient  application,  but  requires  care,  especially  if  the  surface  is 
abraded  (Wa.).  Essential  Oils,  will  kill,  as  rosemary,  anise  (P.) ;  or  powdered 
pyrethrum  (R.).  Cleanliness,  cannot  be  dispensed  with,  and  in  many  cases 
may  alone  be  sufficient.  Boil  underclothing.  Isolation  of  person,  and  of 
brushes,  towels,  etc.,  to  prevent  infection.  In  Vienna  the  following  prescrip¬ 
tions  are  used  : — 


Prescriptions. 


R .  Bals.  Peruvian., 

Petrolei,  .  .  .  .  aa  part.  xv. 

Oil  of  Laurel,  .  .  .  part.  j. 

To  be  applied  and  washed  off  after  3 
hours. 


R.  Ac.  Salicylici,  .  .  part,  ij-iij. 
Toilet  Vinegar,  .  .  part.  xxv. 
Alcohol  (80  per  cent. )  part.  lxxv. 

To  be  rubbed  on  with  a  bit  of  flannel. 
Once  often  enough. 


Pemphigus. 

Arsenic,  is  curative,  especially  when  chronic  (B.) ;  largest  dose,  rtpv  liquor 
arsen.  3  times  a  day,  on  full  stomach  (R.) ;  exercises  a  powerful  influence 
(Wa.).  Mercury.  Citrine  ointment  is  largely  used  (Wa.).  Potassium  Iodide, 
improves  the  condition  in  pemphigus  (Wa.) ;  with  good,  simple  diet;  quinine, 
cod-liver  oil,  etc.  Silver  Nitrate,  in  pemphigus,  after  the  bullae  have  burst,  and 
excoriations  remain  (gr.  ij  ad  §j  aquae)  (Wa.).  Water  Dressings,  on  lint, 
covered  with  oiled  silk,  constantly,  in  pemphigus  and  rupia  (Wa.).  Cod-liver 
Oil,  with  nutritious  diet,  is  a  powerful  auxiliary  to  treatment  (Wa.).  Puncturing 
the  blebs  and  evacuation  of  their  contents  is  necessary  as  soon  as  formed. 
Then  dusting-powders  of  zinc  oxide,  starch,  or  buckwheat  flour,  or  lotions  of 
liquor  plumbi  subacetatis  dilutus. 

Pericarditis. 

Aconite,  when  violent  throbbing  and  extreme  pain  (R.) ;  of  great  value,  if 
given  early  (P.)  ;  proves  in  the  highest  degree  serviceable,  when  object  is  to 
diminish  vascular  excitement  or  irritability  (Wa.).  Spigelia  Anthelmia,  useful 
in  rheumatic  pericarditis  (P.).  Digitalis,  when  rapid  and  feeble  heart,  cyan¬ 
osis  and  dropsy  (P.  N.)  ;  in  second  stage  when  heart  flags,  a  tablespoonful  of 
the  infusion  every  4  hours  is  beneficial.  Bryonia,  exceedingly  valuable  in 
second  stage,  that  of  exudation  ;  fully  equals  any  remedy  in  pericarditis  (P.). 
Opium,  regularly  in  grain  doses,  every  3,  4,  6,  or  8  hours,  is  very  beneficial 
(Wa.).  Veratrum  Viride,  extract  made  by  inspissating  the  juice  of  the  root,  of 
which  gr.  ij,  with  j  of  calomel,  every  2  hours,  valuable  (Waring-Curran).  Quinine, 
gr.  xv-xx  may  suppress  an  acute  attack,  if  given  at  critical  moment  (B.) ;  may 
be  used  as  an  antipyretic.  Counter-irritation,  has  been  much  abused  ;  useful 
at  commencement,  but  not  in  acute  inflammatory  stage  (B.).  Iodine  painted 
over  the  cardiac  region,  or  flying  blisters  in  the  second  stage.  Iron,  the  tinc¬ 
ture  in  full  doses  may  be  required  in  the  second  stage.  Poultices,  large,  hot, 
often  renewed  (R.).  Ice  may  be  used  instead  of  poultices  in  the  early  stage. 
Paracentesis,  by  aspiration  may  be  required  in  the  second  stage.  [Compare 
Endocarditis.] 


PERIOSTITIS - PERITONITIS - PERSPIRATION. 


636 


Periostitis. 

Mezereon,  in  the  rheumatic  and  scrofulous  form  (P.).  Mercury  and  Mor¬ 
phine.  The  oleate  externally  (R.).  Potassium  Iodide,  in  syphilitic  children, 
also  in  non-svphilitic  periosteal  thickening  (R.) ;  holds  the  first  place  for  syphi¬ 
litic  affections  of  the  bones  (Wa.).  Ammonium  Iodide,  cures  periostitis  most 
readily  when  syphilitic  (Wa.).  Staphisagria,  when  long  bones  affected  (P.). 
Iodine,  the  tincture,  or  blisters  locally  of  great  service  in  chronic  form  (R.)  ; 
under  the  external  use  of  Iodine  it  often  rapidly  improves  (Wa.).  Poultices, 
after  an  early  and  free  incision,  when  suppuration  takes  place  (C.).  Incisions, 
carried  deeply,  should  be  made  without  waiting  for  fluctuation,  when  great  ten¬ 
sion  exists  and  there  is  a  tendency  to  suppuration.  The  sides  of  the  abscess 
should  then  be  brought  together  with  compresses  and  a  bandage  (Gross). 
Tonics  and  stimulants,  as  milk-punch,  quinine,  iron,  and  opium,  in  full  and 
sustained  doses,  are  imperatively  demanded  in  many  cases  (Gross).  [Compare 
Nodes,  Onychia.] 

Peritonitis. 

Aconite,  of  great  utility  when  sthenic  reaction  ;  see  Opium  (B.)  ;  should  be 
given  early  in  all  inflammations  of  serous  membranes  (P.).  Bryonia,  exceed¬ 
ingly  valuable  in  second  stage,  when  exudation  (P.).  Mercury,  when  tendency 
to  fibrinous  exudations,  is  employed  with  good  effect  (W.).  Opium,  to  quiet 
intestinal  movements  (R.) ;  by  far  the  best  agent  (P.,  B.).  Morphine,  gr.  l/z 
hypodermically,  will  often  abort,  if  given  early.  Aconite  and  Opium,  the  tinc¬ 
tures,  gtt.  ij  of  the  former  with  gtt.  vj  of  the  latter,  in  water  every  hour  or  two  ; 
a  larger  dose  of  opium  if  pain  is  severe  (B.).  Large  doses  easily  borne  in  this 
affection  (Wa.).  Cocculus  Indicus,  for  tympanites  ;  a  few  doses  will  often  re¬ 
move  the  pain  and  relieve  distention  (P.).  Quinine,  strongly  urged  by  Trous¬ 
seau  ;  is  naturally  indicated  in  most  inflammations  (P.).  Turpentine,  for  tym¬ 
panites  (P.) ;  turpentine  stupes,  v-xv  drops  of  turpentine  on  flannel  wrung  out 
of  hot  water  during  acute  stage,  then  blisters  for  a  short  time  (B.).  Leeches,  to 
abdomen,  if  patient  plethoric,  and  sthenic  reaction,  relieve  pain  (B.).  Purga¬ 
tives,  are  inadmissible  when  from  perityphlitis  or  inflammation  of  appendix 
vermiformis  (B.).  Poultices,  large,  hot,  and  frequently  renewed.  Should  be 
thin,  and  covered  with  cotton-wool  (R.).  Ice,  to  abdomen  (B.).  Cold  relieves 
(W.).  Water,  hot  fomentations  to  relieve  pain,  sometimes  cold  compress  better. 
Ice,  sucked  or  swallowed,  to  assuage  the  vomiting;  sips  of  cold  water.  Diet,, 
after  acuteness  of  attack  passed,  should  be  mild  and  unstimulating.  [Compare 
Puerperal  Peritonitis.] 

Perspiration. 

Belladonna,  as  liniment  locally,  also  the  tincture  internally,  especially  in 
weakly  children  who  sweat  profusely  (R.).  Atropine,  gr.  to  hypoder. 
(or  in  exceptional  cases  even  gr.  ^  in  pill)  in  sweating  of  phthisis  and  exhaust¬ 
ing  diseases  (R.)  ;  gr.  ^  at  bedtime  for  sweats  of  phthisis  (B.).  Jaborandi,  gr. 
-fa  of  pilocarpine,  thrice  daily,  checks  profuse  perspiration  (R.,  Pf.).  Naphthol, 
in  a  5  per  cent,  ointment  or  alcoholic  solution,  is  a  very  efficient  application  for 
local  sweating  (Kaposi).  Potentilla  Sarmentosa,  the  Cinquefoil,  an  infusion  of 
the  vine,  leaves  and  root,  may  be  drank  ad  libitum,  and  is  a  very  efficient 
remedy  for  night-sweats,  having  stopped  them  when  Atropine  failed  to  relieve 
(Pope).  Agaricine,  is  used  very  successfully.  (See  formula  below.)  Salvia,  the 
ordinary  sage-tea  is  very  efficient,  used  internally  and  locally  by  sponging  the 
body.  The  infusion  for  night-sweats  of  phthisis  (DaC.).  Quinine,  in  exhaust¬ 
ing  diseases.  In  many,  a  night-draught  of  quinine,  sulphate  of  zinc,  and  sul¬ 
phuric  acid,  useful  (R.).  Opium,  as  Dover’s  powder,  may  succeed  in  profuse 
colliquative  sweating  (R.)  ;  a  fact,  though  hard  to  account  for  it  (Wa.).  Aro¬ 
matic  Sulphuric  Acid,  to  check  sweats  of  phthisis.  Bad  for  digestion  (B.). 
Muscarine,  has  been  used  with  great  success  in  the  sweats  of  phthisis  and  of 
other  morbid  states  (R.).  Zinc  Oleate,  rapidly  controls  excessive  and  offensive 
sweating  on  slight  exertion  in  the  axillae  and  groins,  also  the  night-sweats  of 


PERTUSSIS. 


637 


phthisis  (Murrell).  Zinc  Oxide,  gr.  iij,  with  gr.  ss  of  ext.  belladonnse,  in  a  pill 
at  bedtime  for  the  sweats  of  phthisis  (R.).  Gallic  Acid,  is  very  useful  for  the 
same  condition,  and  may  be  combined  with  extract  of  belladonna  (B.).  Tannic 
Acid,  may  also  be  used  with  benefit.  Aluminium,  the  oleate,  checks  hyperi- 
drosis  and  antiseptizes  the  sweat,  thus  forming  a  useful  application  to  the  axillae 
and  groins  of  children  (Wa.).  Potassium  Permang.,  gr.  j-^j,  for  fetid  perspira¬ 
tions  of  axillae,  feet,  etc.  (B.).  Salicin,  profuse  sweats  of  hectic  fever  (Wa.). 
Salicylic  Acid,  in  solution  with  borax,  the  most  agreeable  and  efficient  deodor¬ 
ant  for  fetid  perspirations  (B.).  Carbolic  Acid,  2  parts  to  3  of  glycerin  and  water, 
twice  daily  for  fetid  sweat  (Wa.).  Oils,  rubbed  into  the  whole  skin  to  prevent 
sweating  accompanying  exhausting  diseases,  as  phthisis  ;  but  sponging  with  a 
weak  acid  wash  better  (R.).  Ergot,  said  to  arrest  sweating  (R.).  Sponging, 
with  acidulated  water,  or  very  hot  sponging  in  phthisis  (R.).  [Compare  Feet.] 


Prescriptions. 


B .  Acidi  Gallici, . gr.  xxx. 

Ext.  Belladonnse,  .  .  .  .  gr.  ij. 

M.  ft.  pil.  no.  x.  Sig. — Two  pills  at  bed¬ 
time  (B.).  For  sweating  of  phthisis. 


B .  Acidi  Tannici, . gr.  xxx. 

Pulv.  Digitalis, . gr.  xv. 

Ext.  Cinchonae, . q.  s. 

M.  ft.  pil.  no.  xx.  Sig. — One  pill  at  bed 
time. 


B>  Agaricinae  (Merck),  .  .  .  gr.  x. 
Atropinae  Sulph.,  .  .  .  .  gr.  j. 

Ac.  Sulph.  Aromat.,  .  .  .  rrpi200. 
Solve  et  filtra. 

Dose,  irpx  in  syrup  or  simple  elixir,  5  or 
6  hours  before  retiring,  as  action  is  slow. 


Pertussis. 

Aconite,  in  all  acute  congestions  (P.) ;  as  a  preventive  or  abortive  remedy 
very  efficient,  when  associated  with  ipecac,  and  cherry-laurel  water  (Dervieux). 
See  formula  below.  Amyl  Nitrite,  with  Carbolic  Acid,  in  steam  atomizer,  has 
proved  a  very  efficient  inhalation  (Bayliss).  Ipecacuanha,  useful  in  many  cases 
(R.)  ;  irpj  for  5  years  of  age,  every  hour  or  two,  with  the  greatest  relief  (P.)  ; 
when  bronchitic  or  pneumonic  complications,  combined  with  ammonium  bro¬ 
mide  (Wa.).  Pulsatilla,  gr.  j  of  anemonine  (P.).  Belladonna,  obviously  of 
value  in  febrile  stage,  is  of  special  use  when  dentition  is  in  progress  ;  relieves 
the  congestion  of  air-passages  and  also  the  determination  of  blood  to  the  head 
(P.)  ;  good  when  profuse  bronchial  secretion  ;  best  in  spasmodic  stage.  Chil¬ 
dren  bear  this  drug  well  ;  rrpx  of  tinct.  may  be  given  hourly  to  a  child  2  or  3 
years  old  (R.).  Benzoate  of  Sodium  is  highly  efficient.  See  formula  below. 
Conium,or  the  Hydrobromate  of  Coniine,  in  doses  of  gr.  to  gr.  ^  according  to 
age,  a  very  efficient  remedy  (W.).  Drosera,  small  doses  are  very  effective 
(Murrell).  Chamomile  Oil,  a  very  useful  remedy  (P.).  Coccus  Cacti  (Cochi¬ 
neal),  in  doses  of  gr.  y$  thrice  daily  for  infants,  has  been  highly  recom¬ 
mended  (W.)  ;  proves  very  effective  in  most  cases.  Hydrocyanic  Acid,  very 
serviceable  in  cough  by  habit,  after  cessation  of  whooping-cough  proper,  or  in 
nervous  sympathetic  cough  of  mothers  (B.,  P.).  Opium,  in  convulsive  stage, 
to  produce  and  maintain  slight  heaviness  (R.).  Cocaine,  a  5  per  cent,  solution, 
painted  on  tonsils,  fauces,  back  of  tongue,  and  if  possible  on  larynx,  is  very 
efficient  (Labrie).  Bromides,  relieve  spasmodic  element  (B.)  ;  that  of  ammo¬ 
nium  will  readily  cure  many  cases  ;  gr.  ij  or  iij  ter  die  for  infants  (Wa.).  Lobelia, 
in  spasmodic  stages ;  well  tolerated  by  children  ;  rr^x  of  tinct.  every  hour  for 
child  2  years  old  ;  also  additional  dose  when  cough  is  imminent  (R.,  P.).  Alum, 
when  acute  stage  over  and  no  complication,  gr.  ij-vj  every  three  hours,  or  less 
every  hour  in  glycerin  or  honey  (R.).  Chloroform  or  Ether,  to  lessen  severity 
of  the  paroxysms;  as  inhalations  (R.).  Chloral,  gr.  v-x  in  spasmodic  stage, 
relieves  quickly  (B.)  ;  gr.  iij-viij  every  4  hours  (Porter).  Carbolic  Acid,  as 
vapor,  with  steam  atomizer;  found  to  be  very  beneficial  (J.  L.  Smith).  Castanea, 
a  decoction  of  chestnut  leaves  has  been  used  with  much  success  ;  dose  ad 


638 


PHARYNGITIS. 


libitum  (B.) ;  the  fluid  extract,  in  3-doses,  exercises  a  remarkable  influence 
over  the  cough  (W.).  Valerian,  said  to  control  the  paroxysms  (R.).  Nitric 
Acid,  well  diluted  in  sweetened  water,  after  the  subsidence  of  the  catarrhal 
stage  (B.).  Gelsemium,  in  spasmodic  stage  (B.).  Mono-bromide  of  Camphor, 
gr.  v  in  mucilage  and  syrup,  tolu.  3  or  4  times  a  day,  has  been  very  serviceable 
(B.).  Zinc  Sulphate,  gr.  with  ext*  belladon.  gr.  yi-yi,  has  varying  degree 
of  success  (B.).  Lactucarium,  the  syrup  as  vehicle  for  cough-mixtures  (B.). 
Quinine,  in  solution,  locally  to  fauces  (Dawson) ;  the  tannate  with  sodii  bicarb, 
of  each  5,  and  pulv.  acacias  100  parts,  used  with  an  insufflator  (Pollack).  Petro¬ 
leum,  on  rags  around  head  of  the  bed,  is  recommended  highly  by  Hildebrandt. 
Silver  Nitrate,  when  acute  stage  passed  (Tr.) ;  probably  inferior  to  alum  (Wa.). 
[Compare  Cough.] 

Prescriptions. 


Chloralis, . 

•  •  3b 

Potassii  Bromidi, 

•  •  3  ij 

Syr.  Pruni  Virgin.,  . 

•  •  Si- 

Aquae, . 

■  ■  3  J- 

M.  Sig. — A  teasp.  thrice  daily  for  in¬ 
fants  in  the  convulsive  stage. 

(Dessau.) 


R  .  Ext.  Aconiti, . gr.  j. 

Syr.  Ipecacuanhse,  .  .  .  rr^xlv. 
Aquae  Laurocerasi,  .  .  3j. 

Mucil.  Acaciae,  ....  5  vjss. 

M.  Sig. — A  teasp.  to  a  tablesp.  accord¬ 
ing  to  age,  every  hour. 

(Dervieux.) 


R .  Olei  Morrhuae, 

Mellis  Despumat., 

Succi  Limonis,  .  .  .  .  aa  p.  aeq. 

M.  Sig. — A  teasp.  or  two  as  required. 

(Sir  Wm.  Gull.) 


R .  Scdii  Benzoatis, . gr.  lxxx. 

Aquae  Menth.  Pip., 

Aquae  Destillatae,  .  .  .  aa^x. 

Syr.  Aurantii, . gij. 

M.  Sig. — A  dessertsp.  every  hour  or 
two.  (Letzerich.) 


R.  Acidi  Carbolici, . ^ss. 

Potassii  Chloratis,  .  .  .  .  ^ij. 

Glycerini, . g  iv. 

Aquae, . q.  s.  ad  ]|vj. 

M.  Sig. — Use  with  steam  atomizer  thrice 
daily.  (J.  Lewis  Smith.) 


R  .  Amyl.  Nitritis., . £  ss. 

Acidi  Carbolici,  ....  rr\x. 
Glycerini, 

Alcoholis, . aa^ss. 

M.  Sig. — Use  by  inhalation  with  steam 
atomizer.  ( Bayliss .) 


Pharyngitis. 

Aconite  and  Belladonna,  for  acute  attacks  (B.)  ;  when  high  temperature  (R.). 
Belladonna,  is  very  useful,  relaxes  the  pharyngeal  muscles  (W.).  Capsicum,  as 
gargle,  3j  ad  0)4  aquae,  in  very  early  stage  only  (R.).  Alum,  gargles,  in  chronic 
inflammations  (R.).  Silver  Nitrate,  gr.  v-xx  ad  5 j ,  on  sponge  probang,  suc¬ 
cessful  if  systematically  applied  (B.) ;  in  early  stage  of  inflammation  ;  also  in 
chronic  on  brush,  or  as  spray  (R.).  The  solid  stick  to  each  diseased  follicle, 
after  scraping  (A.).  Ammonium  Chloride,  gr.  ij  with  npxv  of  tinctura  cubebae, 
every  half-hour,  often  controls  acute  pharyngitis ;  when  a  gouty  diathesis  exists 
add  npx  of  the  ammoniated  tincture  of  guaiac,  and  give  every  hour  (A.  A. 
Smith).  Xanthoxylum,  a  decoction  of  the  bark  locally  to  throat,  and  npx-xxx 
of  the  fluid  extract  thrice  daily,  a  very  successful  remedy  for  chronic  pharyngitis 
(B.).  Tannin,  insufflation  to  affected  surface  (B.).  Cubebs,  powdered,  locally, 
useful  (B.).  Glycerin,  pure,  locally,  with  tannic  acid,  very  serviceable  (B.) ;  in 
chronic  inflammation  of  the  throat  (R.).  Hydrastis,  the  fl.  extr.,  locally,  and 
gtt.  v-x  per  stomach  (B.).  Alcohol,  dilute,  gargle  in  relaxed  throat  (R.).  Cimi- 
cifuga,  when  pharynx  dry  and  spotted  over  with  inspissated  mucus  (R.).  Ipe¬ 
cacuanha,  the  wine  as  spray  in  non-inflammatory  sore  throat,  with  hoarseness 
from  congestion  of  vocal  cords  (R.).  Pomegranate  Bark,  as  gargle  (P.). 
Potassium  Chlorate,  as  lozenge  to  stimulate  the  follicular  secretions  to  a  healthy 
condition  (A.).  Iron,  Quinine,  and  Strychnine,  as  tonics,  are  mainly  indicated 
A.).  Zinc  Sulphate,  as  gargle,  occasionally  employed  in  relaxed  throat  (R.). 
Inhalation  of  vapors,  or  of  pulverized  fluids,  by  the  atomizer,  found  very  bene- 


PHIMOSIS - PHLEBITIS - PHLEGMASIA. 


639 


ficial  (Wa.).  Food,  of  piquant  kind,  spices,  pepper,  mustard,  etc.,  should  be 
strictly  prohibited.  All  fluids  should  be  used  at  a  moderate  temperature  (A.). 
Water,  by  throat  compress,  relieves  ;  also  in  daytime,  in  obstinate  cases.  Rest 
to  voice,  and  cultivation  of  beard,  are  useful  aids. 


Presci 

1$ .  Tinct.  Aconiti, 

Tinct.  Belladonnae,  .  aa  .  gss. 

Tinct.  Guaiaci  Ammon.  .  .  3  v. 

Syr.  Limonis, . ^  ss. 

Aquae  Cinnamomi,  .  .  ad  3  iv. 

M.  Sig. — A  teasp.  every  3  hours  for 
acute  pharyngitis. 


R .  Tinct.  Aconiti, . 5  ss. 

Ac.  Hydrocyan.  Dil.,  .  .  .  rr^xl. 

Liq.  Ammonii  Acetat.,  .  .  £  iv. 

M.  Sig. — Teasp.  every  2  or  3  hours 
according  to  the  severity  of  the  case.  In 
acute  and  subacute  pharyngitis. 


iplions. 

R.  Aluminis, . gr.  xxx-^ij. 

Sodii  Boratis, . ^jss. 

Glycerini, . ^ij. 

Tinct.  Myrrhae,  .  .  .  .  ,^ij. 

Aquae,  .  .  .  .  q.  s .  ad  $  iv. 

M.  Sig- — Use  as  an  astringent  gargle, 
4  or  5  times  a  day. 


R.  Acidi  Tannici, . gr.  lx. 

Alcoholis,  . rrpxxx. 

Aquae  Camphorae,  .  .  .  .  3  iv. 

M.  Sig. — An  astringent  gargle,  to  be 
used  several  times  a  day. 


Phimosis. 

Belladonna,  as  ointment,  extract  vij-ad  xx  of  lard,  has  proved  effectual 
(Wa.).  Lupulin,  5-15  gr.  doses,  of  advantage  after  operation,  to  keep  penis  at 
rest  (Wa.).  Surgical.  Division  of  the  prepuce  by  a  bistoury  and  director  ; 
circumcision  (D.).  Cocaine,  a  4  per  cent,  solution  injected  at  several  points 
around  edge  of  prepuce,  as  local  anaesthetic  during  the  operation  of  circumci¬ 
sion.  Chloroform,  or  Ether,  may  be  used  as  anaesthetic  in  paraphimosis,  before 
attempting  reduction  (Wa.). 

Phlebitis. 

Hamamelis,  has  as  decided  an  influence  on  the  venous  system  as  Aconite  on 
the  arterial  (Pf.).  Mercury,  in  frequent  and  liberal  doses,  to  early  and  decisive 
constitutional  impression,  the  best  form  being  Calomel,  or  Calomel  and  Blue 
Mass  (Gross).  Rest,  fomentations,  poultices,  early  incision  of  abscesses,  aperients, 
opium  to  relieve  pain  and  insure  quiet  of  mind  and  body  (D.).  Blister,  over 
course  of  an  inflamed  superficial  vein  (R.).  Diet,  nutritious,  and  wine,  espec¬ 
ially  if  great  loss  of  blood  (D.).  Stimulants,  as  Quinine  and  Iron,  especially 
the  tincture  of  the  Chloride,  also  milk-punch,  are  needed  to  combat  the  depres¬ 
sion  which  is  sure  to  arise.  The  disease  is  always  dangerous  and  often  fatal 
(Gross).  Incisions,  must  be  freely  made  if  abscesses  form,  and  the  internal 
organs  watched  for  multiple  abscess.  Ulceration,  if  it  occur,  must  be  watched 
for  hemorrhage,  which  should  be  arrested  by  compression  and  styptics  (Gross). 
[Compare  Phlegmasia,  Varicosis.] 

Phlegmasia  Alba  Dolens. 

Belladonna,  and  Mercury,  equal  parts,  as  ointment,  often  of  much  benefit 
(Wa.).  Hamamelis,  has  specific  action  on  venous  system  (P.) ;  extolled  by  Dr. 
Preston  (R.).  Blisters,  in  early  stage  ;  are  extremely  useful  if  judiciously  em¬ 
ployed  (L.).  Ammonium  Carbonate,  often  valuable  where  great  prostration  ; 
full  doses  (Wa.).  Creasote,  injections  daily  (Wa.).  Hydrochloric  Acid,  %j  of 
dilute  acid  in  Oij  of  barley-water,  with  ^ss  of  potassium  chlorate,  to  be  taken 
daily  (Mackenzie).  Opium,  large  doses  internally,  with  leeches  and  anodyne 
ointments  (Wa.)  ;  laudanum,  if  pain  severe,  sprinkled  on  hot  fomentations  (L.). 
Leeches,  of  great  service  during  the  acute  inflammatory  stage  (Wa.).  Bandag¬ 
ing,  when  the  more  acute  symptoms  subside  ;  at  first  with  flannel,  afterwards 
with  ordinary  roller  bandage  (L.).  Regimen,  should  be  tonic  (L.).  Water, 
compresses  in  active  stage  ;  douches,  hot  and  cold  in  chronic  form. 


640 


PHLEGMON - PHOTOPHOBIA - PHTHISIS. 


Phlegmon. 

Aconite,  or  Belladonna,  are  certainly  efficacious.  Aconite  best  (R.).  Sulph¬ 
ides,  to  abort,  or,  if  inevitable,  to  promote  ;  gr.  ss-j  every  hour  or  two  of  Potassa 
Sulphurata  (B.).  Silver  Nitrate,  strong  solution  may  check  if  applied  early  in 
the  vicinity  (B.).  Carbolic  Acid,  injections  ;  a  2  per  cent,  solution  (B.)  ;  used 
with  great  success  (W.).  Iodine  Injections,  after  evacuation  (B.).  [Compare 
Erysipelas.] 

Photophobia. 

Atropine,  a  neutral  solution  of  the  sulphate,  gr.  j  ad  §j,  for  adult,  dropped 
into  the  eye  every  4  hours  (C.).  If  much  lachrymation,  so  as  to  dilute  the 
solution,  it  may  be  applied  more  frequently.  In  some  cases  belladonna  irritates 
and  has  to  be  abandoned  (Wa.)  Conium,  in  scrofulous  photophobia,  gr.  ss  of 

Coniine  in  £j  of  01.  Amygdalae,  locally  twice  or  thrice  daily  ;  or  the  vapor  of 

Coniine  (Wa.).  Mercury,  Calomel  by  insufflation  (C.).  Canthoplasty,  for  the 
spasm  of  the  orbicularis  in  severe  photophobia  (C.).  Glasses  of  cobalt  blue, 
the  best  (R.).  Arsenic,  in  the  condition  described  by  old  writers  as  strumous 
ophthalmia,  with  its  attendant  photophobia,  is  very  valuable  as  an  internal 

remedy  (C.).  Chloroform,  the  eye  exposed  to  the  vapor  of  a  few  drops  in 

severe  photophobia  will  be  speedily  relieved  (Jones).  Croton-Chloral,  gr.  v-x, 
in  young  people  and  those  suffering  from  syphilitic  corneo-iritis  (Bader).  Potas¬ 
sium  Chlorate,  internally,  is  most  useful  in  some  cases  (Vernon).  Cocaine, 
a  solution  of  the  hydrochlorate,  from  2  to  4  per  cent.,  a  few  drops  upon  the  con¬ 
junctiva,  will  be  found  promptly  efficient  in  most  cases. 

Phthisis. 

Creasotum,  gives  excellent  results  (Bouchard) ;  is  directly  curative,  at  least  in 
the  initial  stage  of  the  disease  (Frantzel);  promotes  the  sclerotic  change  by 
means  of  which  recovery  is  found  to  occur  (Jaccoud)  ;  Morson’s  beechwood 
creasote  should  be  used,  in  doses  of  R\j  in  whiskey  and  glycerin,  every  3  or 
4  hours.  Should  be  largely  diluted  to  prevent  irritation,  and  continued  for 
many  months, — relieves  cough,  diminishes  expectoration,  stops  night-sweats, 
increases  weight,  decreases  fever,  promotes  appetite,  and  in  many  cases  im¬ 
proves  the  local  condition,  as  shown  by  the  physical  signs  (Robinson).  Crea¬ 
sote,  tar  or  carbolic  acid,  to  check  expectoration  (R.,  P.) ;  Creasote  is  often 
curable  in  many  forms,  gr.  iij  in  a  pill  with  Bals.  Tolu.,  three  or  four  times 
daily,  the  dose  being  increased  until  urine  is  darkened  ;  or  it  may  be  inhaled 
with  Iodine  from  hot  water  (B.).  Iodine,  or  Iodoform  with  creasote,  carbolic 
acid,  eucalyptus,  chloroform,  alcohol  and  ether,  as  combination  for  an  antiseptic 
inhalation  (Br.)  ;  extremely  useful ;  also  as  intra-pulmonary  injection,  a  solu¬ 
tion  of  the  compound  tincture  of  iodine  1  to  4  of  distilled  water,  of  which 
rr^x-xx  injected  once  every  4  or  5  days,  through  the  1st,  2d  or  3d  intercostal 
spaces,  anteriorly  or  in  the  axillary  region,  avoiding  the  pericardium  and  great 
vessels  (Robinson).  Iodoform  internally,  has  proved  extremely  effective  in  all 
forms,  as  witnessed  by  numerous  observers  in  various  countries  (S.  Smith) ; 
though  not  one  of  the  most  active  germicides,  it  is  very  destructive  to  the 
bacillus  tuberculosis  (B.).  Iodol  may  be  advantageously  substituted  for  Iodo¬ 
form  (B.).  Cod-liver  Oil,  holds  first  rank  as  a  remedy  and  food  in  the  chronic 
forms  ;  a  teasp.  after  meals  ter  die  is  enough  ;  when  not  well  borne  may  be 
combined  with  aqua  calcis,  comp,  tinct.  of  gentian  ;  or,  when  not  digested,  with 
ether  (B.,  R.)  ;  is  of  great  utility  by  improving  nutrition,  and  by  affecting  the 
tubercle;  give  3SS  thrice  daily  one  hour  after  meals,  with  Tv^x-xv  of  Ether,  or 
an  equal  quantity  of  malt  or  whiskey;  do  not  give  it  in  hot  weather  (DaC.). 
Terebene,  with  Thymol  and  Carbolic  Acid,  equal  parts  of  each,  and  3ss  to  a 
pint  of  hot  water  as  an  inhalation  :  is  extremely  useful  for  the  dyspnoea  (Cam- 
man).  Aconite,  in  small  doses  for  the  irritative  fever,  is  a  remedy  of  much 
value  (DaCosta).  Antipyrine  in  a  2)4  grain  dose  hourly  for  3  doses  daily,  for 
the  hectic  fever  (Pribram).  Cinchona,  for  the  hectic  and  sweats,  gr.  xv-xx 
quinine  (B.) ;  if  small  doses  fail,  a  dose  of  6  or  8  grains  at  once,  or  in  portions 


PHTHISIS. 


64I 


repeated  hourly  (R.).  Ipecacuanha,  spray  to  throat  when  bronchial  asthma  and 
emphysema  combined  with  fibroid  phthisis  (R.).  Opium,  or  Morphine,  in  a 
viscid  vehicle  for  cough,  or  morphine  lozenges  when  cough  due  to  inflamed 
throat  (R.)  ;  must  in  time  be  given  for  the  cough,  which  is  an  irritative  one. 
Codeine,  gr.  to  }£  in  simple  elixir,  is  useful  and  does  not  constipate  (Da  C.). 
Alcohol,  an  important  remedy ;  may  be  given  with  cod-liver  oil ;  or  spt.  fru- 
menti  ^j-Jij  with  some  bitter,  immediately  after  meals,  or  the  stronger  wines. 
If  it  disagrees,  it  harms.  Curiously,  it  induces  an  intractable  form  of  phthisis 
(B.).  Verbascum,  the  Mullein-plant,  has  long  been  a  popular  remedy  in 
phthisis  ;  it  facilitates  expectoration,  improves  the  general  condition,  and  palli¬ 
ates  the  cough.  Calcium  Phosphate,  in  diarrhoea,  and  in  chronic  forms  of 
phthisis,  with  little  or  no  fever  (R.).  Iodine,  should  be  more  used  than  it  is  ; 
the  compound  solution,  gtt.  j-iij  thrice  daily,  or  when  anaemia  and  not  much 
fever  use  Iodide  of  Iron,  gr.  xv  of  the  syrup  pushed  to  £j  ter  die  (Da  Costa) ; 
as  inhalation  in  chronic  phthisis  ;  to  lessen  expectoration  and  cough  ;  also  as 
liniment  painted  under  clavicles,  to  allay  harassing  cough,  and  to  check  secre¬ 
tion  (R.).  Cimicifuga,  useless  in  tuberculosis,  but  in  phthisis  it  relieves  cough, 
improves  appetite,  lessens  intercurrent  bronchitis,  and  so  improves  the  patient’s 
general  condition  (Wa.).  Arsenic,  valuable  in  chronic  forms  as  is  no  other 
remedy ;  but  not  in  caseous,  or  where  much  hectic  ;  may  be  given  by  stomach 
or  fumigation  (B.).  [See  under  Asthma.]  As  cigarettes,  useful  in  the  diar¬ 
rhoea,  probably  diminishes  temperature  ;  caution  required  (R.)  ;  of  great  value 
in  early  stage,  in  later  stages  it  is  of  no  avail,  Arsenious  Acid,  gr.  -fa,  or  tt\Jij 
of  Fowler’s  solution,  thrice  daily  (Da  Costa).  Cocaine,  locally,  for  the  throat 
symptoms,  to  be  applied  just  before  meals  are  eaten  (Da  C.).  Sulphurous 
Acid,  by  inhalation,  spray,  or  fumigation,  in  chronic  phthisis  (R.).  Sanguinaria, 
helps  expectoration,  and  revives  the  enfeebled  stomach  (P.).  Chloroform,  with 
glycerin  or  honey,  for  the  cough  in  fibroid  phthisis  (R.)  ;  by  inhalation  con¬ 
tinuously  as  germicide,  in  connection  with  other  agents  of  same  action  (Pot¬ 
ter,  see  Pacific  Medical  Journal,  October,  1890).  Ferrum,  often  pre¬ 
scribed  ;  has  no  especial  influence  on  deposit  (B.).  Prescribed  in  tuberculosis 
(Tr.).  Liquor  Ferri  Perchloridi,  gj  ad  §j  aquae,  the  most  serviceable  local 
application  in  laryngeal  phthisis,  diminishing  irritability  of  the  mucous  mem¬ 
brane,  and  quieting  cough  (Mackenzie).  Mercury,  gr.  of  corrosive  sublim. 
every  two  or  three  hours,  for  the  diarrhoea  (R.).  Benzoin,  as  inhalation,  to 
lessen  cough  and  expectoration  (R.).  Acids,  Mineral,  for  the  indigestion.  The 
acidum  muriaticum  dilutum  (B.).  Prunus  Virginiana,  the  wild  cherry  has  a 
domestic  reputation,  probably  due  to  its  influence  over  cough  ;  the  syrup  is 
much  used  as  vehicle  for  cough-mixtures  (B.).  Hypophosphites,  are  very  useful 
in  chronic  cases  (B.) ;  have  no  special  effect  (Da  C.).  Digitalis,  as  antipyretic  ; 
deranges  intestinal  canal,  therefore  injurious  in  phthisis  (B.).  Phosphate  of 
Copper  in  nascent  form  soluble  in  an  alkaline  body,  is  held  to  be  specific  by 
Prof.  Luton  of  Rheims.  His  formula  contains  Neutral  Acetate  of  Copper  0.15, 
Cryst.  Phosphate  of  Sodium  0.75,  Glycerin  and  Pulv.  Licorice,  aa  q.  s.  for  one 
pill.  Copper  Sulphate,  gr.  ^ ,  or  Silver  Nitrate,  gr.  ^  >  or  Bismuth,  gr.  xx,  for 
the  diarrhoea  (Da  C.).  Gaseous  Enemata,  Bergeon’s  treatment,  made  a  noise 
for  a  few  months,  but  soon  fell  into  contempt.  Baths,  sea-bathing,  if  chronic, 
little  or  no  fever,  without  active  deposition  of  tubercle,  or  scrofulous  pneumonia  ; 
Turkish  baths  for  the  cough  (R.).  Grape-cure,  is  serviceable  (B.).  Aliment, 
should  be  nutritious  and  digestible,  malt  liquors  better  than  wine  or  spirits. 
Extract  of  malt,  cod-liver  oil,  plenty  of  meat,  and  alcohol  in  moderation  (DaC.). 
Warm  clothing,  bathing  and  friction  of  skin,  moderate  exercise,  and  a  suitable 
climate.  Forced  Alimentation,  when  anorexia  appears,  and  super-alimentation 
at  all  times,  necessary  to  successful  treatment.  Washing  out  the  stomach  daily 
by  syphon-tube,  with  warm  water  alkalinized  with  borax,  and  then  feeding 
through  tube  (Robinson).  Climate,  the  best  by  far  is  that  of  Egypt,  or  Algeria  ; 
next  coming  New  Mexico,  Southern  California,  especially  in  the  desert  along 
the  Colorado  River,  South  Carolina,  and  portions  of  Georgia  and  Florida ;  the 
latter  being  especially  suitable  for  cases  having  a  co-existing  bronchitis.  For 
some  cases  Colorado  is  very  good,  and  the  Adirondack  region  for  early  cases 

4i 


PITYRIASIS. 


642  . 


in  which  there  is  no  tendency  to  hemorrhage  (Da  Costa).  Tuberculin  or  Koch’s 
Lymph  has  been  a  deceptive  bubble  which  for  a  short  time  commanded  the 
attention  and  admiration  of  the  whole  world,  but  which  has  been  ruthlessly 
pricked  by  the  critical  scalpel  in  the  hands  of  the  father  of  modern  pathology 
(Senn).  [Compare  Cough,  Hemoptysis,  Hectic  Fever,  Perspiration.] 


Prescnplioits. 


R  .  Quinince  Sulphatis,  .  .  .  gr.  xviij. 
Pulv.  Digitalis,  .  .  .  .  gr.  vj. 

Pal v.  Opii, . gr.  iij. 

M.  ft.  pil.  no.  xij.  Sig. — One  pill  thrice 
daily,  for  the  irritative  fever.  [Niemeyer.) 


R.  Pepsini  (Jensen),  .  .  .  .  gr.xl. 
Ac.  Hydrochlor.  Dil.,  .  .  3  ijss. 


Glycerini, . 5  v. 

Succi  Limonis, . 3  iv. 


Aq.  Aurantii  Flor.,  q.  s.  ad  5  iv. 

M.  Sig. — Dessertspoonful  with  meals 

for  the  dyspeptic  symptoms. 


R.  Codeinoe  Sulphat.,  .  .  .  .  gr.  v-viij. 
Ac.  Hydrocyan.  Dil.,*  .  .  rtpxx. 

Syr.  Tolutani, . ^ij. 

M.  Sig. — A  teaspoonful  several  times 
daily,  for  the  cough.  ( Potter .) 


R.  Tinct.  Belladonnse,  .  .  .  .  sjij. 

Syr.  Scillse, . t^ij. 

Morphinae  Sulph.,  .  .  .  .  gr.  j. 

Syr.  Tolutani, . ad  3  iv. 

M.  Sig. — Tablespoonful  at  bedtime,  for 
cough  and  restlessness,  to  be  repeated  if 
necessary.  [H.  Gibbons,  Jr.) 


R.  Creasoti  (beech-wood),  .  .  TTpvj. 

Glycerini, . 5j. 

Spt.  Frumenti, . 5  ij. 

M.  Sig. — For  one  day’s  use,  as  directed, 
in  3  ss  doses.  [Robinson.) 


R  .  Iodoformi, . gr.  xxiv. 

Creasoti, . rrpiv. 

01.  Eucalypti, . tqviij. 

Chloroformi, . rtpxlviij. 

Alcoholis, 

Etheris,  .  .  .  aa  q.  s .  ad  ss. 

M.  Sig. — 10  to  20  drops  on  the  sponge 
of  perforated  zinc  inhaler,  to  be  worn  20 
minutes  thrice  daily.  [Brunton.) 


R.  Extr.  Opii  Fluidi,  .  .  .  .  gj. 


Syr.  Rhei  Aromat.,  .  .  .  .  giv. 
Syr.  Glycyrrhizge, . gj. 


Liq.  Ammon.  Acet.,  .  .  .  3  v. 

M.  Sig. — .Shake  well.  A  teaspoonful 
every  2  or  3  hours.  A  soothing  mixture,  to 
quiet  cough,  allay  nervousness,  and  stimu¬ 
late  the  patient.  ( Johnson .) 


R .  Iodoformi, 

Creasoti, 

Pulv.  Benzoini, 

Bals.  Tolu., . aa  gr.  j. 

In  pill,  of  such  2  to  4  daily. 

[Hu  chard.) 


R.  Petrolei  Massae, . 3_j, 

Pulv.  Cubebae, 

Pulv.  Doveri, . aa^ss. 

Cinchonidinse  Sulph.,  .  .  gij. 

M.  ft.  massa,  et  div.  in  pil.  no.  cclxx. 
Sig. — One  pill  every  3  or  4  hours. 

[Griffith.) 


R.  Olei  Morrhute, . 3SS. 

Mucil.  Acacise, . ^  ij. 

Sacchari,  . 3  ij. 

Tinct.  Lavandulae  Co.,  .  .  rtpxx. 

Aquae, . ^ss. 

M.  Sig. — Teaspoonful  for  children.  An 
agreeable  mixture.  [Farquharson.) 


[For  a  Cod-liver  Oil  Emulsion  see  formula  on  page  459.] 


Pityriasis. 

Alkaline  and  Tonic  Remedies  generally  control  mild  cases,  together  with 
baths  and  emollients  ;  the  more  severe  ones  requiring  constant  envelopment  in 
oil,  as  linseed  or  cod-liver  oil  (Bulkley).  Mercury,  in  obstinate  cases,  Dono¬ 
van’s  solution  of  Arsenic  and  Mercury  is  highly  successful  (Wa.) ;  the  green 
iodide,  gr.  x  to  3j  of  lard,  or  a  5  per  cent,  solution  of  the  oleate  of  mercury  in 
oleic  acid  with  one-eighth  part  of  ether,  applied  by  a  camel’s-hair  brush  (B.) ; 
citrine  ointment,  especially  when  the  hairy  parts  of  the  face  are  affected  (R.) ; 
an  ointment  of  ammoniated  mercury  and  calomel  is  very  useful  in  ordinary 
cases  of  dandruff  or  pityriasis  simplex  (Bronson).  Sulphur,  3j  of  sulphur 
lotum  to  3j  of  vaseline  applied  every  morning  to  the  scalp,  with  sweet  almond 
oil  anointing  at  night  (Jackson).  Soap,  the  tincture  of  green  soap  as  shampoo 
every  morning  for  cleanliness,  or  Borax  and  water,  or  the  yolks  of  three  eggs 


PLETHORA - PLEURITIS. 


beaten  up  in  a  pint  of  limewater  with  jfss  of  alcohol,  all  of  which  make  good 
shampooing  mixtures  (Jackson).  Borax,  to  cleanse  the  scalp,  a  saturated 
solution  ;  or  the  glycerite  of  borax  (R.).  Lead,  the  liquor  plumbi,  with  glycerin 
equal  parts,  and  two  parts  of  water,  as  lotion  for  cases  where  there  is  high  in¬ 
flammation  and  abundant  weeping  (R.).  Carbolic  Acid,  2  parts  to  3  of  glycerin 
and  water,  twice  daily,  with  the  daily  use  of  a  carbolized  soap,  is  often  effectual 
(Wa.).  Sulphides,  ^ss  of  Potassa  Sulphurata  to  Oj  of  Lime-water,  as  a  lotion, 
or  the  Bareges  Pomade,  see  formula  below  (B.).  Baths,  frequently,  and  hard 
rubbing  after  shampooing  the  scalp  ;  avoid  stimulating  food  in  bad  cases,  as 
well  as  the  use  of  a  fine-toothed  comb  on  children’s  heads.  [Compare  Sebor- 
rhcea,  and  for  Pityriasis  Versicolor,  see  Tinea  Versicolor.] 


Prescriptions. 


R .  Sodse  Sulphuratae, 

Sodii  Carbonatis,  .  .  .  aa  %  ij. 

Axungise, . 5  ijss. 

M.  Sig. — Pomade  de  Bareges. 


R.  Hydrarg.  Ammoniat.,  .  .  gr.  xx. 
Hydrarg.  Chlor.  Mitis,  .  .  gr.  x. 

Petrolati, . 5  j. 

M.  ft.  unguent.  Sig. — Local  use. 


Plethora. 

Aconite,  is  useful  for  affections  of  plethoric  subjects.  Decidedly  the  best 
remedy  for  apoplexy  in  the  plethoric  (P.).  Arsenic,  used  with  advantage  when 
determination  of  blood  to  the  head  (Wa.).  Sulphur,  as  mild  purgative  for 
plethora,  from  cessation  of  the  menses  (Wa.).  [Compare  Abdominal  Ple¬ 
thora.] 

Pleuritis. 

Aconite,  no  remedy  more  effective  prior  to  stage  of  effusion  (R.,  P.).  [See 
Inflammation.]  The  tincture  in  doses  of  >4  drop  every  3  hours  to  a  child  3 
years  old,  for  2  or  3  days  (J.  Lewis  Smith).  Veratrum  Viride.  Opinions 
differ  as  to  whether  it  should  be  used  in  sthenic  or  asthenic  forms  (R.) ;  gtt. 
viij  of  tincture  every  3  hours,  with  a  drop  added  to  each  dose  until  pulse 
reduced  or  nausea  (Wa.).  Bryonia,  exceedingly  valuable  in  second  stage; 
should  follow  aconite  (P.).  Tartar  Emetic,  see  Inflammation.  In  early 
stages  and  young  plethoric  subjects,  when  much  febrile  action,  small  doses 
(gr.  tV  t0  X)  maybe  useful  (Wa.).  Digitalis,  as  antipyretic  (R.) ;  deranges 
intestinal  canal  (B.) ;  aconite  preferred  (P.);  the  tincture  in  doses  of  one  drop 
every  3  hours  to  a  child  of  2  years  old  (J.  Lewis  Smith).  Potassium  Iodide, 
to  promote  absorption  of  effusions,  steadily  for  a  long  time  (R.) ;  also  chest 
painted  with  tincture  of  iodine,  one  day  on  each  wall  alternately  ;  may  be 
washed  off  with  iodide  of  potassium,  alcohol  or  ether  (B.) ;  as  a  diuretic  to 
remove  effusion  (Clark).  Iodine,  also  as  injections,  with  great  benefit  and  with¬ 
out  risk,  in  empyema  and  hydrothorax  (B.,  R.).  Quinine,  has  abortive  power, 
increased  by  combination  with  morphine  (gr.  xv  -j-  gr.  ss)  ;  also  as  restorative 
tonic  in  low-type  cases  (B.).  Opium,  cannot  be  too  highly  extolled  (P.) ;  is  es¬ 
pecially  beneficial ;  gr.  ss  of  morphine  hypodermically  at  beginning  will  often 
cut  short  an  attack.  During  the  disease,  its  effects  are  very  beneficial.  A  slight 
physiological  effect  should  be  maintained  (B.).  Morphine  for  severe  pain  (R.). 
Burgundy  Pitch,  plaster  externally  as  a  mechanical  support  (P.).  Asclepias, 
the  popular  “pleurisy-root,”  is  a  favorite  remedy  in  the  south  (W.).  Pilocar¬ 
pus,  in  subacute  cases  to  remove  fluids  (Caro)  ;  or  the  nitrate  of  pilocarpine,  gr. 

bis  die,  for  children  (Vigier) ;  is  too  depressing  and  therefore  unsafe  (Smith). 
Sodium  Chloride,  £ss  in  $j  of  water,  flavored  with  licorice,  in  tablesp.  doses 
every  3  hours,  often  very  useful  in  causing  absorption  of  pleuritic  serous  exuda¬ 
tions  ;  but  is  contraindicated  when  exudation  is  purulent  (Br.).  Bloodletting, 
by  cups  or  leeches,  useful  by  reason  of  counterirritation  produced,  and  to  relieve 
pain,  only  in  robust  sthenic  cases  (B.).  Blisters,  often  greatly  abused  ;  are 
harmful  during  inflammatory  stage  (B.).  Poultices,  large,  hot,  and  frequently 
renewed  (R.).  Water,  cold  wet-pack  to  chest  probably  better  than  a  hot  one, 
pinned  tightly  to  limit  movement  of  chest-walls  (B.).  Thoracentesis,  by 
aspiration,  if  the  quantity  of  fluid  seriously  embarrasses  respiration.  [For 


644 


PLEURODYNIA - PNEUMONIA. 


Chronic  Pleurisy  see  Empyema,  also  compare  Hydrothorax,  Pleuro¬ 
pneumonia.] 


Prescriptions. 

R.  Potassii  Acetat., . 3  j.  R. 

Infusi  Digitalis,  .  .  .  ad  £  iv. 

M.  Sig. — Teasp.  every  3  hours  to  a 
child  of  4  or  5  years,  in  the  seeond  stage.  M. 


Morph.  Sulphat.,  .  .  .  .  gr.  j. 

Tinct.  Aconiti, . npxxiv. 

Liq.  Potas.  Citratis,  .  .  .  ^ij. 
Sig. — A  teasp.  every  3  hours. 


Pleurodynia. 

Cimicifuga,  curative  when  rheumatic,  valuable  in  sympathetic  cases  from 
irritability  of  uterus  (P.) ;  or  uterine  derangements  (R.,  Wa.).  Croton  Oil,  in 
obstinate  pleurodynia  especially  when  blackened  feces  (R.).  Belladonna, 
plaster  or  liniment ;  the  latter  generally  best  (R.).  Chloral,  made  liquid  with 
equal  weight  of  camphor,  rubbed  in  gently,  often  affords  instant  relief  in  severe 
pleurisy  (R.).  Sodium  Salicylate,  gr.  xv-xx,  every  2  or  3  hours,  useful  in  most 
cases  (Hughes).  Ether,  as  spray,  sometimes  immediately  and  permanently 
removes  the  pain  (R.).  Opium,  liniment  rubbed  in  after  warm  fomentations 
(Wa.) ;  or  a  hypodermic  injection  of  morphine  (R.).  Iodine,  as  liniment  painted 
on  the  chest,  often  relieves  where  mustard  fails  (R.).  Blistering,  often  success¬ 
ful  when  other  means  fail ;  sometimes  strong  vesication  necessary  (R.).  Rest, 
is  important  and  may  be  obtained  by  strapping  the  affected  side  with  strips  of 
adhesive  plaster.  Poultices,  very  hot,  followed  by  application  of  lint  and  oil¬ 
skin.  Belladonna  liniment  generally  better  (R.).  Mustard,  as  a  poultice,  is 
generally  efficient,  and  can  be  renewed  when  pain  returns  (R.).  [Compare 
Neuralgia,  Myalgia.] 

Pleuro- Pneumonia. 

Bryonia,  often  of  great  service ;  limits  effusion  and  assists  absorption  (P.). 
Carbolic  Acid,  a  2  per  cent,  solution  injected  parenchymatously,  once  or  twice 
a  day,  has  had  remarkable  success  (B.).  Sanguinaria,  as  a  contra-stimulant 
(P.).  Turpentine,  as  a  fomentation  (P.).  Arnica,  the  tincture  in  doses  of 
rrpx  every  3  or  4  hours,  very  useful  in  controlling  the  heart’s  action  (Wa.). 
Pilocarpine,  gr.  ss,  or  gij  of  the  tincture  of  Jaborandi,  benefits  cases  of  pleuro¬ 
pneumonia  (Wa.).  [Compare  Pneumonia.] 

Pneumonia. 

Aconite,  gives  good  results  in  catarrhal  and  fibrinous  (B.) ;  has  marked  effect 
(R.) ;  very  valuable  in  first  stages  (P.) ;  in  several  cases  it  apparently  cut  short 
the  attack  (Wa.) ;  to  reduce  circulation  either  Aconite  or  Veratrum  Viride,  until 
pulse  is  impressed  (Da  Costa).  Veratrum  Viride,  valuable  (P.) ;  in  the  very 
incipiency  (B.) ;  opinions  differ  as  to  whether  it  should  be  used  in  sthenic  or 
asthenic  cases  (R.).  Bryonia,  when  pleural  complications  (P.).  Phosphorus, 
especially  when  typhoid  symptoms;  approved  by  Fleischmann  (R.).  Bella¬ 
donna  is  useful  in  the  first  stage  (P.);  Harley  esteemed  it  highly  in  pneumonia 
(Wa.) ;  as  an  adjuvant  to  Digitalis  in  infantile  pneumonia,  to  soothe  the  irri¬ 
table  nervous  system  and  curtail  superabundant  secretion  (Brown).  Tartar 
Emetic,  formerly  given  in  large  doses  ;  now  abandoned ;  small  doses  may 
be  useful,  but  should  be  used  with  care,  lest  depression  ensue  (B.) ;  at  com¬ 
mencement  with  alcoholic  stimulants,  if  patient  be  weak  (R.) ;  may  benefit 
young,  robust  subjects  (Wa.).  [See  Pleuritis.]  Sanguinaria,  as  a  contra-stimu¬ 
lant,  when  fever  abated,  and  graver  symptoms  have  amended  (P.).  Iodides, 
none  more  efficient ;  the  Iodide  of  Ammonium  with  Arsenic,  to  prevent  casea¬ 
tion  of  inflammatory  products  (R.)  ;  Ethyl  Iodide,  gtt.  v-xx  ter  die  by  inhala¬ 
tion,  very  valuable  in  catarrhal  form  (B.).  The  Iodide  of  Sodium  is  useful  in 
catarrhal  pneumonia  (Da  C.).  Ipecacuanha,  the  wine  in  infantile  pneumonia, 
should  never  be  dispensed  with,  as  it  promotes  expectoration,  controls  hemor¬ 
rhage  and  regulates  secretion  (Brown).  Senega,  in  advanced  stages  as  expec¬ 
torant,  when  cough  is  dry,  irritating  and  painful,  tightness  and  oppression  of 
chest  (P.).  Opium,  morphine  by  injection,  sometimes  needed  for  severe  pain 


POLYPUS. 


645 


(R.) ;  opium  is  very  desirable  in  many  cases,  relieves  the  symptoms  and  arrests 
delirium  (Wa.).  Copper  Acetate,  Kissel  regards  it  curative  ;  under  it  the  mor¬ 
tality  was  only  4^  per  cent.  Ammonium  Carbonate,  at  crisis  for  depression  ; 
give  in  infusion  of  senega  (B.) ;  see  formula  below  ;  is  useful  as  expectorant 
late  in  disease  when  lung  tissue  breaks  down  (Da  C.).  Digitalis,  of  doubtful 
value ;  may  be  useful  for  high  temperature,  ischaemia,  and  low  tension  of  ves¬ 
sels  (B.) ;  as  case  goes  on  and  circulation  is  to  be  further  controlled,  digitalis  is 
indicated  (Da  C.)  ;  the  best  agent  to  slow  the  heart  in  infantile  pneumonia,  with 
Belladonna  as  an  adjuvant  (Brown).  Antipyrine,  to  reduce  pyrexia;  is  deci¬ 
dedly  more  serviceable  in  pneumonia  than  quinine  (Wa.) ;  gr.  xv  several  times 
a  day,  or  3  hourly  doses  each  of  gr.  xxx,  then  stopping  until  temperature  rises 
again  (R.).  Stimulants,  in  asthenic  cases,  those  of  malignant  type,  and  those 
occurring  in  aged  people  (Wa.).  Ammonia,  the  aromatic  spirit  as  substitute  for 
Ammon.  Carbonate,  in  doses  of  3ss  in  simple  elixir  (Da  C.).  Turpentine,  as 
stimulant  at  crisis  (B.).  Serpentaria,  with  carbonate  of  ammonium  in  low 
types,  as  a  stimulant  about  the  crisis.  Quinine  or  Salicylic  Acid,  to  reduce  tem¬ 
perature  (R.) ;  Quinine  as  a  tonic  in  cases  which  are  asthenic  from  the  first 
(P.);  in  conjunction  with  Aconite  and  Veratrum,  gr.  viij-xij  daily  at  start,  is 
beneficial  (Da  C.).  Blisters,  useful  at  very  beginning  only  or  at  crisis  of  dis¬ 
ease  ;  harmful  in  inflammatory  stage  (B.)  ;  to  lessen  the  pain,  but  should  be 
used  in  moderation  (R.).  Wet-pack,  hot,  tightly  pinned  to  limit  motion  of  chest- 
walls  (B.).  Poultices,  encircling  whole  chest  in  children  (R.).  Diet,  farina¬ 
ceous,  mucilaginous  drink,  and  rest  in  warm  room  (R.). 


R  .  Tinct.  Verat.  Viridis,  .  .  .  n^xl. 

Spt.  ^Etheris  Nitrosi,  .  .  .  gvj. 

Liq.  Potassii  Citratis,  .  .  'Z  ivss. 
Syr.  Zingiberis,  .  .  q.  s.  ad  3  vj . 

M.  Sig. — A  tablesp.  every  3  hours,  in 
the  early  stage.  ( Da  Costa.) 


R.  Sodii  Iodidi, . 3JSS- 

Morphinae  Sulph.,  .  .  .  .  gr.  ss. 
Elixir  Simplicis, . ^ij. 

M.  Sig. — Teasp.  thrice  daily,  with  blis¬ 
ters  over  the  apex,  in  catarrhal  pneumonia. 

(. Da  Costa.) 


R.  Potassii  Iodidi, . 3  j. 

Ammonii  Muriatis,  ....  3jss. 
Mist.  Glycyrr.  Comp.,  .  .  3  vj. 

M.  Sig. — Tablesp.  4  times  daily,  to  pro¬ 
mote  absorption,  together  with  blisters  to 
the  chest.  ( Univ .  Penna.) 


Ammonii  Carbonat.,  .  .  .  gr.  xl. 
Infusi  Serpentariae,  .  .  .  5  iv. 

M.  Sig. — A  teasp.  every  3  hours,  as  a 
stimulant  about  the  crisis.  (B.) 


R .  Ammonii  Iodidi,  .  .  .  .  gr.  xl. 
Spt.  Ammon.  Aromat.,  .  .  3ij. 

Elixir  Simplicis,  .  .  .  .  j|j. 

Aquae, . q.  s.  ad  3  viij. 

M.  Sig. — One-eighth  thrice  daily,  in 
syphilitic  lobar  pneumonia,  together  with 
the  following  pill.  (Da  Costa.) 


R.  Digitalis, . gr.  vj. 

Quininae  Sulph., . gr.  xij. 

Extr.  Opii, . gr.  iij. 

Extr.  Ipecac, . gr.  iij. 

M.  ft.  pil.  no.  xij.  Sig. — One  pill  thrice 
daily,  with  the  preceding  mixture. 

(Da  Costa.) 


Prescriptions. 

(  Si- 


Polypus. 

Sanguinaria,  has  been  employed  as  snuff  for  nasal  polypi  (P.) ;  with  doubtful 
benefit  (Wa.).  Tannin,  finely  powdered,  as  snuff  blown  daily  into  nostrils 
through  a  quill,  is  especially  adapted  to  the  soft  and  gelatinous  varieties  ;  while 
it  has  apparently  no  effect  on  the  healthy  mucous  membrane,  it  causes  the 
complete  withering  of  the  polypus  (Wa.).  Zinc  Chloride,  has  been  injected 
interstitially  with  success  in  a  case  of  naso-pharyngeal  polypus  (Barthelemy). 
Iron,  a  solution  of  the  perchloride  is  advised  as  an  interstitial  application 
(Auger).  Acetic  Acid,  glacial,  injected  into  the  body  of  the  tumor,  will  cause  it 


646 


POULTICES - PREGNANCY. 


to  shrink  up  and  to  drop  off  in  a  few  days.  Alum,  in  powder,  applied  to  point 
of  origin  to  prevent  recurrence  (D.).  Surgical.  A  nasal  polypus  should  be 
seized  with  polypus  forceps  and  twisted  off  at  the  neck ;  it  may  be  removed 
through  the  mouth  or  the  nostril.  In  a  few  cases  the  nostril  must  be  dilated 
with  a  speculum,  or  the  ala  slit  to  give  access  to  root  of  tumor  (D.). 

Poultices. 

Poultices  and  Fomentations  are  simply  local  baths  utilizing  warmth  and 
moisture,  relaxing  the  tissues  and  relieving  pain.  If  applied  early  they  will 
check  inflammation,  or  assist  the  evacuation  of  pus  when  suppuration  has  set 
in.  Poultices  should  be  applied  thick  (thin  in  peritonitis),  as  hot  as  possible, 
covered  with  cottonwool,  and  frequently  changed  ;  large  at  onset,  very  small 
after  maturation.  Belladonna  and  Glycerin,  partes  aequales,  smeared  over  tis¬ 
sues  under  a  poultice,  aid  the  latter  greatly,  alsoTinctura  Opii,  especially  where 
skin  is  broken.  Linseed-meal  or  Oatmeal,  Starch,  Bread,  Bran,  are  best  in  the 
order  mentioned ;  add  meal  to  boiling  water,  stir  and  spread  quickly  on  warm 
linen.  Charcoal  under  the  poultice,  when  foul  sores  are  being  treated. 

An  excellent  method  of  preparing  poultices  is  to  make  a  lot  of  bags  of  various 
sizes,  and  of  the  fabric  known  as  “  Swiss,”  filling  each  one  half-full  of  the  lin¬ 
seed-meal  or  other  agent  employed  before  sewing  up  its  open  end.  When 
wanted  for  use  one  of  these  bags  is  submerged  in  boiling  water  for  a  few  minutes, 
and  on  taking  it  out  the  meal  is  found  to  have  swelled  so  as  to  fill  the  bag,  which 
should  then  be  squeezed  enough  to  rid  it  of  the  superfluous  water,  laid  on  the 
part  and  covered  with  oiled  silk  and  a  bandage. 

Fomentations.  Flannel  should  be  wrung  very  dry  out  of  boiling  water,  and 
covered  with  oiled  silk.  Spongio-piline,  a  fabric  composed  of  sponge  and  wool, 
coated  with  india-rubber,  is  an  excellent  vehicle  for  the  application  of  warmth 
and  moisture.  The  inner  surface  is  moistened  with  hot  water  ;  and  its  utility 
may  be  increased  by  sprinkling  the  moistened  surface  with  charcoal,  yeast ;  or 
saturating  it  with  any  desired  lotion  or  liniment. 

Pregnancy,  Disorders  of. 

Mercury,  a  few  grains  of  blue  pill  to  correct  clay-colored  stools  (L.).  Iodine, 
the  tincture  internally  for  cardialgia  (Wa.).  Aloes,  have  cured  piles  in  preg¬ 
nancy,  by  removing  constipation  ;  cautiously  (P.).  Alum,  Tannin  or  Catechu, 
in  medicated  pessaries  for  vaginal  leucorrhcea  (L.).  Castor  Oil,  an  excellent 
laxative  (P.)  ;  to  clear  out  the  bowels  in  diarrhoea  (L.).  Cocculus  Indicus, 
when  intestines  much  distended  with  flatus,  and  frequent  desire  to  urinate  from 
flatulent  pressure  on  bladder  (P.).  Bismuth,  Calumba  and  Antispasmodics, 
with  minute  doses  of  Opium,  for  gastrodynia  and  pyrosis  (L.).  Potassium  Bro¬ 
mide,  with  chloroform,  as  an  antispasmodic  in  dyspnoea  (L.).  Sumbul,  is  invalu¬ 
able  in  restlessness  ; — lib  xxx-xl  of  tincture  with  a  little  chloric  ether,  giving 
quiet  nights  for  a  long  time  (P.).  Galla,  unguentum  gallae  cum  opio,  the  best 
local  application  to  hemorrhoids,  also  fomentations  with  sponges  wrung  out  in 
very  hot  water,  to  relieve  pain  (L.).  Digitalis,  in  infusion,  very  beneficial  in 
albuminuria  (L.).  Potassium  Acetate,  with  Basham’s  mixture  (Liq.  Ammonii 
Acetatis),  when  albuminuria  with  anaemia.  Calcium  Phosphate,  believed  to 
exert  an  influence  on  the  foetus  if  administered  during  pregnancy,  so  that  mothers 
who  have  borne  only  rachitic  or  scrofulous  children  will  bear  healthy  ones  (W.). 
Berberine,  found  very  useful  in  the  periodical  neuralgiae  of  pregnancy,  even  in 
cases  in  which  quinine  had  previously  failed  (Maclagan).  Camphor,  liniment 
for  lumbar  pains  (Wa.).  Senna,  the  confection  proves  a  mild  and  efficient 
purgative  in  the  constipation  of  pregnancy  (Wa.).  Milk-diet,  for  albuminuria 
of  pregnancy  the  best  remedy,  if  strictly  carried  out  (Parvin).  Injections,  must 
be  used  carefully,  even. tepid  water  often  induces  uterine  contractions  (L.). 
[Compare  Vomiting  of  Pregnancy,  Ptyalism,  Albuminuria,  Nephritis, 
Nervousness.] 


PROLAPSUS  ANI - PROSTATORRHCEA. 


647 


Prolapsus  Ani. 

Nux  Vomica.  Strychnine,  especially  when  in  children,  with  constipation  ;  in 
the  latter  event  add  nux^vomica  to  a  purgative,  as  tincture  of  rhubarb  (R.,  P.), 
or  strychnine  hypodermically,  gr.  ^  for  an  adult  every  48  hours,  ^  inch  from 
anus  and  parallel  to  rectum,  into  the  cellular  tissue ;  generally  requires  4  to  8 
injections  (Weber).  Piper,  the  confectio  piperis  in  doses  of  gr.  lx-gr.  cxx, 
persevered  in  for  3  or  4  months,  in  chronic,  weak  subjects  (Wa.).  Sulphur, 
has  a  beneficial  effect  in  addition  to  its  laxative  value  (R.).  Alum,  in  solution, 
gr.  vj  to  the  3  (R.).  Ice,  locally,  when  parts  inflamed  (R.).  Ergot,  the  fluid 
extract  injected  into  the  perineum,  is  followed  by  immediate  relief  (Vidal). 
Ferrum  Sulphate,  3j  to  3 v i i j  aquae,  of  which  one-third  by  enema  twice  daily. 
Podophyllin,  in  small  doses  for  rectal  prolapse  in  children  (P.).  Tannin,  injec¬ 
tion  to  restrain  the  prolapsus  (R.).  Hydrastis,  by  enema,  or  as  a  lotion  (P.). 

Prolapsus  Uteri. 

Cimicifuga,  to  prevent  miscarriage  in  prolapsus  uteri  (R.) ;  has  a  remarkable 
effect  upon  the  uterus  (P.).  Astringents,  decoctum  quercus,  decoctum  gallae, 
(Wa.).  Pomegranate  bark  (P.).  Tannin,  as  catechu,  kino,  red  gum,  rhatany. 
Alum,  a  solution  gr.  vj  ad  3j  (R.) ;  lb.  j  ad  Cj  aquas,  as  hip-bath,  also  should 
be  passed  well  up  vagina  (Wa.).  Ice,  locally  when  parts  inflamed  (R.)  ;  ap¬ 
plied  to  the  spine  (Wa.).  Pessaries,  in  any  form,  are  of  but  temporary  benefit, 
and  in  the  end  positively  detrimental  (E.) ;  but  many  cases  cannot  be  treated 
without  mechanical  support  of  some  kind. 

Prostate,  Hypertrophied. 

Alkalies,  for  the  cystic  irritation  with  acid  urine.  Great  benefit  from  liquor 
potassae,  citrates  and  acetates  of  potassium  (B.).  Triticum  Repens,  benefit 
follows  its  use  in  the  prostatic  enlargement  of  old  men  (Sir  H.  Thompson). 
Ammonium  Benzoate,  for  the  cystitis,  urine  alkaline  (B.).  Ammonium  Chloride, 
is  occasionally  useful,  gr.  xv-xxx,  3  or  4  times  daily  (Wa.).  Iodine  Injections, 
through  rectal  walls  (B.) ;  a  weak  ointment  applied  by  rectum  (Wa.).  Iodine, 
has  been  tried  in  all  forms,  but  is  of  no  value  (Thompson).  Iodoform,  as  sup¬ 
pository  in  rectum,  has  proven  of  great  value  (B.).  Colchicum,  in  persons  of  a 
gouty  diathesis  (Wa.).  Medicine  is  not  likely  to  have  any  control  over  this 
condition,  which  is  a  simple  hypertrophy.  [Compare  Cystitis.] 

Prostatitis. 

Cantharides,  gtt.  j  of  tincture  (5  may  be  required)  3  or  4  times  a  day  (R.). 
Triticum  Repens,  is  found  to  be  of  benefit  (Sir  H.  Thompson).  Urino-Genitals, 
especially  turpentine,  cubeb,  juniper,  cantharis  (B.) ;  cubeb,  in  doses  of  gr.  xx 
daily,  is  found  of  much  benefit  (Wa.)  ;  buchu  relieves  (P.).  Silver  Nitrate,  a 
solution  (gr.  v-x  ad  j§j),  applied  to  the  prostatic  urethra  in  chronic  prostatitis, 
may  be  useful  (Wa.).  Blisters,  in  chronic  prostatitis,  a  small  blister  on  each 
side  of  the  raphe  of  the  perineum,  kept  open  4  to  6  weeks,  has  given  the  best 
results  (Wa.).  Tonic  medicines  and  regimen  should  be  prescribed  (Wa.).  Hot 
Injections,  to  relieve  pain  (R.).  [Compare  Prostatorrhcea.] 

Prostatorrhcea. 

Iron,  the  tincture  of  the  chloride,  when  there  is  much  debility  (B.) ;  chalybeate 
tonics  with  quinine  and  strychnine  (Gross).  Atropine,  indicated  in  all  cases, 
with  potassium  bromide  (Gross).  Potassium  Bromide,  when  irritability  and 
excitement  (B.)  ;  indicated  in  all  cases  (Gross).  Lead,  injections  of  Goulard’s 
extract,  3j  to  £x  of  water,  night  and  morning,  for  10  minutes  at  a  time  (Gross). 
Ergot,  when  relaxation  exists  (B.).  Bougie,  methodically  introduced,  is  one  of 
the  best  local  measures  (Gross).  Hydrastis,  locally  applied,  a  useful  medicine 
(B.).  [Compare  Prostatitis.  ] 


648 


PRURIGO - PRURITUS. 


Prurigo. 

Alkaline  Baths,  followed  by  a  carbolized  ointment,  and  carbolic  acid  inter¬ 
nally,  are  of  value  in  the  papular  eruption,  known  as  prurigo  (Bulkley).  Sul¬ 
phides,  Potassa  Sulphurata,  with  tar  and  benzoated  lard,  as  ointment  in  genuine 
prurigo  (R.).  Arsenic,  in  doses  of  npv  of  liquor  arsenicalis  thrice  daily  and 
gradually  increased,  has  exercised  a  more  or  less  powerful  influence  (Wa.)  ; 
has  only  a  moderate  effect  (Bulkley).  Belladonna,  controls  cases  which  have 
resisted  ordinary  treatment  (B.).  Carbolic  Acid,  locally  and  internally,  is 
especially  serviceable  in  prurigo  senilis  (B.).  Mercury,  the  bichloride,  gr.  xx 
with  Ammonii  Chloridi,  gr.  xxx,  in  Oj  of  pure  water,  as  lotion  in  prurigo  con¬ 
tagiosa,  “  army-itch  nothing  equal  to  it  (White).  Borax,  a  saturated  solution 
in  rose-water  locally  (R.) ;  gr.  v-x  to  §j  of  hot  water  for  pruriginous  eruptions 
on  mucous  membrane  of  vulva  and  vagina  (R.).  Galvanism,  when  prurigo  is 
referable  to  alterations  in  the  cutaneous  nerves  (B.).  Tonics,  are  required, 
nerve-tonics  as  well  as  general  ones,  Cod-liver  Oil,  Quinine,  Strychnine  and 
Phosphorus  (E.  Wilson).  Quinine,  in  large  doses,  gr.  v-x,  will  control  violent 
exacerbations  (Wilson).  Baths,  the  Turkish,  frequently  repeated,  with  inunc¬ 
tion  of  the  skin,  may  be  regarded  as  curative  in  most  cases  (Wilson).  ] Com¬ 
pare  Pruritus.] 


Pruritus. 

Alkaline  Baths,  locally,  followed  by  the  application  of  Carbolic  Acid  Oint¬ 
ment,  give  great  comfort  in  all  forms  of  pruritus  (Bulkley).  Sodium  or  Potas¬ 
sium  Carbonate  preferred  (Tr.) ;  in  solution  locally,  £>iij  ad  ^ iv  (B.).  Carbolic 
Acid,  as  lotion  with  glycerin,  to  the  itching  surface,  gives  great  relief  (Bulkley) ; 
internally  and  locally  in  pruritus  senilis  (B.) ;  a  one  per  cent,  solution  as  lotion 
in  pruritus  ani  (R.).  Mercury,  strong  solutions  of  the  Bichloride,  black  wash, 
yellow  wash  or  mercurial  ointment,  in  itching  of  skin  affections  (R.) ;  Yellow 
Wash  is  one  of  the  most  efficient  applications  for  pruritus  ani.  Solutions  of  the 
Bichloride  are  very  useful  applications  in  pruritus  vulvas  etani  (Tr.)  ;  for  pruri¬ 
tus  vulvas  a  lotion  of  the  Bichloride  1  to  2500  parts  of  water,  with  alum  and 
starch,  is  recommended  (B.).  Calomel  3j  to  of  lard,  as  ointment,  is  the  best 
application,  except  in  the  pruritus  of  urticaria;  very  useful  in  pruritus  ani,  less 
so  in  pruritus  pudendi  (R.).  The  Oleate,  a  5  per  cent,  solution  in  oleic  acid 
with  one-eighth  part  of  ether,  applied  by  a  camel’s-hair  brush,  in  pruritus  ani  et 
pudendi  (Marshall).  Alum,  a  strong  solution  is  very  useful  for  pruritus  vulvas 
(Tr.).  Hydrocyanic  Acid,  diluted  as  lotion,  often  very  serviceable;  may  be 
prescribed  in  solution  with  borax  (B.) ;  or  laurel-water  as  lotion,  especially  in 
pruritus  senilis  (P.).  Potassium  Cyanide,  3j  to  Oj  of  water,  as  lotion  for  pru¬ 
ritus  of  various  kinds  when  the  skin  is  unbroken  (R.)  ;  as  ointment  or  solution, 
if  strong  enough,  relieves  greatly,  but  must  be  used  with  caution  (B.) ;  or  rtbxxx 
of  the  dilute  acid  of  the  Br.  Pharmacopoeia  in  of  water  or  glycerin,  may  be 
used  instead  (R.).  Silver  Nitrate,  a  solution,  gr.  xx  ad  gj,  painted  over  the 
affected  parts  in  pruritus  vulvse,  is  very  effective  (B.).  Tobacco,  is  an  effective 
but  dangerous  application  (B.).  Iodoform,  as  ointment,  3j  ad  §j  adipis  (R.). 
Iodine,  for  itching  of  the  nose  or  inner  canthus,  sneezing,  etc.,  iodine  inhala¬ 
tions  have  a  marked  effect  (R.).  Arsenic,  for  itching  of  the  nose,  accompany¬ 
ing  asthmatic  symptoms  (R.).  Benzoin,  the  compound  tincture  painted  on  the 
skin,  for  the  itching  of  eczema,  urticaria,  etc.  (R.).  Boracic  Acid  makes  an 
excellent  lotion  in  pruritus  pudendi,  a  teasp.  to  the  pint  of  hot  water  (R.). 
Borax,  gr.  v-x  ad  3  j  hot  water  (R.).  See  Prurigo.  Balsam  of  Peru,  is  a  very 
good  application  in  pruritus  ani,  scabies,  and  many  other  forms  of  itching 
(Auerbach).  Camphor,  with  Chloral,  rubbed  together,  makes  a  liquid  which, 
added  to  vaseline,  makes  an  ointment  which  is  powerfully  antipruritic  (Bulkley); 
added  to  dusting  powders,  allays  heat  and  itching  of  eczema  and  intertrigo 
(R.).  Chloroform,  as  ointment  to  allay  itching  of  skin  diseases  (R.).  Gelse- 
mium,  TT\,xv  of  the  tincture  every  half  hour,  up  to  3j.  for  itching  which  is  out  of 
proportion  to  the  cutaneous  lesion  (Pelcher).  Lead  Lotions,  to  ease  the  itching 
of  urticaria,  pruritus  pudendi,  etc.,  especially  when  the  mucous  membrane  is  red 


PSORIASIS. 


and  excoriated  (R.).  Salicylic  Acid,  as  ointment,  in  pruritus  ani  et  vulvae  (R.). 
Sodium  Salicylate,  in  15-grain  doses  by  mouth  every  four  hours,  will  greatly 
relieve  pruritus  vulvae,  when  due  to  diabetes  (Goodell).  Tar,  as  ointment,  is 
strongly  recommended  (Tr.)  ;  for  general  pruritus,  if  no  cause  can  be  found, 
the  two  best  remedies  are  Tar  and  Sulphur,  as  lotion  or  bath  (Sparks) ;  oint¬ 
ments  containing  Tar  give  relief  in  many  instances  (Bulkley).  Sulphur,  may 
be  employed  as  a  bath,  Potassa  Sulphurata,  ^ij  ad  Cxv  of  hot  water  (Sparks) ; 
or  the  alkaline  sulphites  locally  (Wa.) ;  the  iodine  of  sulphur  externally  and 
internally,  in  pruritus  senilis  (Wa.).  Chlorine,  the  liquor  Sodae  Chloratae,  diluted, 
a  useful  application  in  pruritus  ani  (Wa.).  Cocaine,  in  5  per  cent,  solution  or 
oleate,  is  by  far  the  most  efficient  of  all  antipruritics  ;  relieves  the  itching  of 
scrotal  eczema,  pruritus  ani  et  pudendi,  and  especially  in  lesions  of  the  epider¬ 
mis  where  the  oleate  or  solution  can  penetrate  at  once  to  the  true  skin.  [Com¬ 
pare  Eczema,  Erythema,  Lice,  Pediculi,  Prurigo,  Scabies,  Urticaria.] 


Prescriptions. 


R.  Ac.  Carbolici, . £ij. 

Glycerini, . ^j. 

Aquae  Rosae,  .  .  .  q.  s.  adgv iij. 
M.  Sig. — Lotion  for  pruritus. 


R.  Ac.  Hydrocyanici  Dil.,  .  .  ^ss-j. 


Infusi  Altheae, . Jv-viij. 

M.  Sig. — Lotion.  ( Fox .) 


R .  Potassii  Cyanidi,  .  .  . 

.  .  gr.  xv. 

Aquae  Laurocerasi,  .  . 

.  .  ,1  viij. 

M.  Sig. — Lotion. 

(Anderson.) 

R  .  Liq.  Carbonis  Detergentis,  .  25  ss. 


Glycerini, . t^j. 

Aquae, . ad^x. 

M.  Sig. — Lotion.  ( Sparks .) 


R  .  Acidi  Benzoici, . gr.  cx. 

Ol.  Caryophylli,  .  .  .  .  gtt.  xl. 

Alcoholis, . %  ijss. 

Solve  et  adde — 

Cerati  Simplicis,  ....  ^viij. 
Balsami  Peruviani,  .  .  .  %  j. 


M.  ft.  unguentum.  Especially  good  for 
scabies,  but  may  be  used  for  any  pruritus. 


R.  Ac.  Hydrocyan.  Dil.,  .  .  3  ij. 


Sodii  Boratis, . zj. 

Aquae  Rosae, . ^  viij. 

M.  Sig. — Lotion.  (Pox.) 


R .  Potassii  Cyanidi,  .  .  .  .  gr.  vj. 

Pul v.  Cocci, . gr.  j. 

Ung.  Aquae  Rosae,  .  .  ^j. 

M.  Sig. — Ointment.  (Anderson.) 


R.  Cretae  Praeparatae,  .  .  .  .  ^j. 

Coal  Tar, . zj-ij. 

01.  Lini, . 3  ijss. 

M.  ft.  unguent. 


R .  Gummi  Camphorae, 

Chloralis  Hydratis,  .  .  aa  ^  j— ij. 
Rub  together  until  liquefied, 
then  add,  slowly  with  friction, — 

Unguenti  Aquae  Rosae,  .  .  gj. 

Sig. — Ointment  for  itching. 

(Bulkley.) 


R.  Hydrarg.  Chlor.  Corr.,  .  .  gr.  j. 
Pulv.  Aluminis,  .....  gr.  xx 


Amyli, . ^jss. 

Aqua.', . 3  vj. 

M.  Sig. — Apply  locally.  (  Goodell.) 


Psoriasis. 

Arsenic,  at  first  apparently  aggravates,  but  soon  heals  the  disease  (R.,  B.) ; 
in  lepra  must  be  persistently  used  for  a  long  time  (B.) ;  exercises  a  powerful 
influence  (Wa.) ;  maximum  dose  rr^v  liquor  arsenicalis  ter  die,  never  on  empty 
stomach  (R.).  Mercury,  in  patches  of  obstinate  psoriasis,  especially  of  hands 
even  when  not  syphilitic.  Calomel  and  mercuric  nitrate  ointment  may  be 
mixed,  and  tar  ointment  added  (R.).  Lappa  Major,  a  tincture  of  the  seeds  in 
whiskey,  used  by  tablespoonful  doses,  curative  of  psoriasis  of  long  standing 
(Reiter).  Carbolic  Acid,  1  to  4  of  lard,  as  ointment  (Wa.).  Mezereon,  a  useful 
adjunct  (Wa.).  Sulphur,  internally  (R.)  ;  a  solution  of  potassa  sulphurata  in 


650 


PTERYGIUM - PUERPERAL  CONVULSIONS. 


water,  is  excellent  in  chronic  psoriasis  (B.)  ;  not  in  acute  (R.).  Sulphur  Iodide, 
externally  and  internally,  in  doses  of  gr.  j-vj  used  with  great  advantage  (Wa.). 
Silver  Nitrate,  in  psoriasis  of  tongue  and  buccal  mucous  membrane  occasion¬ 
ally  ;  if  syphilitic,  mercurials  best  (R.).  Chrysarobin,  has  the  most  decided 
effect  on  psoriasis,  3 ss— ij  ad  ^i  of  ung.  aquas  rosae  ;  often  irritates,  and  should 
be  employed  at  first  with  caution  (Bulkley).  Nitric  and  Nitro-Hydrochloric 
Acids,  when  symptomatic  of  imperfect  digestion  and  assimilation  (B.).  Phos¬ 
phorus,  as  substitute  for  arsenic  (B.).  Coptis,  has  reputation  in  New  England 
(B.).  Copper  Sulphate,  applied  solid  to  spots  (R.).  Lead,  the  ointment  of  the 
iodide  (B.).  Tar,  painted  on,  in  obstinate  cases  (R.).  Oils,  Cod-liver  Oil  inter¬ 
nally  and  locally,  is  the  sheet-anchor,  especially  when  of  strumous  origin  (B.) ; 
oils  and  fats  to  lubricate  skin,  with  warm  baths  (R.).  Diet  and  Hygiene, 
nourishing  diet,  frequent  small  quantities  of  raw  vegetables.  Cod-liver  oil  for 
growing  persons,  especially  when  stale  fish  the  cause.  Rest  and  change  for 
overworked  subjects.  Daily  baths  and  cold  sponging.  Free,  open-air  exercise 
is  also  most  useful.  Warm  or  tepid  soft-water  baths  at  night,  with  use  of  pure 
soap. 

Pterygium. 

Silver  Nitrate,  locally,  especially  when  pterygium  with  catarrhal  conjunc¬ 
tivitis  (Wa.).  Treatment  unavailing.  Benefit  seldom  derived  from  any  opera¬ 
tion  (C.).  Arlt’s  Operation,  the  most  satisfactory  ;  cut  away  as  little  tissue  as 
possible,  dissect  cleanly,  close  with  suture  (Green). 

Ptosis. 

Veratrine,  gr.  x  in  £ij  of  sulphuric  ether  and  3]  of  alcohol,  brushed  over 
the  eyelids,  brows  and  temples  every  morning,  till  a  slight  burning  sensation 
is  produced ;  conjoined  with  the  use  of  electricity  (W.).  Ergot,  aqueous 
infusion  as  collyrium  (Wa.).  Electricity,  the  constant  current  may  often  relieve 
recent  cases  (C.).  Operation  for  shortening  the  lid,  by  removing  an  elliptical 
piece  of  skin  and  subjacent  muscle  (C.) ;  is  not  advisable  unless  the  ptosis  is 
nearly  or  quite  complete,  and  of  great  inconvenience. 

Ptyalism. 

Iodine,  as  gargle,  3 ij  of  tinct.  ad  3  viij  aquae  (R.) ;  is  worthy  of  trial  (Wa.). 
Acids,  as  astringents,  small  medicinal  doses  (R.).  Sulphuric,  int.  and  as  a 
gargle  with  decoctum  cinchonae,  of  great  benefit  in  mercurial  ptyalism  (Wa.). 
Potassium  Chlorate,  in  simple  or  mercurial  ptyalism  (R.)  ;  in  the  latter  form 
3j  ad  5vj  aquae  as  mouth-wash,  and  internally  in  teasp.  doses,  4  or  5  times 
daily  (St.).  Belladonna,  very  effective  in  mercurial  ptyalism,  and  that  of  preg¬ 
nancy.  Gtt.  v-x,  or  Atropine  gr.  y^y  to  TRy  every  4  to  6  hours  (B.).  Atropine 
hypodermically  (R.)  ;  should  be  useful  (W.).  Tannic  Acid,  in  mercurial  ptyal* 
ism  is  an  excellent  gargle,  3)  of  tannin  to  3 ij  of  mel  rosae,  and  3yj  of  water 
(B.).  Alcohol,  diluted,  as  a  gargle  (R.).  Potassium  Iodide,  sometimes  bene¬ 
ficial  in  mercurial  ptyalism,  but  often  aggravates  it  (R.). 

Prescriptions. 

R.  Sodii  Boratis . 3  ij. 

Pulv.  Myrrhae, . 3]. 

Aquae, . 3  vj. 

M.  Sig. — Mouth-wash  or  gargle. 

Puerperal  Convulsions. 

Aconite,  one  of  the  best  agents  (P.) ;  gtt.  j-ij  of  tinct.  every  10  or  15  minutes 
for  the  first  hour,  then  at  longer  intervals  (B.).  Belladonna,  the  tincture  in¬ 
ternally  with  atropine  hypoder.,  of  verified  utility  (P.).  Veratrum  Viride,  in 
3ss  doses  of  fluid  extract  every  15  minutes,  to  nausea,  invaluable  (R.)  ;  the 
fl.  extract,  in  doses  of  npviij-x  hypodermically,  may  be  repeated  in  half-hour 


R .  Tinct.  Myrrhae,  .  . 

Aquae, . 

M.  Sig. — Mouth- wash. 


PUERPERAL  DISORDERS - PUERPERAL  FEVER. 


651 


with  Morphine,  or  rr^x  by  enema,  promptly  efficient  in  the  worst  cases  (Elmer)  ; 
a  very  bad  case  cured  by  20-minim  doses  every  hour  for  5  days  (Dunn) ;  the 
worst  case  seen  in  my  30  years’  experience,  after  14  seizures  was  promptly 
cured  by  a  hypodermic  injection  of  tt\Jv  of  Norwood’s  tincture  in  a  little  water 
(Etheridge).  Pilocarpine  Nitrate,  gr.  ^  hypodermically  every  2  hours,  very  suc¬ 
cessfully  used  in  several  cases  (Finniss).  Potassium  Bitartrate,  administered 
for  a  month  prior  to  confinement,  in  quantity  sufficient  to  bring  about  free 
action  of  kidneys  and  bowels,  will  certainly  prevent  puerperal  convulsions. 
(Anderson).  Opium  is  apt  to  induce  eclampsia,  unless  its  use  be  preceded  by 
free  purgation  or  venesection  (Idem) ;  as  morphine  hypodermically  ;  the  most 
important  agent  for  cure  of  uraemic  convulsions  (B.)  ;  with  the  lancet,  some¬ 
times  required  (P.).  Anaesthetics,  especially  chloroform  (R.) ;  utility  unques¬ 
tionable,  when  not  due  to  cerebral  hemorrhage  (B.).  Chloral,  full  doses  (gr. 
xx-xxx)  every  2  hours,  may  arrest  (B.) ;  a  remedy  of  the  greatest  value,  a  full 
dose,  gr.  xx-xxx,  before  proceeding  to  one  of  the  bromides  (Playfair,  Barnes, 
etc.).  Amyl  Nitrite,  by  inhalation  (B.) ;  may  cause  alarming  hemorrhage  (W.). 
Ice,  to  the  head  (R.) ;  and  mustard  poultices  at  same  time  to  the  feet  (Wa.). 
Venesection,  by  far  the  most  efficient  measure  (Wallace)  ;  when  great  cerebral 
congestion  and  vascular  tension,  shown  by  a  livid  face,  a  full  and  bounding 
pulse,  and  strong  pulsation  in  the  carotids  (Playfair). 

Puerperal  Disorders. 

Cimicifuga,  in  puerperal  hypochondriasis,  and  depression  (Wa.,  P.).  Opium, 
either  alone  or  with  alteratives,  highly  serviceable  in  puerperal  intestinal  irri¬ 
tation  ;  a  few  drops  of  tincture  effectually  arrests  the  diarrhoea  (Wa.)  ;  when 
shock  and  marked  exhaustion,  a  moderate  dose  is  of  benefit  (L.).  Castor  Oil, 
undoubtedly  the  best  laxative  (L.)  ;  purgatives  generally  are  not  required. 
Castor  oil  the  very  worst  (Fordyce  Barker);  action  uncertain  (Parry).  Rhu¬ 
barb,  or  enemas,  best  means  of  stimulating  bowels  after  fourth  day  (L.) ;  gr. 
xx-xxx  in  some  aromatic  water  a  good  aperient  (Wa.).  Aliment,  in  puerperal 
state  should  be  easy  of  digestion  and  sustaining  (L.).  Catheter  necessary  often 
for  several  days  when  bladder  paralyzed,  if  warm  water  lavements  fail  to  excite 
(L.).  Water,  tepid  sponging  of  external  parts,  vaginal  washings  daily  with  warm 
water,  with  part  carbolic  acid  (L.).  [See  After-pains,  Hemorrhage, 
Labor,  Lactation,  Mastitis,  Nipples,  Phlegmasia  Alba-Dolens,  etc.] 

Puerperal  Fever. 

Aconite,  drop  doses  every  one  or  two  hours  steadily,  with  an  occasional  dose 
of  castor  oil,  and  repeated  hot  poultices  or  laudanum  fomentations,  the  most 
successful  treatment,  even  in  the  worst  cases,  but  is  useless  if  not  promptly 
efficient  (P.).  Veratrum  Viride,  is  used  with  great  benefit  in  most  cases  (F. 
Barker).  Opium,  for  wakefulness  and  delirium  (B.) ;  a  very  valuable  remedy, 
tending  to  allay  pain,  and  reduce  excitement  of  the  nervous  and  vascular 
systems  (Wa.).  Alkaline  Sulphites,  especially  valuable  in  early  stages,  inter¬ 
nally  and  locally  ;  gr.  xx-xxx  of  magnesium  or  calcium  sulphite  every  2  or  3 
hours,  with  injections  every  day  (Wa.).  Stramonium,  when  cerebral  excite¬ 
ment  (P.).  Potass.  Permang.,  gr.  ter  die,  has  been  given  with  benefit  (B.). 
Alcohol,  freely  used,  until  all  evidence  of  sepsis  subsided,  caused  recovery  in 
one  of  the  most  desperate  cases  of  puerperal  septicaemia,  of  three  weeks’  stand¬ 
ing,  with  temp,  falling  to  950  and  rising  to  107°  (Hills).  Calumba,  preferable 
to  cinchona  (P.).  Quinine,  only  large  doses  are  useful  :  gr.  v-xx  every  4  hours 
(B.) ;  reduces  temperature  (P.).  Turpentine,  when  depression  of  vaso-motor 
nervous  system,  cardiac  weakness,  and  tympanitic  distention  of  abdomen 
(P.,  R.).  Resorcin,  is  much  used  in  Vienna  by  Braun  ;  gr.  xl  repeated  p.  r.  n. 
Antiseptic  Injections  into  uterus,  opposed  very  strenuously  by  many  of  our  best 
men.  See  N.  Y.  Med.  Rec.,  1884.  p.  14.  For  antiseptic  treatment  by  Hydrarg. 
Bichlor.,  see  Dr.  Garriguesin  N.  Y.  Med.  Rec.  of  December  29,  1883,  and  N.  Y. 
Med.  Jour,  of  March  1,  1884,  and  the  discussion  in  the  N.  Y.  Academy  of  Medi- 


652 


PUERPERAL  MANIA — PURPURA. 


cine,  reported  in  the  N.  Y.  Med.  Record  of  January  5  and  February  16,  1884, 
et  seq.  Water,  hot  fomentations  frequently  to  parts,  a  valuable  preventive. 
Rest,  and  quiet  but  attentive  nursing  ;  frequent  liquid  nourishment.  Warburg’s 
Tincture,  is  more  efficient  than  the  largest  doses  of  quinine  in  cases  of  puerperal 
malarial  fever,  ^ss  every  four  hours  until  fever  abates,  then  in  diminishing 
doses  to  3j-ij,  until  convalescence  is  established  {Fordyce  Barker).  [Compare 
Puerperal  Peritonitis.] 

Puerperal  Mania  and  Melancholia. 

Stramonium,  will  allay  cerebral  excitement,  and  soothe  nervous  system  ; 
when  delirium  wild  and  furious,  but  intermittent ;  tendency  to  suicide  or  to 
destroy  the  child,  vr^x-xx  of  tinct.  every  3-4  hours  (P.).  Hyoscyamus,  in 
milder  cases ;  nervous  system  greatly  excited  (P.).  Aconite,  in  puerperal 
mania,  with  high  fever,  restlessness ;  speedy  and  marked  success  if  given  soon 
after  chill  (P.).  Cimicifuga,  has  cured  (B.) ;  its  effects  are  truly  remarkable  in 
mania,  and  hypochondriasis  of  puerperal  state  (P.).  Chloral,  often  alleviates 
symptoms  (B.)  ;  to  produce  sleep  (Wa.).  Potassium  Bromide,  in  sthenic  cases 
(R.) ;  its  effects  are  very  variable  (Wa.).  Anaesthetics,  ether  inhaled  in  violent 
paroxysms  of  mania  (B.).  Tartar  Emetic,  in  frequently  repeated  doses  (Wa.). 
Quinine,  when  much  weakness ;  skin  cold  and  sweating  (B.).  Chalybeates, 
tinct.  ferri  chlor.  (rr^v-xx)  in  anaemic  form  (B.).  Opium,  cautiously  (B.)  ;  gives 
the  best  results  in  such  doses  as  may  be  necessary  to  allay  irritation  and  procure 
sleep  (Wa.).  Poultices,  hot  fomentations,  enemas,  or  gentle  laxatives ;  nutri¬ 
tious  and  stimulating  diet.  Lochia  should  be  watched  (P.).  Weaning,  impera¬ 
tive  in  melancholia ;  not  so  in  acute  mania. 

Puerperal  Peritonitis. 

Aconite,  has  cured  cases  of  the  usual  type  (P.).  [See  Puerperal  Fever.] 
Cimicifuga,  in  rheumatic  form  especially,  has  remarkable  effects  (P.).  Opium, 
its  curative  power  in  this,  one  of  the  best  established  facts  in  therapeutics  (B.) ; 
is  good,  but  aconite  often  better  (P.) ;  especially  valuable  in  adynamic  cases 
(Wa.)  ;  the  drug  of  all  others  to  be  relied  on  (Godson).  Turpentine,  as  stimu¬ 
lant,  rtpx  frequently  repeated  ;  better  than  alcohol  (B.) ;  enemas,  also  hot  tur¬ 
pentine  epithems,  may  be  used  with  advantage  (Wa.).  Quinine,  in  consider¬ 
able  doses,  with  or  without  opium  (B.) ;  gr.  x-xx  twice  daily  as  an  antipyretic 
(Wa.).  Antimony,  as  Tartar  Emetic,  gr.  to  ^  every  hour  to  shorten  attack 
and  render  it  more  mild  (R.).  Cathartics,  advised  by  many,  prohibited  by  as 
many;  evidence  is  in  favor  of  mild  aperients  combined  with  Dover’s  powder  or 
Hyoscyamus  (Wa.).  Poultices,  hot,  of  very  great  value  (B.).  Water,  ice  in 
mouth  or  swallowed,  hot  fomentations  to  abdomen.  In  some  cases  cold  com¬ 
presses  best.  [Compare  Puerperal  Fever.] 

Pulse. 

Aconite,  for  a  quick,  resisting  pulse  (P.) ;  a  moderate  dose,  while  it  makes  the 
pulse  less  frequent,  renders  it  fuller,  stronger  and  less  compressible  (R.). 
Veratrum  Viride,  reduces  febrile  heat  with  abnormal  rapidity  of  pulse  (P.). 
Veratrine,  pulse  at  first  quick  and  strong,  then  slowed;  afterwards  quick,  weak 
and  irregular  (R.).  [Compare  Vascular  Stimulants,  etc.,  ante ,  page  34.] 

Purpura. 

Sulphuric  Acid,  often  acts  happily  (B.).  Ergot,  has  been  strongly  urged 
(R.) ;  is  most  useful  in  removing  purpura  (P.);  many  cases  are  recorded  as 
cured  by  hypodermic  injections  of  Ergotin  (Wa.).  Turpentine,  has  been  used 
(R.)  ;  with  invariable  benefit  (Wa.).  [See  Hematemesis.]  NuxVomica.no 
prescription  more  generally  useful  than  the  Syrup  of  Iron,  Quinine,  andStrych- 


PUSTULE,  MALIGNANT - RACHITIS.  653 

nine  (B.).  Iron,  when  due  to  anaemia  ;  the  tincture  of  the  chloride  (B.) ;  is 
preeminently  the  curative  remedy  for  purpura  hemorrhagica,  arresting  the 
hemorrhagic  tendency  in  24  to  48  hours  (Pize).  Vinegar,  and  water,  is  an 
excellent  application  by  sponging  over  the  body  (E.  Wilson).  Quinine,  or  Hux- 
ham’s  tincture  of  bark,  are  much  used  (H.).  Potassium  Nitrate,  gr.  x  thrice 
daily  in  purpura  simplex,  used  successfully  (Wa.).  Styptics,  as  the  ammonio- 
ferric  alum,  tinct.  of  ferric  chloride  (Tr.) ;  tannic  and  gallic  acids,  used  in  some 
cases  (H.).  Alum,  and  brandy,  or  whiskey  and  water  at  such  temperature  as 
is  not  chilling,  applied  by  sponging  the  body,  is  the  best  local  measure  (H.). 
Wines  are  generally  indicated  (B.).  [Compare  Hemorrhage,  Scurvy. J 

Pustule,  Malignant. 

Nitric  Acid,  strong,  applied  steadily  (after  thorough  cleansing  and  drying)  to 
destroy  the  diseased  mass  (D.).  Bromine,  to  saturate  the  surface  (D.).  Car¬ 
bolic  Acid,  undiluted,  as  caustic,  or  with  oil,  the  favorite  (D.) ;  the  most  prefer¬ 
able  caustic  (Greenfield).  Quinine  and  Carbolic  Acid,  internally,  are  indicated 
in  all  forms,  also  stimulants,  as  Ammonia,  Ether,  and  Alcohol  (Greenfield). 
Eschar  should  be  promptly  destroyed,  to  avoid  contagion  (R.).  Excision  and 
cauterization  demanded,  when  from  direct  inoculation  ;  the  two  most  successful 
remedies  (Greenfield). 

Pyaemia  and  Septicaemia. 

Quinine,  large  doses  only  (gr.  xv-xx)  are  useful  (B.) ;  supposed  to  diminish 
the  temperature  (R.) ;  to  cinchonism,  in  childhood  the  best  remedy  (Wa.) ;  is 
probably  the  most  useful  medicine,  given  in  full  and  frequently  repeated  doses 
(Haward).  Salicin,  to  reduce  the  temperature  in  septicaemia  and  to  relieve  the 
cerebral  symptoms  (R.).  Salicylic  Acid,  has  decided  value  (B.).  Potassium 
Permanganate,  given  with  advantage,  gr.  %-gr.  j  thrice  daily  in  distilled  water 
(B.).  Boracic  Acid,  a  saturated  solution  to  wounds,  ulcers,  etc.  Also  Chlorine, 
as  disinfectant  (B.).  Oleum  Caryophylli,  locally.  Also  olei  gaultheriae,  thymi, 
etc.  (B.);  as  antiseptics.  Water,  cold,  as  dressing.  Hot  better,  95°-ioo®  F. 
Hamilton’s  immersion  plan  for  wounds  (B.).  Stumps  to  be  immersed  in  a 
warm  bath,  to  avert  pyaemia  (R.).  Sulphites,  may  do  some  good  in  chronic 
cases,  but  the  use  of  sulphurous  acid  has  not  given  the  results  in  man  which 
Polli  obtained  from  its  use  on  animals  (Haward).  Turpentine,  is  a  better  stim¬ 
ulant  than  alcohol  (B.).  Ice,  dissolved  in  the  mouth  (Wa.).  Aliment.  Plentiful 
nourishment,  with  wine  and  good  ventilation,  are  not  to  be  neglected  (Wa.). 
Malt  liquors  are  justly  esteemed  (B.).  Stimulants  necessary;  brandy  the  best 
(Wa.).  Abscesses,  must  be  opened  early,  especially  when  in  joints. 

Pyrosis  and  Cardialgia. 

Capsicum,  in  atonic  dyspepsia,  with  heartburn  and  diarrhoea  (P.).  Nux 
Vomica,  of  the  highest  possible  value  in  atonic  dyspepsia  with  heartburn,  hic¬ 
cough,  regurgitation,  etc.  An  excellent  combination  is  npv-x  of  the  tincture 
with  rr^xv  of  dilute  nitric  acid  for  one  dose  (P.).  Pulsatilla,  a  good  medicine 
in  heartburn  of  dyspepsia  in  phlegmatic  subjects  (P.).  Podophyllin,  gr.  night 
and  morning  in  obstinate  heartburn,  with  liver  derangement  (P.).  Almonds, 
six  or  eight  blanched,  said  to  relieve  heartburn  (P.).  Diet,  lemon-juice,  aerated 
bread,  plain  biscuit,  etc. ;  but  avoid  new  bread,  much  vegetable  food,  and 
pastry.  [Compare  Acidity,  Dyspepsia.] 

Rachitis. 

Lime,  as  lime-water,  or  the  carbonate,  or  the  syrupus  calcii  lacto-phosphatis 
(B.) ;  in  small  doses  (R.) ;  the  phosphate  may  be  advantageously  combined 
with  cod-liver  oil  (Wa.).  Iron,  the  syrup  of  the  iodide  preferred  ;  calcium  and 
ferric  phosphates  excellent  in  combination  (B.) ;  must  be  continued  a  long  time 


654 


RECTUM,  DISEASES  OF - RELAPSING  FEVER. 


(R.).  Nitro-hydrochloric  Acid,  as  baths,  gives  excellent  results  (Wa.).  Qui¬ 
nine,  often  very  valuable  (P.).  Aliment,  food  rich  in  phosphate  of  lime  and 
other  phosphatic  salts  ;  oatmeal,  Graham  bread,  etc.  (B.).  Cod-liver  oil,  the 
best  constructive  agent  (B.).  A  full  animal  diet  (Wa.).  Cold  sponging  (R.). 


Rectum,  Diseases  of. 

Podophyllum,  in  doses  of  gr.  -^o  to  y1^  night  and  morning,  for  a  child,  may 
relieve  prolapsus  of  the  rectum  (P.).  Belladonna,  the  extract  locally  in  fissure 
(R.);  and  irritable  ulcers  (P.) ;  internally  and  locally  to  remove  ulcers,  also 
excellent  in  burning  pain  following  defecation,  or  with  mercurial  ointment  in 
equal  parts,  for  fissures  and  ulcers  (P.).  Phosphorus,  in  chronic  inflammation 
of  the  rectum,  has  been  highly  recommended  (R.).  Cocaine,  gr.  xl  to  §j  of 
Glycerite  of  Starch,  applied  by  Seeley’s  Pile-pipe,  very  efficient  in  controlling 
spasm  of  the  rectum.  Potassium  Bromide,  in  5  parts  of  glycerin,  locally,  fis¬ 
sures  and  painful  growths  (R.).  Iodoform,  as  suppository  in  painful  diseases, 
relieves  greatly  (R.).  Pepper,  the  confection,  as  gentle  stimulant  in  fistula, 
ulcers,  hemmorrhoids  (P.).  Castor  Oil,  in  fissure  and  hemorrhoids,  is  commonly 
used  as  purgative  (R.,  P.).  Sulphur,  with  confectio  sennae,  in  irritable  rectum, 
is  very  soothing  (Wa.).  Stramonium,  ointment  from  fresh  leaves  to  alleviate 
pain  (P.).  Conium,  the  extract  in  doses  of  gr.  x  to  allay  pain  and  irritability  in 
cancer  (Wa.).  Purgatives,  best  for  proctalgia  (D.).  Surgical,  in  ulcer  or  fissure, 
an  incision  through  mucous  membrane,  and  in  severe  cases  to  divide  part  of 
the  sphincter.  A  flake  of  cotton  should  be  laid  in  the  wound,  so  that  it  may 
heal  by  granulation  (D.).  [See  Anus,  Diarrhcea,  Dysentery,  Rectum  Ul¬ 
ceration  of,  Hemorrhage  Intestinal,  Hemorrhoids,  Prolapsus.] 


Rectum,  Ulceration  of. 

Mercury,  the  red  oxide,  £j  to  the  5  of  unguentum,  as  ointment  in  flat  ulcers 
of  rectum  existing  just  within  the  anus  (Coulson).  Belladonna,  locally  the 
extract  for  rectal  ulcers,  is  very  efficient  (P.).  Carbonic  Acid,  the  gas,  per  anum, 
is  strongly  advised  (Wa.).  Chloroform,  as  ointment,  in  irritable  ulcer  of  rectum 
(Curling).  Iodoform,  in  suppository,  extremely  useful  in  painful  ulceration  (R.) ; 
used  in  many  cases  with  very  satisfactory  results,  but  in  some  instances  poison¬ 
ing  occurs;  hence  it  should  be  used  with  caution  (Wa.).  Phosphorus,  as  an 
internal  remedy,  is  highly  recommended  in  chronic  inflammation  of  the  rectum 
(R.).  Copper  Sulphate,  with  opium,  may  often  be  used  internally  with  advan¬ 
tage,  and  a  weak  solution  of  the  same,  or  of  Silver  Nitrate,  locally  (Curling) ; 
the  writer  had  a  case  which  resisted  treatment  for  3  years,  and  in  which  a  cure 
was  effected  by  a  persevering  use  of  a  pill  of  Cuprum  Sulphate,  Extract  of 
Opium,  and  Quinine  Sulphate.  Silver  Nitrate,  gr.  combined  in  pill  with 
Opium,  gr.  ss;  and  a  solution,  gr.  x-xx  to  the  pint,  by  enema  (B.). 


R .  Cupri  Sulphat., 

Morphinae  Sulphat., 
Quininae  Sulphat.,  . 
M.  ft.  pil.  no.  xxiv. 
thrice  daily. 


Prescriptions. 

R.  Chloroformi, 


.  .  aa  gr.  ij. 

.  .  .  gr.  xxiv. 
Sig. — One  pill 
(. Potter .) 


Zinci  Oxidi,  .  . 
Olei  Olivae,  .  . 
Cerati  Cetacei, 
M.  ft.  unguentum. 


SH- 
Sss- 
Zb 
Z 1V- . 

{Curling.') 


Relapsing  Fever. 

Cathartic,  mild  at  beginning  (H.)  ;  if  jaundice  or  other  hepatic  derange¬ 
ment,  a  calomel  purgative,  cautiously,  lest  irritation  (Wa.).  Potassium  Citrate, 
as  cooling  diaphoretic.  Quinine,  in  moderate  doses  after  the  crisis,  at  least 
until  the  relapse,  which  will  not  be  prevented  by  any  amount  of  quinine  (Wa.). 
Leeches  or  Cupping,  best  for  headache  (A.).  Alcohol,  required  by  some  pa¬ 
tients.  Diet,  supporting,  especially  in  third  week,  beef-tea,  etc.  Urine,  should 
be  watched  carefully  (A.).  [Compare  Typhus  Fever.] 


REMITTENT  FEVER - RHEUMATIC  ARTHRITIS. 


655 


Remittent  Fever. 

Aconite,  in  hot  stage,  if  any  febrifuge  is  required,  frequently  repeated  doses 
(B.)  ;  is  next  in  value  to  quinine  for  high  fever  and  headache,  gtt.  j  of  a  good 
tincture  every  hour  (Da  Costa).  Quinine,  20  to  30  grs.  in  single  dose  once 
or  twice  daily  till  temperature  is  reduced,  with  other  appropriate  remedies 
(B.)  ;  1 5  to  20  grs.  at  most  (Maclean) ;  30  to  50  or  60  grs.  in  severe  cases  of 
pernicious  remittents  several  times  a  day  without  regard  to  exacerbation  (P., 
B.).  Warburg’s  Tincture,  has  achieved  a  very  high  reputation,  but  must  be 
used  in  less  dosage  than  directed,  and  supporting  treatment  given  when  its 
sudorific  action  commences  (Wa.).  Gelsemium,  exercises  a  really  beneficial 
influence ;  depresses  temperature  (B.)  ;  valuable  in  bilious  remittents  of  the 
South  (Pf.).  Morphine,  gr.  %  hypodermically  to  abort  pernicious  remittent 
fever  (B.).  Purgation,  by  calomel  with  jalap  or  salines  afterward,  is  very 
necessary  during  course  of  the  disease  (Da  Costa).  Quassia,  an  excellent  tonic 
in  convalescence,  combined  with  mineral  acids  (Wa.).  Packing,  by  wet  sheet, 
is  resorted  to  with  advantage,  except  when  hepatic  or  splenic  congestion 
(Wa.). 

Retina,  Affections  of. 

Mercury,  in  syphilitic  retinitis  is  of  great  value ;  calomel  gr.  j-ij  with  opium 
gr.  every  4  or  6  hours  ;  also  mercurial  inunction  till  the  gums  are  affected 

or  the  disease  yields  (Wa.).  Potassium  Iodide  and  Bromide,  in  combination, 
in  retinal  hemorrhage,  to  promote  absorption  of  the  effused  blood,  and  benefit 
congestion  (C.).  Eserine,  locally  to  contract  pupil,  and  diminish  the  amount  of 
light  admitted  to  the  eye  (Wa.).  Iron,  in  full  doses,  generally  the  tinct.  of 
the  perchloride,  in  pigmentary  retinitis  ;  seems  to  have  a  tendency  to  arrest  the 
malady  (C.).  Leeches,  to  the  temple  better  than  general  bloodletting  (Wa.). 
When  much  local  congestion  present,  depletion  by  artificial  leech  is  almost 
always  indicated  (C.).  Pilocarpus,  in  detached  retina  and  optic  neuritis  ;  has 
been  found  a  very  useful  remedy  in  retinal  affections  generally.  [Compare 
Amaurosis.] 

Rheumatic  Arthritis. 

Aconite,  highly  spoken  of;  as  liniment,  conjoined  with  internal  use  (Wa.). 
Cimicifuga,  when  joints  enlarged  and  much  stiffened,  and  when  traceable  to 
uterine  derangement,  is  very  useful  (R.) ;  when  pains  worse  at  night  (Wa.). 
Iodine,  tinct.  internally,  said  to  be  better  than  potassium  iodide  (R.),  Iodoform, 
10  parts  to  20  of  Ether  and  20  of  Alcohol,  as  liniment  to  the  joint,  applied  by 
a  pencil,  and  covered  with  oiled  silk  (Gubler).  Iodides,  often  signally  benefit, 
especially  when  due  to  syphilitic,  mercurial,  or  mineral  poisoning  (B.).  Large 
doses  of  potassium  iodide  sometimes  required  (R.) ;  combined  with  guaiacum, 
or  corrosive  sublimate,  often  curative  in  cases  resisting  these  remedies  given 
separately  (Wa.) ;  Potassium  Iodide  should  always  be  fairly  tried  (Da  Costa). 
Guaiac,  the  ammoniated  tincture,  in  doses  of  gj-ij  in  milk,  often  gives  excel¬ 
lent  results  (Da  C.).  Colchicum,  with  alkalies,  extremely  useful  (B.).  [See 
Gout,  for  formulas.]  Arsenic,  when  referable  to  nervous  affections  (B.) ;  as  a 
bath  containing  3iv  washing  soda  and  gr.  xx  arseniate  of  sodium;  in  large 
doses,  continued  for  some  time,  sometimes  of  great  benefit,  but  action  is  capri¬ 
cious  (R.)  ;  in  small  doses  is  of  great  benefit  (Da  Costa).  Lithium  Salicylate, 
very  efficient  in  acute  and  progressive  subacute  articular  rheumatism,  and  has 
some  effect  also  in  chronic  cases,  where  some  of  the  joints  are  deformed, 
swollen  and  painful ;  £j  may  be  given  daily,  in  doses  of  gr.  vij  to  x,  in  water 
(Vulpian).  Lithium  Bromide,  of  great  value  in  acute  and  chronic  (B.).  Potas¬ 
sium  Bromide,  sometimes  allays  the  severe  pain  (R.).  Arnica,  the  tincture  and 
infusion  are  said  to  be  of  great  value  (P.).  Cod-liver  Oil,  internally  and 
locally,  of  much  value  (R.).  Baths,  Turkish  or  sulphur.  The  cold  douche, 
which  may  be  slightly  warmed  in  winter ;  use  for  one  or  two  minutes  and  rub 
dry  (R.).  Adhesions  may  be  broken  up  under  the  anaesthetics  (DaC.).  Mas¬ 
sage  may  be  used  with  benefit  to  ameliorate  the  condition  in  chronic  cases, where 
a  cure  cannot  be  obtained  (Da  C.). 


RHEUMATISM,  ACUTE. 


656 


Prescriptions. 


R.  Vini  Colchici  Sem.,  .  .  .  3  iij. 


R .  Lithii  Bromidi, 


Spt.  Ammon.  Aromat.,  .  .  £xiij. 


Syr.  Zingiberis, 
Aquae,  .  .  .  . 


M.  Sig.— A  teasp.  every  3  hours,  until 
some  physiological  effect  is  produced.  (B.) 


M.  Sig. — A  teasp.  thrice  daily,  con¬ 
jointly  with  a  lotion  of  the  same.  (B.) 


Rheumatism,  Acute. 


Aconite,  very  serviceable  when  much  heat  and  dry  skin  (B.) ;  subdues  pain 
in  inflamed  joints  and  perhaps  shortens  the  fever  (R.) ;  small  doses  frequently 
repeated  of  the  greatest  value,  and  if  used  from  the  start  prevent  permanent 
organic  disease  (P.) ;  is  not  reliable  as  a  cure,  but  a  valuable  adjunct  to  other 
remedies  (Wa.).  Veratrum  Viride,  tinct.  said  to  be  useful  (R.)  ;  as  antipy¬ 
retic,  small  doses ;  may  be  combined  with  opium  (P.).  Bryonia,  has  proved 
useful,  especially  for  painful  and  stiff  rheumatic  joints  (P.).  Salicin,  gr.  x-xxx 
every  2,  3,  or  4  hours.  Gr.  xv  every  3  hours  in  powder  mixed  with  water  (Mac- 
lagan),  or  same  dose  of  Salicylic  Acid,  is  of  great  benefit;  good  effect  gener¬ 
ally  experienced  within  48  hours  (R.) ;  the  acid  is  better  than  the  salicylates, 
but  must  be  abandoned  if  not  effective  after  3  or  4  days  (Da  Costa).  Salol,  the 
great  remedy,  none  superior  (B.).  Sodium  Salicylate,  behaves  as  Salicin  (R.). 
Oil  of  Gaultheria,  as  a  substitute  for  salicylic  acid,  used  very  successfully  in 
form  of  emulsion  (B.).  Rhus  Toxicodendron,  positively  invaluable  in  after¬ 
stage,  also  in  subacute  forms,  muscular  or  tendinous,  worse  at  night  (P.,  Pf.). 
Hydriodic  Acid,  the  syrup,  in  dessertsp.  doses  every  2  or  3  hours,  the  best 
remedy  for  acute  and  subacute  rheumatism,  relieving  pain  and  swelling  in  18 
to  24  hours  (Craig).  Cimicifuga,  excellent  reports  from  (B.) ;  has  been  much 
used,  said  to  quell  the  pain  speedily  (R.);  found  very  serviceable  (P.).  Dulca¬ 
mara,  recommended  especially  in  persons  who  are  subject  to  catarrhal  affec¬ 
tions  in  cold  and  damp  weather  (P.).  Ammonium  Bromide,  a  very  excellent 
treatment,  followed  by  quinine  ;  gives  a  very  low  proportion  of  cardiac  compli¬ 
cations,  gr.  xv-xx  every  4  hours  (Da  C.) ;  disagreeable  but  strongly  recom¬ 
mended  (B.).  Arnica,  lowers  pulse  and  temperature,  relieves  articular  pain 
and  swelling,  diminishes  urea  (P.).  Trimethylamine,  rnjv-viij  in  peppermint 
water,  often  has  remarkable  power  in  acute  rheumatism  and  gout  (B.).  Spi- 
gelia  Anthelmia,  rheumatic  pericarditis  and  endocarditis;  rheumatic  fever  with 
pain  shiftingffrom  joint  to  joint  (P.)  :  seems  to  fix  the  disease  in  certain  joints, 
and  prevent  its  shifting  around  (P.).  Sulphurous  Acid,  fumigation,  and  patient 
covered  with  blankets  exposed  to  strong  fumes,  produces  perspiration,  sleep  and 
relief  (R.).  Colchicum,  alleviates  the  symptoms,  and  shortens  their  duration 
(Wa.).  Laville’s  Mixture,  is  said  to  be  a  tincture  of  quinine  and  colocynthine, 
but  it  is  more  than  probable  that  colchicine  is  the  active  agent  therein.  (See 
N.  Y.  Med.  Record,  Dec.  5,  1885,  page  642.)  Quinine,  as  antipyretic;  not  so 
useful  as  wet  pack  or  cold  bath  ;  gr.  ij-v  after  the  more  acute  symptoms  have 
subsided  (B.) ;  is  best  for  the  head  symptoms  (Da  C.).  Opium,  strongly  recom¬ 
mended  as  anti-rheumatic ;  gr.  j  every  2  or  3  hours,  increased  to  gr.  xij  in  24 
hours  ;  tolerance  remarkable  in  this  disease.  Also,  in  rheumatic  carditis  it  is 
indispensable  (Wa.) ;  a  very  good  remedy  in  moderate  doses  (Da  C.).  Lithium 
Bromide,  equally  good  in  all  forms,  especially  for  insomnia,  delirium,  etc.  (B.). 
Digitalis,  in  powder,  gr.  ij  every  4  hours,  usually  effective  after  2  to  7  days ; 
especially  useful  in  cardiac  complications  with  cyanosis  and  oedema.  Iron, 
tincture  of  chloride  very  serviceable  in  pale,  delicate  subjects,  rr^xx-xxx  every 
4  hours  ;  also  as  prophylactic  where  tendency  ( Anstie) ;  harmful  to  the  plethoric 
and  overfed  (B.).  Alkalies.  The  alkaline  treatment  is  now  seriously  ques¬ 
tioned  ;  an  injurious  dyscrasia  results  from  their  use  (B.).  Potassium  Bicarbon¬ 
ate,  gr.  xxx  every  4  hours,  in  a  dilute  solution,  until  joint-symptoms  and  fever 
disappear  (Wa.).  Lime-juice,  3 viij  daily,  lemon-juice  inferior  (R.).  Blisters, 
are  a  very  effective  method ;  a  number  of  small  blisters  applied  to  vesication 
around  a  joint  (B.) ;  large  flying  blisters  around  a  joint  (R.).  Water,  cold  baths 
for  the  hyperpyrexia  (Da  C.) ;  the  wet  pack  very  efficacious  in  rheumatism,  also 


RHEUMATISM. 


657 


a  vinegar  vapor  bath  (B.);  the  wet  pack,  20  or  30  minutes,  and  tepid  (70°) 
shallow  bath  1  or  2  minutes.  Cold  applications  only  when  skin  hot  and  dry, 
and  temperature  high.  Warm  baths,  or  hot  compresses  very  useful.  Spongio- 
piline  an  excellent  substance  for  applications.  Diet,  low  during  the  fever, 
water,  barley  water,  milk-and-water,  gruel,  etc.  All  through  use  liquid  food. 
Avoid  malt  liquors,  port  wine,  and  sugar.  Lemon-juice  maybe  used  freely. 
Blankets,  instead  of  sheets  to  sleep  in,  and  flannel  underclothing  are  useful 
adjuncts.  Pack  the  joints  with  cotton  covered  with  rubber  cloth  or  oiled  silk. 

Plans  of  Treatment,  may  be  resolved  into  three,  viz., — (1)  that  by  Salicin, 
(2)  that  by  Alkalies,  (3)  that  by  Iron.  Salicylic  Acid  and  the  Salicylates,  in 
20-grain  doses,  to  not  less  than  Aij  in  24  hours,  in  solution  with  excess  of 
alkali,  is  especially  suited  to  vigorous,  sthenic  subjects,  whose  stomachs  will 
bear  it,  in  whom  it  often  effects  a  cure  in  3  or  4  days.  Alkalies,  for  flabby, 
fat  subjects;  alkaline  carbonates,  as  the  Potas.  Carb.,  Ajss,  every  24  hours, 
alone  or  with  a  vegetable  acid,  until  the  urine  becomes  neutral  or  alkaline, 
when  it  may  be  reduced  one-half,  and  so  maintained  for  some  days,  when 
quinine  or  iron  maybe  used.  If  successful,  this  treatment  brings  about  a  cure 
in  two  weeks.  Tincture  of  the  Chloride  of  Iron,  for  the  feeble,  anaemic,  and 
nervous  subjects,  rtkxxx  every  4  hours,  with  an  occasional  saline  laxative, 
blisters  around  joints,  and  Atropine  as  an  anodyne  rather  than  Opium,  used 
hypodermically  in  the  vicinity  of  the  affected  joints  (B.).  Iron  and  Salicylic 
Acid  in  combination,  should  be  most  valuable,  but  as  heretofore  prescribed 
has  always  made  an  insoluble  precipitate.  This  is  overcome  by  Dr  Peabody 
in  the  formula  given  below,  which  makes  a  ruby-red  mixture,  and  has  the 
advantage  of  preventing  the  anaemia  which  results  from  Salicylic  Acid  given 
alone. 

Cardiac  Complications  require  Ammonium  Carbonate,  in  5-grain  doses  fre¬ 
quently,  also  Infusion  of  Digitalis  with  hypodermics  of  Morphine,  and  a  blister 
over  the  praecordium,  followed  by  Iron  and  Quinine  after  the  acute  symptoms 
have  subsided  (B.). 

Prescriptions. 


R.  Olei  Gaultheriae, . .5  j. 


Acidi  Salicylici,  .... 

.  gr.  lxxx.  L 

Sodii  Boratis,  ..... 

•  si- 

Syr.  Picis  Liquidae,  .  . 

.  A'J- 

Aquae  Anisi, . 

•  AT 

M.  Sig. — A  dessertsp.  every 

two  hours. 

R .  Propylaminae  Chlorid., 

.  gr.  xxiv. 

Aquae  Menthae  Pip.,  .  . 

•  A  VJ* 

M.  Sig. — A  tablesp.  every  two  or  three 

hours. 

(  Tyson.) 

R .  Acidi  Salicylici,  .... 

•  AT 

Ferri  Pyrophosphat.,  .  . 

•  si- 

Sodii  Phosphatis,  .  .  . 

.  gr.  xij. 

Aquae, . 

• 

M.  Sig. — A  tablesp.  every  2  hours. 

( Peabody.') 


R.  Potassii  Iodidi, . gij. 

Virii  Colchici  Sem., 

Syr.  Simplicis,  .  .  .  .  aa  q  iv. 
Aquae  Menthae  Pip.,  .  .  .  ^  v. 

M.  Sig. — Tablesp.  every  4  hours. 

(Ne 70  Orleans  Charity  Hosp.) 


R .  Ammonii  Phosphatis,  .  .  .  ^jss. 
Tinct.  Colchici  Seminis,  .  .  %)■ 


Tinct.  Aconiti, . £ij. 

Syr.  Simplicis, . Jjiij. 

M.  Sig. — A  teasp.  every  three  or  four 
hours.  (Corson.) 


R  .  Sodii  Salicylatis, . 3  ss. 

Tinct.  Lavand.  Co  ,  ....  giij. 
Glycerini, . ^vj. 


Aquas . q.  s.  ad  3  vj. 

M.  Sig. — A  tablesp.  every  three  hours, 
well  diluted. 


Rheumatism,  Chronic. 

Arsenic,  is  very  good  in  most  cases,  given  in  small  doses  steadily  (Da  C.)  ; 
with  Guaiac  instead  of  Sulphur  in  the  Chelsea  Pensioner  (see  ante ,  page  470), 
the  latter  is  more  efficient  (Fothergill).  Bryonia,  is  useful,  especially  for  pain¬ 
ful  and  stiff  joints  (P.).  Rhus  Toxicodendron,  a  very  powerful  agent  in  sub- 
42 


658 


RHEUMATISM. 


acute  muscular  or  tendinous  rheumatism,  worse  at  night  (Pf.) ;  the  tendons, 
ligaments,  and  fasciae  are  most  benefited  ;  externally,  as  lotion  on  compresses  ; 
also,  internally,  small  doses  every  two  hours  (P.).  Potassium  Iodide,  especially 
when  pains  are  worse  at  night,  or  of  syphilitic  origin  (R.) ;  should  always  be 
fairly  tried  in  chronic  rheumatism  (Da  C.) ;  was  Sir  Astley  Cooper’s  remedy  for 
rheumatism.  Cimicifuga,  sometimes  has  wonderful  success,  yet  often  fails  ; 
no  indications  (B.)  ;  in  rheumatic  neuralgias  and  headaches,  and  rheumatism  of 
uterus  (P.) ;  signally  beneficial  in  many  forms  (R.).  Mercury,  and  Morphine, 
the  oleate  locally,  for  joint  affections  (R.).  Colchicum,  is  of  decided  advantage 
in  neuralgia  of  chronic  rheumatism  (B.).  Mezereon,  strongly  recommended 
(P.,  R.).  Phytolacca,  has  been  useful  (B.).  Iodides  often  prove  very  satisfac¬ 
tory,  especially  in  strumous  or  syphilitic  subjects  (B.).  Aconite,  the  extract  as 
plaster  to  joints  is  unquestionably  very  useful  (P.) ;  is  more  useful  in  chronic 
than  acute  rheumatism  (Wa.)  ;  the  liniment  of  the  B.  P.  locally  over  the 
sciatic  nerve  when  affected  (Fothergill).  Dulcamara,  has  been  employed  with 
advantage  (P.)  ;  Sulphur,  locally,  also  sulphides  as  baths  (R.) ;  is  certainly  of 
benefit  (B.);  sulphur  waters  are  undoubtedly  efficient  (DaC.);  sulphur  is  an 
ingredient  of  the  Chelsea  Pensioner  (see  ante ,  p.  470),  an  old  English  remedy 
for  rheumatism.  Iodine,  for  pain  around  joints  (R.).  Lithium  Bromide,  gives 
excellent  results,  when  smaller  joints  swollen,  tender  (B.).  Lithium  Salicylate, 
in  15  to  20  grain  doses  every  four  hours,  gives  good  results  in  lingering,  sub¬ 
acute  cases  after  acute  attacks  (Da  C.).  Quinine,  in  rheumatism  with  debility, 
shown  by  night  sweats,  or  sweats  during  sleep,  and  only  then  (Wa.).  Arnica, 
the  tincture  and  infusion  are  useful  (P.).  Cajeput  Oil,  internally  and  externally 
in  muscular  rheumatism  (P.).  Turpentine,  benefits  and  relieves  the  pains;  in¬ 
ternally  and  externally  as  liniment  (P.).  Guaiac,  used  with  varying  success 
(B.) ;  often  gives  excellent  results ;  the  ammoniated  tincture,  Sj-ij  in  milk 
(Da  C.) ;  is  vile  to  the  taste.  Eucalyptus,  the  leaves  wrapped  around  the 
affected  part,  renewing  them  daily  for  a  week  or  more,  often  very  efficient  as 
a  local  stimulant,  and  will  produce  vesication  if  too  long  continued  (Gibbons). 
Xanthoxylum,  has  long  had  deserved  reputation,  rr^xv- 3  ij  fluid  extract  (B.). 
Thuja  Occidentalis,  is  useful  for  rheumatic  pains  (P.).  Manganese  Sulphate, 
is  one  of  the  remedies  (B.).  Belladonna,  the  extract  locally  very  valuable  for 
pains  (P.).  Cod-liver  Oil,  internally  and  externally,  exercises  some  influence 
(B.).  Chimaphila,  may  prove  useful,  especially  when  lithiasis  (P.).  Lupulin, 
as  an  anodyne  (P.).  Burgundy  Pitch,  as  plaster  locally  (P.).  Aliment,  avoid 
alcoholic  and  malt  liquors,  coffee,  also  starchy,  animal  and  saccharine  food. 
The  farinaceous  vegetables  and  acid  fruits  suitable  (B.).  Alkaline  mineral 
waters  have  deserved  reputation  (B.).  Turkish  Baths,  in  chronic  muscular 
rheumatism  (B  ) ;  steam  bath  daily  of  great  benefit,  may  be  obtained  at  home 
by  pouring  water  on  hot  bricks  in  a  tub,  the  patient  sitting  on  a  board  or  chair 
above,  enveloped  in  a  blanket  (Brick).  Red  Flannel,  next  skin,  very  popular, 
but  white  better,  as  the  red  gives  rise  often  to  eruptions  (Da  C.).  [Compare 
Lumbago,  Myalgia,  Pleurodynia,  Rheumatic  Arthritis,  Sciatica.] 


Prescriptions. 


R.  Pulv.  Resin.  Guaiaci, 

Potassii  Iodidi,  .  .  .  .  aa  gj. 
Tinct.  Colchici  Seminis,  .  .  3  iij. 
Aqum  Cinnamomi, 

Syrupi,  ,  .  .  .  aa  q.  s.  ad  gvj. 

M.  Sig. — A  dessertsp.  to  a  tablesp. 


thrice  daily. 

( Pepper. ) 

R.  Tinct.  Guaiaci  TEther.,  .  . 

•  SJ- 

Tinct.  Colchici  Alther.,  . 

•  3VF 

Tinct.  Cann.  Ind.  ./Ether., 

•  ST 

M.  Sig. — 25  to  30  drops  on  sugar,  every 
4  hours,  for  rheumatic  and  neuralgic  symp¬ 
toms.  ( Atlee .) 


R.  Linim.  Aconiti  (B.  P.), 

Linim.  Belladon.,  .  .  .  aa  %  ij. 

Glycerini,  .  .  .  .  q.  s.  ad  5  ij. 

M.  Sig. — Apply  locally  over  the  seat  of 
pain.  ( Fothergill .) 

R.  Olei  Sinapis, . £ss. 

Olei  Terebinth.,  .  .  .  .  3  iij. 

Camphorse, . 3  iv. 

Liq.  Ammon.  Fort.,  .  .  .  5  iij. 

Tinct.  Capsici, . 3  iv. 

Alcoholis,  .  .  .  .  q.  s.  ad  5yj. 

M.  Sig. — Russian  Spirit,  a  liniment  for 
rheumatism. 


RHEUMATISM - SCABIES. 


659 


R  .  Ac.  Arseniosi, . gr.  iij. 


Pulv.  Guaiaci, . 3  iij. 

Pulv.  Capsici, . 3  ss. 


Pil.  Aloes  et  Myrrh.,  .  .  .  3  iij. 

Ft.  pil.  no.  cxx.  Sig. — One  thrice  daily. 
The  modified  Chelsea  Pensioner. 

(. Fothergill .) 


R.  Potassii  Iodidi, . gj. 

Potassii  Nitratis, . 3  ss. 


Ext.  Cimicif.  FI., 

Glycerini, . aaj^ss. 

Vini  Colchici  Sem.,  .  .  .  acTi*  ij. 

M.  Sig. — A  teasp.  after  each  meal. 

( Potter. ) 


Rheumatism,  Gonorrhoeal. 

Opium,  as  Dover’s  powder,  in  the  acute  stage,  full  doses  (Wa.).  Potassium 
Iodide,  with  tonics  and  stimulants,  after  the  acute  stage  has  passed,  followed  by 
friction,  shampooing,  and  passive  movements  of  the  joints  (Wa.).  Ammonium 
Chloride,  in  free  doses,  especially  when  the  muscles  are  affected  (Fuller). 
Potassium  Chlorate,  internally,  and  as  urethral  injection,  until  urethral  dis¬ 
charge  is  entirely  stopped,  then  n pxx  of  tinct.  ferri.  chlor.  4  times  daily,  with  gr. 
x  of  quinine  daily,  and  good  food  (Da  Costa).  Aspirate,  when  pus  is  dis¬ 
covered  around  the  joints,  as  the  case  will  be  one  of  pyaemic  rheumatism,  and 
may  involve  more  joints  than  one  (Da  C.). 

Rheumatism,  Muscular. 

Diaphoretics,  as  Dover’s  powder,  with  Potassium  Nitrate,  or  Salts  of  Ammo¬ 
nium,  with  dry  heat  to  the  part  involved  and  rest  in  bed  (Da  C.).  Morphine 
and  Atropine,  gr.  and  gr.  together  hypodermically,  are  of  great  service 
in  most  forms  (R.).  Lithium  Bromide,  is  almost  specific  (B.).  Jaborandi,  or 
Pilocarpine  hypodermically,  to  get  the  skin  acting  freely,  a  great  desideratum 
(Da  C.).  Potassium  Iodide  and  Colchicum,or  Quinine,  gr.  xij-xvj  in  24*hours, 
if  case  lingers  over  a  week  (Da  C.).  Liniments  are  of  little  use  except  to 
amuse  the  patient,  but  Chloral  Jj  in  Jjvj  of  Linim.  Saponis,  makes  a  good  one 
(Da  C.).  Capsicum,  powdered,  with  lard,  gij  ad  §j,  rubbed  over  the  part,  night 
and  morning,  with  a  gloved  hand,  is  very  efficient  (Macdonald).  Cimicifuga,  is 
often  very  efficient  in  lumbago,  myalgia,  pleurodynia,  and  similar  conditions 
(Wa.).  Xanthoxylum,  gives  relief  in  some  cases  of  muscular  rheumatism  (B.). 
Lithium  and  its  salts,  where  there  is  a  uric-acid  diathesis  (B.).  Colchicine, 
5-minim  doses  of  a  t  solution  of  Merck’s,  hypodermically  into  affected  muscles, 
thrice  daily,  very  effective  in  cases  resisting  other  treatment.  [Compare  Lum¬ 
bago,  Myalgia,  Pleurodynia,  Torticollis.] 

Roseola. 

Scarcely  any  treatment  called  for  ;  no  local  application  needed,  as  the  rash 
is  but  slightly  irritating.  Aconite  or  Belladonna,  according  to  the  symptoms,  or 
the  Carbonate  of  Ammonium,  answers  all  the  indications.  [  Compare  Measles.] 

Sarcinse. 

Sulphites  and  Hyposulphites,  have  been  employed  to  destroy  sarcinae  and 
torulae  in  the  stomach  (R.)  ;  or  Sulphurous  Acid,  diluted,  before  each  meal 
(Wa.). 

Scabies. 

Sulphur,  a  solution  of  pot.issa  sulphurata  Sss-3j,  as  local  application.  An 
extemporaneous  sulphide  may  be  made  by  boiling  one  part  of  quick-lime  and 
two  of  sulphur  in  ten  of  water  (B.).  Sulphurous  acid,  as  gaseous  bath,  the 
quickest  method.  Hebra’s  mixture  of  sulphur,  chalk,  tar,  soap  and  lard,  less 
irritating,  and  equally  sure  (R.).  Calcium  Sulphide,  as  a  bath  (W.).  Sul¬ 
phuric  Acid,  internally,  has  cured  when  other  remedies  failed  (Wa.).  Storax, 
equally  serviceable  and  not  irritating  as  is  sulphur,  one  part  to  two  of  olive  oil, 
with  a  warm  bath  (R.).  Mercury,  the  bichloride  is  very  efficient,  if  used 


66o 


SCARLATINA. 


strong  enough,  but  caution  is  required  in  its  employment  (B.).  See  formula 
below.  Staphisagria,  a  certain  remedy;  3  parts  to  5  of  lard,  boiled  at  2120 
F.  for  24  hours,  when  cooled  after  straining  add  a  little  essence  ;  friction  with 
this  4  times  daily  (Wa.).  Balsam  of  Peru,  the  best  of  all  applications,  killing  the 
acarus,  relieving  the  itching  and  dermatitis,  and  disinfecting  the  parts  ;  rub  in 
3j  over  the  body  after  a  warm  bath  (Bruce)  ;  is  fatal  to  the  itch-mite  (Oldberg). 
Manganese,  the  oxide,  Sij-^j  adipis  suilli  as  ointment  (B.).  Copper  Sulphate, 
as  lotion  ( 5 j — Oj )  has  been  used  with  great  success,  after  crusts  are  thoroughly 
removed  with  soap-and-water  (B.).  Alkalies,  as  soaps  or  ointments  to  remove 
cuticle  and  break  up  burrows  (R.).  Carbolic  Acid,  locally  (B.).  [See  Tinea 
for  formula.]  Cocculus  Indicus,  as  ointment,  useful  (P.).  Tar  Ointment, 
relieves  itching  quickly  and  cures  disease  in  10  to  12  days  (P.).  Anise,  Ka- 
mala,  as  ointments,  efficient  (P.).  Benzoic  Acid,  gr.  x-xx  ad  0]/2  aquae,  as 
lotion,  effectual  for  the  pruritus  (R.).  [See  last  formula  on  left-hand  column, 
under  Pruritus.]  Linen  should  be  immersed  in  boiling  water  ;  other  gar¬ 
ments  well  fumigated  with  sulphur  vapor  to  destroy  insects  or  their  ova,  or 
baked  in  oven  (R.). 

Prescriptions. 


R.  Styracis  Liquidis, . ^ij.  R.  Sulph.  Sublimat., . 3  j. 

Ung.  Sulphuris, . 3  iv.  Balsam.  Peruv., . £ss. 

Ung.  Petrolei, . Adipis, . . 


M.  Sig. — Apply  after  washing.  M.  Sig. — For  children.  ( Duhring .) 

[Bulk  ley.) 


R  .  Hydrarg.  Chlor.  Corr.,  .  .  .  gr.  iv. 

Alcoholis, . 3  vj. 

Ammonii  Chloridi,  .  .  .  .  3  ss. 
Aquae  Rosae,  .  .  .  .  q.  s.  ad£x). 

M.  Sig. — Lotion  for  scabies,  phthi- 
riasis,  and  tinea  versicolor.  [Pox.) 


R .  Sulph.  Sublimat., 


Olei  Cadini, . aa^ij. 

Cretae  Preparatae, . 3  ijss. 

Saponis  Viridis, 

Adipis, . aa^j. 

M.  ft.  unguentum.  [Bulk ley. ) 


Scarlatina. 

Aconite,  of  the  highest  value  for  all  marked  increase  of  temperature  (B.,  R.) ; 
helps  the  development  of  eruption  when  due  (P.) ;  in  the  early  stage,  when 
not  decidedly  adynamic,  is  very  useful  (W.).  Belladonna,  during  the  erup¬ 
tive  stage,  when  depression  exists,  and  rash  is  imperfectly  evolved  (B.).  As 
prophylactic  has  been  recommended  (R.) ;  is  often  efficacious  as  prophylactic 
(P.) ;  the  preponderance  of  evidence  is  certainly  in  favor  of  such  use  of  the 
drug  (Pf.) ;  this  virtue  is  claimed  by  imposing  authorities;  when  so  given  its 
dose  is  gr.  several  times  a  day  (Tr.).  Mercury,  of  gray  powder  every 
hour  has  marked  effect  on  inflamed  tonsils  (R.).  Ammonium  Carbonate,  feeble 
circulation,  cyanosis,  delirium  (B.) ;  in  all  forms,  especially  if  given  early  (R.) ; 
one  of  the  most  reliable  remedies  ;  gr.  iij-vij,  according  to  age,  in  milk  or  cin¬ 
namon  water,  every  hour  or  two  (Wa.).  Potassium  Iodide,  in  full  doses,  a  very 
sadfactory  remedy  (Mitchell).  Mineral  Acids.  Muriatic,  internally  and  as 
gargle;  Nitric,  to  sloughs  in  throat  (R.).  Carbolic  Acid,  internally  and  as 
gargle,  successfully  used.  [See  Measles,  for  formula.]  Seems  to  exercise 
some  influence  as  prophylactic  (Wa.) ;  is  good  for  the  vomiting  and  for  its  gen¬ 
eral  effect  on  the  disease;  tr^ss,  every  2  or  3  hours  (Da  Costa).  Veratrum 
Viride,  in  convulsions  (R.).  Rhus  Toxicodendron,  of  great  service,  if  typhoid 
or  rheumatic  symptoms  (P.).  Digitalis,  very  useful;  lowers  temperature  and 
maintains  kidney  action  (B.) ;  the  best  antipyretic  and  diuretic,  the  infusion 
with  dry  cups  for  the  renal  dropsy  in  its  inception.  Later  on,  milk  diet  and 
Basham’s  Mixture  (Da  C.).  Potassium  Permanganate,  locally  to  throat,  and 
internally  (gr.  %-)  ter  die)  has  undoubted  benefit  (B.).  Sulphurous  Acid,  by 
inhalation,  spray,  or  fumigation,  in  malignant  sore  throat  (R.).  Chlorine  Water, 
in  sloughing  of  throat  (R.)  ;  seemingly  prophylactic  (Wa.).  Quinine,  small 
doses,  in  adynamic  states,  large  in  hyperpyrexia  (B.) ;  very  successful  when 


SCIATICA. 


66 1 


used  systematically  from  the  start  (Wa.).  Ferrum  Perchloride,  the  tincture  in 
doses  of  tt^x-xv,  according  to  age,  in  advanced  stage,  when  with  albuminuria 
and  hematuria,  is  very  valuable  (Wa.).  Potassium  Chlorate,  in  grain-doses 
every  X  hour,  will  not  injure  the  kidneys,  and  will  give  equal  results  as  larger 
doses  on  the  throat  inflammation  (A.  A.  Smith).  Asclepias,  to  promote  the 
eruption  (W.).  Zinc  Sulphate,  gr.  ^  every  3  hours,  believed  to  have  specific 
influence  on  the  disease  (Hoyt).  Sodium  Benzoate,  is  highly  efficient,  having 
slower  but  more  permanent  effects  on  the  fever  than  quinine  or  the  salicylates 
(Klebs).  Boric  Acid,  makes  an  excellent  gargle  (Da  C.).  Juniper,  as  diuretic 
when  dropsy  (R.).  Magnesium  Sulphate,  as  purgative,  to  prevent  sore  throat 
and  other  sequeke  (R.).  Sodium  Sulpho-carbolate,  as  a  means  of  introducing 
carbolic  acid  into  the  system.  Has  been  successfully  employed  (Wa.).  Mustard 
Bath,  on  recession  of  rash,  to  bring  it  back  (R.).  Oil  Inunctions,  very  grateful, 
especially  useful  in  desquamative  stage.  Cocoa-butter  the  most  elegant  (B.). 
Ice  sucked,  in  the  sore  throat  (R.).  Water,  cold  baths  with  oil  are  all  that  are 
needed  in  mild  cases.  When  temperature  above  104°,  urine  scanty  and  rash 
retroceding,  the  cold  wet-pack  renders  signal  service  (B.,  R.).  A  cold  wet 
compress  to  neck,  through  the  whole  course,  renewed  every  3  hours  (R.). 
Diet,  fruit,  if  ripe,  in  season,  toast,  gruel,  etc.,  in  simple  cases.  In  malignant, 
extract  of  beef,  stimulants  as  per  pulse.  Milk  the  most  suitable  aliment,  both 
as  nutrient  and  as  diuretic. 


Prescriptions. 


R.  Ac.  Borici, . 3?s. 

Potassii  Chloratis,  .  .  .  .  gij. 
Tinct.  Ferri  Chloridi,  .  .  ^  ij. 
Glycerini,  Syrupi,  .  .  .  aa  £j. 

Aquae, . 5  H* 

M.  Sig. — Tablesp.  every  2  hours,  to  a 
child  of  five  years.  ( Smith .) 


R  .  Acidi  Salicylici,  .... 

.  3»j. 

Tinct.  Aconiti,  .  .  .  . 

.  gtt.  xij. 

Infusi  Digitalis,  .  .  .  . 

•  5J-S- 

Spt.  Ammon.  Aromat  ,  . 

•  3 11  j- 

Syr.  Aurantii  Cort.,  .  . 

.  gss. 

Aquae,  . 

•  3  J- 

M.  Sig. — Teasp.  every  3 

hours,  for 

child  of  five  years. 

(. Brown 

R.  Acidi  Carbol., . gss-j. 

Vaselini, . ^  iv. 


M.  Sig. — By  inunction  to  the  entire  sur¬ 
face. 


R.  Acidi  Borici, . 3  iij . 

Glycerini, . 5  iv. 

M.  Sig. — For  a  pint  of  water  as  a  gar¬ 
gle.  ( Da  Costa.) 


Sciatica. 

Aconite,  locally  (P.) ;  as  ointment  controls  in  some  instances  (R.)  ;  valuable 
and  efficient  in  many  obstinate  forms  (Wa.).  Rhus  Toxicodendron,  a  very  pow¬ 
erful  therapeutic  agent  in  various  rheumatic  affections  of  the  fibrous  tissues  (P.). 
Cimicifuga,  is  highly  extolled  (R.).  Turpentine,  causes  an  exquisite  sensibility 
along  the  track  of  the  great  nerves  (Tr.) ;  occasionally  of  great  value  in  sciat¬ 
ica,  yet  not  a  specific,  nor  have  we  scientific  indications  for  its  use  (P.) ;  5SS 
doses  for  4  or  8  successive  nights  (R.).  Sulphur,  locally,  believed  to  relieve 
the  pain  ;  effect  probably  due  to  the  flannel  surrounding  it  (R.)  ;  is  worthy  of 
trial  after  active  symptoms  are  subdued  (Wa.).  Phosphorus,  in  neuralgic  form  ; 
less  satisfactory  in  sciatica  than  in  other  neuralgias  (R.).  Nux  Vomica,  often 
successful  in  chronic  (Wa.).  Belladonna,  has  afforded  relief  (R.).  Atropine, 
hypodermically,  is  curative  ;  large  doses,  gr.  ^  to  ^  in  vicinity  of  nerve  (B.). 
Cocaine,  hypodermically  along  the  nerve,  has  afforded  instant  relief  (Wa.). 
Veratrine,  as  strong  ointment;  Veratrum  Viride,  as  tincture,  is  also  recom¬ 
mended  (R.).  Ammonium  Chloride,  in  mild  forms  (R.)  ;  occurring  in  the  young 
(Anstie).  Ether  Spray,  generally  of  temporary  value  (R.)  ;  Chloroform,  on 
flannel  along  course  of  nerve,  covered  with  oiled  silk  (Wa.);  injected  deeply 
into  vicinity  of  nerve,  gives  the  best  results  in  old  cases,  rrpxv  of  the  spirit  hypo¬ 
dermically  (B.).  Stramonium,  gr.  every  3  or  4  hours  for  4  or  5  doses, 

often  affords  decided  relief.  Stop  when  slightest  symptoms  of  narcotism  appear 
(P.).  Opium,  internally  and  externally  (Wa.) ;  Morphine,  hypodermically  is 


662 


SCLERODERMA — SCROFULOSIS. 


especially  curative  in  sciatica  (B.) ;  3  or  4  injections  of  gr.  yi  each;  it  may 
almost  be  regarded  as  a  specific  (Wa.)  ;  a  single  application  sometimes  cures 
long-standing  cases  permanently ;  if  not  it  may  be  repeated  every  second  day 
or  so  (R.) ;  should  be  injected  deeply  into  the  adjacent  muscular  structure 
(Pepper).  Iodides,  in  syphilitic  or  metal  poisoned  subjects  (B.) ;  often  fails  (R.). 
Potassium  Iodide  in  doses  of  Zj  daily,  dissolved  in  decoction  of  sarsaparilla, 
most  efficacious  in  subacute  or  chronic  (Wa.).  Salicylic  Acid,  as  paste  locally, 
Zj  with  3iv  of  Lanolin  and  01.  Olivae,  q.  s.,  also  Rhus  Tox.,  gtt.  j.  of  a  1  percent, 
solution  of  the  fluid  extract  every  4  hours,  cured  one  very  obstinate  case  (Aulde.) 
Salol,  gr.  vij  in  evening  and  gr.  xv  more  at  midnight,  completely  cured  me  after 
3  weeks’  suffering  in  bed,  unrelieved  by  other  remedies  (Aschenberg).  Cold  of 
intense  degree,  produced  by  refrigeration  of  limb  by  Methyl  Chloride,  extremely 
efficient  (Jacoby).  Has  been  found  effectual  when  applied  to  the  sound  limb. 
Cantharides,  as  counter-irritant,  to  free  vesication  (R.).  Aquapuncture,  has 
had  extraordinary  success  (B.).  [See  under  Neuralgia.]  Acupuncture, 
occasionally  affords  instant  relief  (B.)  ;  often  cures  cases  of  long  standing  (R.). 
Nerve-stretching,  by  forcibly  flexing  the  thigh  on  the  abdomen  (Lange).  Poul¬ 
tices,  applied  very  hot  (R.).  Turkish  Baths,  are  often  very  useful  (R.).  Elec¬ 
tricity,  produces  excellent  results  (B.) ;  does  great  good,  but  often  aggravates  ; 
the  continuous  current  best,  when  stage  of  acute  inflammation  past  (W.) ;  gal¬ 
vanism  often  quickly  relieves  the  pain  (Pepper).  Cod-liver  Oil,  should  always 
be  tried  in  obstinate  cases  (W.).  [Compare  Neuralgia,  Rheumatism 
Chronic.] 

Prescriptions. 


R  .  Tinct.  Colchici  Seminis, 

*  Tinct.  Belladonnas, 

Tinct.  Aconiti,  .  .  .  .  aa  £j. 

M.  Sig. — n\vj  every  6  hours.  Remark¬ 
ably  efficient.  {Metcalf.') 


R  .  Tinct.  Cholchici  Sem., 

Tinct.  Cimicifugae, 

Tinct.  Belladonnae, 

Tinct.  Aconiti,  .  .  .  .  aa  rr[xv. 

M.  Sig. — rqjij  every  3  to  6  hours. 

{Metcalf.) 


Scleroderma. 

Cod-liver  Oil,  our  sheet-anchor,  used  internally  and  locally  (B.).  Electricity, 
is  used  successfully  (B.) ;  with  stimulating  inunctions  offers  the  best  prospect  of 
improvement  (Bulkley). 

Scrofulosis. 

Iodides,  the  Iodide  of  Ammonium  when  glandular  enlargement ;  that  of  Iron 
when  debility  and  emaciation,  a  powerful  and  efficacious  remedy ;  also  in 
anpemia  of  scrofula,  the  syrup  r^xx-^j,  ter  die  (Wa.);  disappointing,  useful  in 
simple  glandular  hypertrophy  (B.).  Iodine,  tinct.  or  oint.  applied  over  scrofu¬ 
lous  glands — take  care  not  to  increase  inflammation  (R.).  Iodine  and  Iron  the 
best  remedies,  but  all  medicines  utterly  useless  without  strict  hygiene  (A.). 
Calcium,  the  chloride,  in  doses  of  gr.  x-xx  in  milk  after  food,  when  glandular 
enlargement  of  neck  and  chronic  diarrhoea.  The  phosphate  of  great  use  for 
sores  (R.)  ;  is  of  eminent  service  as  a  palliative  (Wa.) ;  see  Sulphides  below. 
Spongia  Usta,  formerly  held  in  high  repute  ;  has  fallen  into  perhaps  unmerited 
neglect.  Contains  sodium  iodide,  magnesium  bromide,  calcium  phosphate,  and 
ferric  protoxide,  in  small  quantities  (Wa.).  Iron,ferrum  and  calcium  phosphates 
combined  give  good  results,  also  chalybeate  waters  (B.) ;  must  be  long  continued 
(R.).  Sulphides,  for  sores,  abscesses,  suppurating  glands  ;  gr.  or  ^  of  cal¬ 
cium  sulphide  every  hour  or  two  (R.).  Coniine,  gr.  yi  to  Zj  almond  oil, 
locally,  two  or  three  times  a  day  to  conjunctivas  in  “  scrofulous”  photophobia  ; 
has  proved  very  successful  (P.).  Cod-liver  Oil,  the  best  remedy  to  promote 
assimilation  (B.)  ;  of  great  service  in  the  various  manifestations  of  this  disease 
(R.).  Stillingia,  a  domestic  remedy,  used  with  much  success  (B.).  Capsicum, 
in  scrofulous  and  fistulous  ulcerations,  a  weak  infusion  becomes  a  useful  stimu¬ 
lant  (P.).  Mezereum,  strongly  recommended  (P.).  Sarsaparilla,  useful  by  reason 


SCURVY - SEA-SICKNESS - SEBORRHCEA. 


663 


of  its  tonic  and  alterative  properties  (P.).  Hyoscyamus,  the  bruised  leaves  as 
cataplasm  for  scrofulous  ulcers  (P.).  Phosphates,  for  mal-nutrition  (B.).  Prunus 
Virginiana,  is  found  very  useful  in  the  hectic  (P. ).  Chimaphila,  holds  a  cer¬ 
tain  amount  of  reputation  as  a  useful  remedy  (P.).  Tussilago,  was  employed 
by  Cullen  (P.).  Gentian,  is  valued.  As  infusion  a  useful  vehicle  for  chaly- 
beates,  etc.  (P.).  Blisters,  for  scrofulous  glands  (R.).  Grape-cure,  renders 
much  service  (B.).  Alcohol,  no  doubt  as  to  its  great  value  ;  with  cod-liver  oil, 
or  in  small  amounts  at  meals  (Wa,).  Phosphorus,  eminently  serviceable  in 
scrofuloderma,  gr.  x  in  01.  Olivae  ^j,  doses  of  rr^v-x,  thrice  daily  after  meals 
(Broadbent).  Aliment,  raw  or  broiled  meat,  the  latter  for  children.  Abun¬ 
dance  of  fresh  air  and  sunshine.  Sea-air,  sunlight,  moderate  exercise,  and  light, 
digestible  food  are  necessary.  [Compare  Cachexia,  Glands,  Coxalgia, 
Ophthalmia.] 

Scurvy. 

'  Citric  Acid,  used  with  great  advantage,  though  inferior  to  lemon-juice  (Wa.). 
Lemon-  or  Lime-juice,  of  the  utmost  value,  both  as  preventive  and  a  curative 
agent.  Efficacy  believed  to  be  due  to  its  potassium  salts.  Oranges  highly 
useful  (Wa.).  Acids,  especially  vinegar,  to  prevent  scurvy,  in  the  absence  of 
lime-juice  or  fresh  vegetables  (R.) ;  dilute  Muriatic  Acid,  gtt.  v,  thrice  daily 
with  juice  of  three  lemons  daily,  vegetables  and  fresh  meat  (Da  Costa).  Po¬ 
tassium  Chlorate,  is  probably  a  remedy  of  some  value  (Wa.) ;  is  not  (W.). 
Cinchona,  a  decoction,  or  the  dilute  tincture  with  myrrh  or  the  chlorates,  a 
very  useful  gargle.  Quinine,  internally  when  much  prostration,  combined 
with  mineral  acids  (Wa.).  Alcohol,  diluted,  as  gargle  (R.).  Atropine,  hypo- 
derm.  for  salivation  (R.).  Alum,  a  solution  in  water  with  tinct.  myrrhae  3  ss, 
several  times  daily  as  lotion  for  ulceration  of  the  gums  (W.).  Liquor  Sodae 
Chloratse,  gvj  ad  ^xij  aquae,  as  a  mild  application  to  gums  (Wa.).  Dietetic 
Treatment  alone  required.  Lemon-juice  plays  no  essential  part  in  the  treat¬ 
ment.  The  full  diet  of  an  hospital,  comprising  fresh  meat,  vegetables,  and 
milk,  is  generally  sufficient.  [Compare  Cancrum  Oris,  Purpura.] 


Sea-sickness. 

Chloral,  the  most  effective  remedy  ;  gr.  xv-xxx  every  four  hours  (R.).  Sta- 
phisagria,  has  given  relief  (P.).  Creasote,  checks  the  vomiting  (R.).  Chloro¬ 
form,  drop  doses  pure  (R.) ;  n\jj-v  on  sugar  (B.).  Atropine,  hypodermically, 
gr.  yIq  in  epigastrium,  will  relieve  (B.) ;  gr.  -3^  to  250  given  with  Strychnine, 
gr.  7C  to  ^0  hypodermically,  is  really  specific  in  most  cases,  and  in  some  if  given 
before  sailing,  will  prevent  for  the  whole  voyage,  though  but  one  dose  be  ad¬ 
ministered  (Giberson).  Cocaine,  quite  efficient;  the  hydrochlorate  in  water  1  to 
100,  of  which  rr\Jv— v  on  a  bit  of  ice  thrice  daily  (Otto).  Morphine,  gr.  -fa  to  jf 
hypodermically,  will  often  relieve  severe  cases  (B.)  ;  often  fails  (Wa.).  Amyl 
Nitrate,  by  inhalation  (B.) ;  is  strongly  recommended,  but  must  be  cautiously 
used.  Champagne,  iced  ;  tablesp.  doses  every  quarter-hour  (B.).  Calumba,  a 
few  drops  of  the  tincture  will  sometimes  relieve  (B.).  Spinal  Ice-bag,  often 
successful  (R  ).  Cocaine  is  reported  quite  successful.  Bromides,  in  lull  doses 
(Beard).  [Compare  Nausea,  Vomiting.] 


Seborrhcea. 

Glycerin,  especially  useful ;  with  lead  acetate,  borax,  zinc,  diminishing  secre¬ 
tion  ;  also  acts  efficiently  when  there  is  a  want  of  sebaceous  secretion  (W.).  Zinc 
Oxide,  3j.  plumbi  carbonat.  3j,  cetacei  3 j ,  ol.  olivae  q.  s.  Ft.  unguent  (B.). 
Oleate  of  Arsenic,  is  of  benefit  (Wa.).  Mercury,  an  ointment  of  the  white 
precipitate  is  serviceable  on  the  scalp,  with  an  occasional  shampoo  with  tar  soap 
or  green  soap  in  solution,  followed  later  by  mildly  stimulating  iotions  (Bulkley). 
[Compare  Acne,  Pityriasis.] 


66\ 


SNEEZING - SPERMATORRHOEA. 


Sneezing. 

Arsenic,  a  drop  of  liquor  arsenicalis  three  times  a  day  in  paroxysmal  sneez¬ 
ing,  allied  to  asthma  (R.).  Potassium  Iodide,  gr.  x,  several  times  a  day  (R.). 
Iodine,  inhalations  in  paroxysmal  sneezing,  with  itching  of  nose  (R.).  Camphor, 
in  incessant  sneezing,  with  profuse  running  from  eyes  and  nose.  The  powder 
should  be  snuffed,  or  the  alcoholic  solution  inhaled  (R.).  [Compare  Catarrh, 
Hay-fever,  Influenza.] 

Somnambulism. 

Potassium  Bromide,  will  give  decided  relief  in  the  somnambulism  of  children 
allied  to  epilepsy,  often  with  squinting,  which  may  become  permanent ;  generally 
the  result  of  deranged  digestion.  The  nightmare  of  adults  will  usually  yield  to 
the  same  drug  (R.).  [Compare  Nightmare.] 

Spasmodic  Affections. 

Aconite,  ext.  and  int.  for  spasms  not  of  a  severe  type  ;  Aconitine,  as  ointment 
in  the  most  severe,  as  well  as  in  the  milder  local  spasmodic  affections  ;  in  angina 
pectoris,  spasmodic  asthma,  cough,  etc.  (P.) ;  in  spasmodic  laryngitis  of  good 
effect  (R.).  Camphor,  in  many  forms  said  to  relieve,  as  strangury,  etc.  (R.). 
Belladonna,  of  value  for  spasms  of  sphincter  muscles,  especially  of  pelvic  organs 
(P.);  atropine  hypoderm.  in  local  spasm  (R.).  Strychnine,  of  great  value  in 
spasmodic  asthma  (P.)  ;  also  in  tetanus,  chorea,  and  epilepsy  (Pf.,  S.).  Vera- 
trine,  as  solution,  brushed  over  lids  once  a  day  in  painful  spasmodic  contraction 
of  the  orbicularis  (Wa.).  Opium,  very  useful  as  an  antispasmodic,  especially 
if  given  with  a  stimulant,  as  alcohol,  ether,  or  chloroform  (R.).  Ipecacuanha, 
in  spasms  of  respiratory  organs,  of  great  value  (P.).  Chamomile  Oil,  in  spasms 
of  hysterical  persons,  in  4  to  6  doses,  a  very  excellent  remedy  ;  also  useful  in 
pseudo  angina  pectoris  (P.).  Lobelia,  a  valuable  antispasmodic  in  cautious 
hands  (P.).  Lupulin,  in  gouty  spasms  (P.).  Tobacco,  in  spasmodic  asthma, 
and  for  relaxation  of  muscular  spasms  (P.).  Sumbul,  in  gastric  spasms  is  of 
use  (P.).  Cardamoms,  are  usefully  employed  in  gastric  spasms  (P.).  Ammonia, 
useful  in  children's  colic  (R.).  Chloroform,  inhaled  for  intestinal  spasm  (R.). 
Sulpho-carbolates,  in  flatulent  “spasm,”  sometimes  phosphorus  better  (R.). 
Mustard  Poultice,  an  excellent  counter-irritant  in  spasmodic  affections  (P.). 
[Compare  list  of  Antispasmodics  on  page  28,  and  in  this  section  the  titles 
Angina  Pectoris,  Asthma,  Chorea,  Colic,  Cough,  Convulsions,  Croup, 
Dysuria,  Epilepsy,  Gastrodynia,  Hydrophobia,  Hysteria,  Laryngismus, 
Pertussis,  Tetanus,  Torticollis,  Trismus.] 

Spermatorrhoea. 

Potassium  Bromide,  when  plethora-erections  normal,  but  persistent  and 
teasing  ;  is  harmful  in  debilitated  states,  or  daily  losses  (B.) ;  with  cold  sponging 
and  use  of  a  hard  bed  (R.).  Digitalis,  Tj  or  ij  of  the  infusion  twice  or  thrice 
daily ;  few  remedies  are  more  successful  in  arresting  spermatorrhoea  (R.,  P.)  ; 
feeble  erections,  frequent  emissions,  cold  hands  and  feet  (B.).  Cantharis,  defi¬ 
cient  tone  of  seminal  vesicles,  erections  feeble,  sexual  feeling  torpid;  tinct.  gtt: 
ij-iij  ter  die  (R.);  with  Iron  internally  in  emissions  (R.).  Phosphorus,  for  the 
induced  physical  and  mental  debility;  also,  hypophosphites  of  lime  and  soda 
(R.).  Gelsemium,  as  anaphrodisiac,  may  be  combined  with  Belladonna  or 
Cimicifuga  (B.).  Nux  Vomica,  relaxation  and  atony  (B.).  Strychnine,  in  large 
doses,  especially  when  impotence  (R.).  Quinine,  has  been  recommended  (R.). 
Belladonna,  gr,  of  extract  with  gr.  jss  zinci  sulphat.,  three  or  four  times  a 
day,  often  successful  in  nocturnal  emissions  (R.).  Atropine,  relaxed  genitalia, 
no  dream  or  orgasm  (B.).  Camphor  Bromide,  has  been  useful  (W.).  Lupulin, 
is  a  good  anaphrodisiac ;  with  Camphor,  when  a  genital  sedative  is  required 
(B  ).  Iron,  the  iodide,  useful  in  anaemic  cases  (B.).  Ergot,  beneficial  in  relaxed 


SPINA  BIFIDA - SPINAL  PARALYSIS. 


state  (B.).  Hydrastis,  is  a  useful  injection,  gtt.  x  of  the  fluid  ext.  through  a 
urethral  tube  to  the  prostatic  portion  of  the  urethra  (B.).  Cimicifuga,  useful  in 
weak,  relaxed  conditions  (B.) ;  with  hypochondriasis,  very  beneficial  (P.).  Silver 
Nitrate,  a  vesicating  solution  applied  to  perineum  generally  useful,  and  without 
danger  (B.).  Arsenic,  when  from  weak  and  relaxed  seminal  vesicles.  Kind 
Advice,  frequently  the  best  treatment,  as  this  is  often  the  phantasm  of  a  morbid 
imagination.  Bladder  should  be  emptied  after  the  first  sleep.  [Compare 
Emissions,  also  List  of  Anaphrodisiacs  on  page  47.] 


Prescriptions. 


R.  Potassii  Bromidi,  .  .  .  .  gj. 

Sodii  Bicarbonat.,  .  .  .  .  gr.  xv. 

Infusi  Digitalis, . 3  ss. 

Atropinae  Sulphat.,  .  .  .  gr.  ^L. 

M.  Sig. — One  dose,  to  be  taken  at  bed¬ 
time.  (Cross.) 


R .  Tinct.  Gelsemii,  .  .  .  .  %}. 

Tinct.  Belladonnas,  .  .  .  £ij. 

M.  Sig. — 15  drops  thrice  daily. 

(B.) 


R .  Lupulini, . gr.  x. 

Pulv.  Camphoroe,  .  .  .  .  gr.  vj. 

Ext.  Belladonnae,  .  .  .  .  gr.  ij. 

M.  ft.  pil.  no.  xij.  Sig. — One  pill  thrice 
daily.  (B.) 


R.  Tinct.  Cantharidis,  .  .  .  £ij. 
Tinct.  Ferri  Chlor.,  .  .  .  £vj. 

M.  Sig. — 20  drops  in  water  thrice  daily. 
In  impotence  with  spermatorrhoea,  of  great 
utility.  (//I  C.  Wood.) 


Spina  Bifida. 

Iodine,  injected  into  the  sac,  £ss  of  tinct.,  or  gr.  ss,  with  potassium  iodide  gr. 
v,  aquae  £j,  has  cured  numerous  cases  (B.)  ;  iod.  gr.  )4,  pot.  iod.  gr.  x/2  ad  aq. 
3j  (Wa.).  Collodion,  as  a  means  of  compression  (B.). 


Spinal  Concussion. 

Lead  Water  and  Opium,  as  lotion  over  the  seat  of  injury  (A.).  Leeches,  if 
pain  persistent  (A.). 

Spinal  Congestion. 

Ergot,  gives  excellent  results  (Brown-Sequard).  Turpentine,  hot  epithems, 
useful  (Wa.).  Antiphlogistic  measures,  with  rest  and  absolute  diet;  wet  cups 
or  leeches  to  the  column  ;  cool  affusions  to  the  spine  while  patient  in  a  warm 
half-bath  (Ros.).  [Compare  Meningitis.] 

Spinal  Irritation. 

Aconite,  as  ointment  locally  (R.).  Belladonna  preparations,  locally,  gen¬ 
erally  are  better  than  Aconite  (B.).  Ignatia,  in  small  doses  diminishes  irrit¬ 
ability  of  cerebro-spinal  axis  (Pf.).  Strychnine,  persistently,  will  ameliorate 
wandering  neuralgic  pains  due  to  irritability  of  nervous  system  (B.).  Ergot, 
large  doses  for  congestion  (Hammond).  Conium,  in  functional  derangement 
of  the  cord,  with  excessive  irritability  of  the  reflex  function  (Wa.).  Firing, 
sometimes  very  beneficial  (B.).  Electricity.  An  inverse  galvanic  current 
gives  much  relief  (Hammond).  Blisters,  with  hot-water  bag  to  spine,  large 
doses  of  strychnine,  phosphorus,  phosphoric  acid,  and  opium,  are  the  methods 
based  upon  the  anaemic  theory  of  the  disease.  Out  of  156  cases  133  were 
thoroughly  cured  (Hammond).  [Compare  Meningitis,  Myelitis.] 

Spinal  Paralysis  and  Softening. 

Ergot,  to  starve  the  inflammation  by  occluding  the  spinal  arteries  (Ham¬ 
mond).  Electricity,  best ;  galvanic  current  from  spine  to  nerves  and  muscles 
(Ros.).  Treatment  must  be  palliative  and  supporting  only,  in  softening  (H.). 


666 


SPLENIC  AFFECTIONS - STERILITY. 


Splenic  Affections. 

Mercury  Biniodide,  gr.  j  ad  unguent.  3j,  rubbed  in  before  a  hot  fire,  has 
given  excellent  results  in  chronic  malarial  enlargements  of  spleen  (Wa.). 
Quinine,  in  simple  malarial  enlargement  (B.)  ;  gr.  xv  or  xx  or  more  daily,  one 
of  the  most  effectual  remedies  (Wa.).  Ergot,  the  most  effective  remedy  for 
enlarged  spleen  (Da  Costa).  Ammonium  Iodide,  effective  in  chronic  splenitis, 
with  unguent,  hydrarg.  iod.  rubri  externally  ;  also  small  doses  frequently  re¬ 
peated  in  all  splenic  derangements  from  malaria  (B.).  Iodine,  locally  in  chronic 
forms  (B.).  [Compare  LeucocytHvEMIA.] 

Sprains. 

Arnica,  is  very  useful ;  the  infusion  internally  and  externally  (P.) ;  the  tinct. 
diluted  as  lotion  is  very  effectual  (Wa.).  Aconite,  the  liniment  to  painful 
sprains  often  affords  speedy  relief  (Wa.).  Turpentine,  the  oil  as  a  liniment 
(P.).  Ammonium  Chloride,  in  solution,  as  lotion,  or  with  bread  as  poultice, 
to  remove  discoloration  from  sprains  (W.).  Rhus  Toxicodendron,  the  tinct. 
Ass  to  Oj  of  water  a  good  external  application  to  sprains.  Oil  of  Bay  as 
stimulating  liniment  (P.).  Cold  Douche,  salt  may  be  added.  The  force  must 
be  regulated  by  the  condition  of  the  tissues  (R.).  Rest,  the  most  essential 
measure,  should  be  perfect.  Warm  fomentations,  or  cold  affusion,  opiates, 
and  plain  diet  (D.).  A  roller  bandage  with  splints,  often  required  to  secure 
rest  of  the  part. 

Stains. 

Nitrate-of-silver  Stains  may  be  removed  by  washing  with  Potassium  Cyanide 
o ij ss ;  Iodine,  gr.  xv  ;  Water,  5 iij  ;  or,  after  moistening  the  spots,  drop  on 
them  a  few  drops  of  Tinct.  Iodine,  and  wash  out  with  a  solution  of  Sodium 
Hyposulphite,  Sss-3j  (B.).  Blood-stains,  if  on  dark-colored  materials  are 
best  seen  by  an  artificial  light.  After  a  few  hours  they  become  of  a  rusty, 
reddish-brown  color,  which  they  maintain  for  years.  The  microscope  shows 
the  characteristic  corpuscles.  These  stains  when  on  iron  are  difficult  to  dis¬ 
tinguish  from  rust ;  the  latter  is  not  soluble  in  water,  while  blood  is  extremely 
so.  Heat  applied  to  the  metal  will  cause  the  blood  to  peel  off,  unless  the  stain 
has  been  exposed  long  enough  to  have  rust  mingled  with  the  blood.  A  solu¬ 
tion  of  blood  in  water,  heated,  forms  a  coagulum  which  is  soluble  in  hot  caustic 
potash,  the  solution  thus  formed  is  green  by  transmitted  light,  and  red  by 
reflected  light.  Menstrual  blood  cannot  be  distinguished  from  that  resulting 
from  a  wound  (Husband). 


Stammering. 

Vocal  Training.  The  rhythmical  method,  the  most  successful;  the  chief 
end  in  view  is  to  regulate  the  precipitate,  irregular  form  of  respiration.  Long 
continuance  necessary,  six  months,  a  year,  or  more,  in  special  institutions 
(Ros.).  The  patient  must  be  taught  the  use  of  language  anew,  treated  with 
especial  kindness,  and  never  subjected  to  mockery  or  punishment.  [See  Potter 
on  Defects  of  Speech,  Lea  Prize  Essay,  Philadelphia,  1882.] 


Sterility. 

Aurum,  cures  sterility  when  dependent  on  chronic  metritis  or  amenorrhcea 
or  coldness,  more  certainly  than  any  other  remedy.  Auri  chlor.  gr.  ^  (B.). 
Potassium  Iodide,  when  due  to  syphilis  (R.).  Dilation  of  os  and  cervix  care¬ 
fully  when  sterility  depending  on  obstruction,  with  dysmenorrhcea  (H.).  Ster¬ 
ility  is  frequently  associated  with  uterine  displacement  (Meadows)  ;  less  often 
with  atresia.  In  persons  of  good  health  may  be  caused  by  an  acid  discharge 
from  the  uterus,  which  kills  the  spermatozoa  ;  for  this  Vichy  water  internally 


STINGS  AND  BITES - STOMATITIS. 


667 


and  per  vaginam,  and  alkaline  baths  (Charrier).  Is  due  to  aspermatism  of  the 
husband  in  more  cases  than  generally  believed  (Gross).  Many  cases  are  due 
to  blocking  of  the  cervical  canal  with  a  morbid  discharge  from  the  cervical 
glands,  and  such  may  be  relieved  simply  by  repeated  cleansing  thereof  with  a 
cotton-wrapped  probe  or  forceps. 


Stings  and  Bites. 

Ammonia  or  Alkalies,  a  weak  solution,  in  stings  of  insects,  to  neutralize  the 
formic  acid  (R.).  Ammonia,  as  nervine  stimulant  in  snake-bites,  more  useful 
than  brandy  or  any  other  stimulant;  rr^x-xx  of  liquor  ammonias  in  water  or 
wine,  every  half-hour  or  oftener;  also  externally  or  hypodermically,  1  part  to 
2  aquas  into  a  vein  (Wa.).  Carbolic  Acid,  a  weak  solution  sponged  over  the 
body,  to  keep  off  mosquitoes  (R.).  Salicylic  Acid,  1  to  19  of  Flexible  Collo¬ 
dion,  locally  for  bites  of  insects,  allays  pain  at  once,  and  only  in  rare  cases 
is  the  neighboring  tissue  swollen.  Mercury.  The  Bichloride,  1  to  1000  of 
Flexible  Collodion,  is  equally  effective.  Potassium  Permanganate,  in  strong 
solution,  1  to  6,  locally,  is  promptly  efficient  for  all  reptile-bites  and  insect- 
stings.  If  wound  is  small,  make  incision  to  enlarge  it,  and  insert  lint  soaked 
in  the  solution.  If  a  rattlesnake-bite,  inject  the  solution  hypodermically  above 
the  wound  (Dupon).  Viola  Cucullata,  the  common  violet,  is  used  as  an  inter¬ 
nal  remedy  in  Pennsylvania  for  rattlesnake  bite,  and  is  successful  in  a  remark¬ 
able  degree.  The  leaves  are  eaten,  and  a  poultice  of  indigo  and  salt  is  at  the 
same  time  applied  to  the  wound.  Arsenic,  1  part  to  5  of  black  pepper,  is  the 
“Tanjore  Pill,”  highly  esteemed  in  India  for  bites  of  venomous  snakes  (Wa.). 
Chloride  of  Lime,  a  filtered  solution  injected  into  wound  from  snake  bite,  suc¬ 
cessful  in  seventeen  cases  (Binz).  Silver  Nitrate,  the  sharpened  stick  applied 
to  every  sinuosity  of  the  wound.  Excision  safer  (Wa.).  Sugar,  applied  to 
stings  of  wasps,  said  to  relieve  almost  instantly  (Wa.).  Ipecacuanha,  as  poul¬ 
tice  or  paste,  allays  pain  and  irritation  ;  is  regarded  by  some  as  almost  specific 
(Wa.).  Stimulants,  in  snake-bites,  freely  ;  most  important.  Liquor  ammonias 
the  best  (Wa.) ;  stimulants  are  indicated  in  snake-bites,  but  there  is  no  remedy 
of  any  value  (Gross).  Sting,  should  always  be  removed  if  left  in  the  wound  ; 
pressing  upon  it  with  the  barrel  of  a  small  key  will  expose  it. 


R  .  01.  Picis  Liquidae, 

01.  Olivse, 

01.  Hedeomse,  .  .  .  .  aa  £]. 
Spt.  Camphorge, 


Glycerini, . aa  3  ss. 

Ac.  Carbolic!, . ^ij. 


M.  Sig. — Shake  well.  Lotion  against 
mosquitoes,  for  fLhermen  and  hunters. 


Carho  Vegetab., . fbj. 

Potassii  Nitratis,  .  .  .  .  ^ij. 

Ac.  Carbolici, . s;  jss. 

Persian  Insect  Powder,  .  .  3  viij. 

Mucil.  Tragacanth.,  q.  s. 

To  make  fumigating  pastilles  for  use 
against  mosquitoes. 


Prescriptions. 

R. 


Stomatitis. 

Potassium  Chlorate,  locally  and  internally.  Large  doses  necessary  (gr.  x-xx) ; 
in  ulcerative  stomatitis  of  nursing  women,  and  aphthae;  of  no  value  in  mercu¬ 
rial  form  (R.).  Hydrastis,  fluid  extract  locally  in  mercurial  and  aphthous 
stomatitis  (B.).  Carbolic  Acid,  concentrated,  in  glycerin,  carefully,  as  a  mild 
caustic  in  aphthous  stomatitis  (Wa.).  Alcohol,  Brandy-and-water  an  excellent 
lotion  (B.).  Acids,  Mineral,  pure  Hydrochloric  on  pine  wood  to  ulcers  (B.). 
Eucalyptus,  a  decoction  of  the  leaves  an  efficient  local  application  (B.).  Gly¬ 
cerin  of  Tannin,  in  ulcerative  stomatitis  (R.).  Copper  Sulphate,  solution  painted 
over  edges  of  gums  in  ulcerative  stomatitis;  generally  dry  alum  better  (R.). 
Alum,  in  ulcerative,  applied  dry  with  the  finger  several  times  a  day,  especially 
when  disease  affects  one-half  the  jaw  (R.).  Salicylic  Acid,  to  ease  the  pain  of 
catarrhal  stomatitis.  One  part  (dissolved  in  sufficient  alcohol)  to  250  parts  of 
water  (R.).  [Compare  Aphtha:,  Caxcrum  Oris.J 


668 


STABISMUS - SYNCOPE. 


Strabismus. 

Belladonna,  for  the  strabismus  of  encephalitis  (P.).  Atropine,  with  strong 
convex  glasses,  to  suspend  accommodation  for  months,  or  years  if  necessary; 
may  cure  convergent  strabismus  in  its  earlier  stages,  in  children  of  3  years  of 
age  or  younger  (Green  in  C.).  Operation,  required  in  most  cases,  especially 
when  of  congenital  origin.  Glasses,  properly  adjusted  to  sight,  serve  to 
strengthen  the  weak  muscles  in  children,  and  to  pull  the  axes  right  (Gould). 


Strophulus. 


Glycerin,  locally,  combined  with  bismuth,  and  digitalis  (Wa.).  Lancing  the 
gums  is  proper  (H.). 

Sunstroke. 


Water.  Cold  affusion  when  patient  is  stricken  down  unconscious  (R.) ;  abso¬ 
lute  rest  and  quiet,  free  air,  loose  clothes.  Potassium  Bromide,  in  cold  water 
enemata.  Stimulants  when  frequent  and  feeble  pulse.  Chloroform,  if  convul¬ 
sions.  Leeching,  in  stage  of  reaction  (Wa.).  Veratrum  Viride,  and  Gelsemium, 
as  sedatives,  instead  of  stimulants,  when  pulse  full  and  strong  (Ely). 


Suppuration. 

Sulphides,  small  doses  (gr.  ss-j),  frequently  repeated,  are  very  serviceable 
(B.).  Calcium  Sulphide,  when  ichor  secreted  instead  of  pus;  also  arrests  sup¬ 
puration,  or  if  that  is  impossible  will  hasten  maturation  (R.).  Quinine,  recom¬ 
mended  in  profuse  suppuration  (R.) ;  to  sustain  system  when  suppuration  pro¬ 
longed  (B.).  Sarsaparilla,  is  very  useful  (P.).  Phosphates,  Parrish’s  to  repair 
waste  from  suppuration  (B.).  Iodide  of  Manganese  and  Iron,  the  syrup  in 
cachectic  states  resulting  from  suppuration  (B.).  Alcohol,  an  excellent  anti¬ 
septic  dressing  (B.).  [Compare  Abscess,  Boils,  Carbuncle,  Pyaemia.] 


Surgical  Fever. 

Aconite,  quickly  and  repeatedly  in  early  stages,  during  chill  or  soon  after, 
the  safest  treatment  (P.).  Salicylic  Acid,  or  Salicylate  of  Sodium,  especially 
useful  as  an  anti-pyretic  (B.).  Chloral,  gr.  xx-xxx  of  the  hydrate  every  2  hours, 
no  better  treatment  (Wa.). 

Sy  cosis. 

Nitric  Acid,  $j  to  Oj  aquae,  as  wash,  used  frequently  (R.).  Boracic  Acid, 
3jss  finely  powdered  and  incorporated  with  gj  of  vaseline,  is  found  most  use¬ 
ful  (Wa.).  Mercury,  citrine  ointment  has  been  extensively  employed,  also  the 
oleate  of  mercury,  both  with  good  results  (Wa.).  Arsenic,  the  oleate  is  found 
beneficial,  and  the  Solution  of  Arsenic  and  Mercury,  Donovan’s  solution,  inter¬ 
nally  is  highly  useful.  Mercurial  Ointments  are  extensively  employed  (Wa.). 
Sodium  Sulphite,  3j  ;  glycerini,  ;  aquae,  3hj  ;  locally,  when  of  parasitic 
origin  (Wa.).  [Compare  Condylomata,  Mentagra.] 


Syncope. 

Cinnamon,  the  oil,  as  a  powerful  stimulant,  sometimes  employed  (P.).  Alco¬ 
hol,  as  brandy,  or  wine,  when  heart  suddenly  enfeebled  from  fright,  etc.  (R.). 
Amyl  Nitrite,  in  some  forms,  especially  in  anaemic  subjects,  its  inhalation 
speedily  restores  consciousness  (O’Neill).  Atropine,  gr.  iiyo-?o  subcutaneously, 
the  best  means  of  resuscitation,  there  being  no  medicine  which  so  promptly  exalts 
the  force  and  rapidity  of  the  heart’s  action  (Harley).  Ammonia,  internally,  or 
breathed  into  the  air-passages  (R.) ;  the  carbonate  as  “smelling  salts”  (Wa.). 
Lavandula,  the  compound  tincture  (Wa.).  Chloroform,  internally,  for  hysteri¬ 
cal  people,  as  cardiac  stimulant  (R.).  Position,  leaning  forward,  with  head  as 
low  as  possible  (R.).  Galvanization  of  pneumogastric  (B.).  Cold  Water  over 
the  face,  and  volatile  substances  to  the  nose  (R.).  Cold  affusion  always  (Wa.). 


SYNOVITIS — SYPHILIS. 


669 


Synovitis. 

Potassium  Iodide,  with  iron  and  quinine,  in  syphilitic  patients  with  consti¬ 
tution  broken  down  (D.).  Iodide,  in  chronic,  painted  around  joint ;  the  solu¬ 
tion  injected  into  white  swelling  (R.).  Quinine,  and  free  stimulation  in  all 
cases  of  pyasmic  synovitis,  such  as  occurs  in  acute  rheumatism  of  gonorrhoeal 
causation,  occasionally  in  typhoid  fever,  and  may  from  a  trifling  injury  in 
strumous  subjects.  Mercury,  and  Morphine,  the  oleate  locally  (R.)  ;  an  ele¬ 
gant  and  efficient  application  (B.) ;  in  syphilitic  cases  Mercury  internally  when 
acute  symptoms  have  subsided  (D.).  Aconite,  for  pains  in  inflamed  joints  (R.). 
Silver  Nitrate,  locally,  to  vesication  almost,  often  very  beneficial  (Wa,).  Car¬ 
bolic  Acid,  injected  into  joint  (B.).  Alcohol,  and  water,  equal  parts,  an  excel¬ 
lent  evaporating  lotion  (B.).  Blisters,  a  flying  blister  every  night  in  chronic 
synovitis  (R.).  Cod-liver  Oil,  in  strumous  cases  (B.).  Surgical  Treatment. 
Splints  to  keep  limb  motionless  in  all  cases  arising  from  injury  ;  during  acute 
stage  splint  should  be  fastened  at  some  distance  above  and  below  joint, 
and  not  touch  joint  itself.  Straight  position,  leeches  to  joint,  or  cupping  near 
it ;  ice,  evaporating  lotions  or  hot  fomentations.  Blisters  inapplicable  until 
acute  stage  subsides  (D.).  If  suppuration  occurs  the  joint  must  be  dealt  with 
as  any  other  abscess  cavity  (MacCormac).  Heat,  as  fomentations  or  poultices 
in  the  acute  form.  Bandage,  or  Strapping,  to  cause  absorption  of  fluid ; 
bandages  (cold  water)  after  alternate  bathing  with  hot  and  cold  water,  in 
chronic.  [Compare  Coxalgia,  Joint  Affections.] 

Syphilis. 

Mercury,  the  mainstay  in  earlier  and  later  stages  ;  the  protiodide  in  pills  of 
gr.  jt  each,  one  after  each  meal  increased  by  one  every  third  day,  until  teeth 
sore  or  bowels  disordered,  then  drop  two  pills  from  each  dose  (Keyes).  The 
best  remedy  for  primary  and  secondary,  not  so  in  tertiary,  or  in  chancroid  ; 
small  doses  are  best,  to  stop  short  of  ptyalism  (B.).  Blackwash,  calomel  or 
citrine  oint.  very  useful  in  mucous  sores,  tubercles,  and  elevated  indurations  ; 
in  syphilitic  ozaena,  psoriasis,  rashes,  condylomata,  etc.,  the  bichloride,  gr.  ij- 
v  in  ^j  alcoholis,  painted  over  syphilitic  mouth  lesions  daily  (Keyes).  The 
serious  secondary  and  tertiary  symptoms  can  be  produced  both  by  syphilis  and 
by  mercury  ;  the  phenomena  produced  by  mercury  are  singularly  similar  to 
those  which  result  from  syphilis.  Mercury  believed  to  be  a  true  vital  antidote 
against  the  virus  (R.) ;  used  for  at  least  two  years  can  eradicate  it  (Keyes). 
Nitric  Acid,  in  secondary  forms  (R.) ;  holds  a  high  place  as  an  internal  remedy 
(Wa.) ;  when  sponginess  of  gums  excessive,  ^  iv— ^ij  aq.,  teasp.  4  times  daily; 
also  use  locally  (St.);  as  cautery  for  the  initial  lesion,  the  fuming  acid,  if  done 
at  all,  should  be  early  and  thoroughly,  followed  by  Blackwash  locally  on  lint 
(Bulkley).  Potassium  Iodide,  approached  by  no  remedy  in  constitutional  syph¬ 
ilis  ;  also  for  mercurial  cachexia,  syphiloma  of  nervous  system,  and  many  dis¬ 
orders  of  syphilitic  origin.  Will  certainly  arrest  ulceration  of  nares,  palate,  etc., 
if  given  in  large  doses,  gr.  xx-,Tj  every  4  hours  (R.)  ;  is  of  little  value  in  early 
stages  ;  in  later  should  be  combined  with  mercury  (St.).  Iodine,  as  gargle  for 
ptyalism;  the  tincture  applied  to  syphilitic  sores  of  the  throat  (R.) ;  or  3SS  of 
tincture  to  ^iv  syr.  fusci ;  a  teaspoonful  well  diluted  ter  die,  after  meals,  when 
Pot.  Iod.  cannot  be  borne  (St.).  Iodoform,  powdered  and  dusted  over  ulcers 
(B.).  Aurum,  after  mercury  and  the  iodides,  in  old  cases  of  secondary  and 
tertiary,  ulceration  of  the  throat,  ozaena,  phthisis,  syphilitic  bone-diseases  (B.) ; 
its  beneficial  action  incontestable  (Tr.).  Stillingia,  with  nitric  acid  in  chronic 
cases  of  broken-down  constitutions  from  mercury  and  iodides;  has  been  most 
satisfactory  (B.).  Cascara  Amarga,  is  said  to  have  remarkable  powers  as  an 
alterative  in  syphilis,  but  to  be  useless  if  alcohol  and  tobacco  are  used  at  the 
same  time.  Sanguinaria,  in  secondary  and  tertiary,  is  held  to  be  very  useful 
(P.).  Sarsaparilla,  a  most  important  remedy,  as  adjunct  to,  and  in  abuse  of 
mercury  (P.)  ;  with  guaiac  and  mezereon,  as  the  compound  decoction  of  sarsa¬ 
parilla,  in  tertiary  form  (B.).  See  Guaiac,  below.  Belladonna,  with  mercurial 


670 


TABES  MESENTERICA. 


ointment,  for  secondary  ulcerations  of  rectum  (P.) ;  tincture  £iv  ad  3  i j  aquae,  a 
teaspoonful  4  times  a  day  in  water,  instead  of  mercurials  (St.).  Iron,  the 
iodide  in  constitutional  syphilis,  to  promote  constructive  metamorphosis  (B.)  ; 
where  anaemia  exists  (R.)  ;  the  potassio-tartrate,  gr.  xv-xx,  every  4  hours, 
especially  in  the  gangrenous  form  (Otis).  Guaiacum,  in  tertiary  only  ;  or  as 
vehicle  for  potassium  iodide  and  mercuric  chloride  (B.).  Carbolic  and  Salicylic 
Acids,  locally  to  syphilitic  abscesses,  carbolic  best  (B.).  Zinc  Chloride,  Iodide, 
Nitrate,  locally  to  syphilitic  ulcers  (R.).  Denutrition.  The  Arabic  “  hunger- 
cure  ”  efficient,  but  unpopular  (B.).  Turkish  Baths,  or  wet  packing,  amelio¬ 
rate  and  aid  cure  of  constitutional  syphilis  (B.).  Hygiene,  is  of  the  greatest 
importance  in  syphilis  (Bulkley).  Cod-liver  Oil,  remarkably  improves  condi¬ 
tion  resulting  from  prolonged  use  of  mercury  and  iodides,  the  syphilodermata, 
and  squamae  ;  internally  and  by  inunction  (R.).  [Compare  Chancre,  Con- 
DYLOMATA,  ULCERS,  PTYALISM.J 


Prescriptions. 


R.  Massae  Hydrargyri,  .  .  .  gr.  ij. 

Ferri  Sulph.  Exs-iccat.,  .  gr.  j. 

Extr.  Opii  Aquosi,  .  .  .  gr.  l/±. 

In  pill,  thrice  daily.  (  Otis.) 


j  R.  Hydrarg.  Chlor.  Corr.,  .  gr.  viij. 
Potassii  Iodide,  .  ...  g  viij. 

Syr.  Sarsaparillae  Co.,  .  .  ^  viij. 

M.  Sig. — “  The  Three  Eights” — Dose, 
a  teasp.  thrice  daily. 


R  .  Hydrargyri  Bichloridi, 

Ammonii  Chloridi,  .  .  aagr.  iij. 
Tinct.  Cinchonae  Comp., .  3  iij* 

Aquae, . 3  iij. 

M.  Sig. — A  teasp.  thrice  daily.  Each 
5  contains  gr.  Jg  of  corrosive  sublimate. 

(Bumstead.) 


R.  Potassii  Iodidi,  .  .  .  .  5pj. 
Ammonii  Carb.,  .  .  .  .  3  ss. 

Tinct.  Cinchonae  Comp.,  3  iv. 

Glycerini, . j§j* 

Syr.  Aurantii  Cort.,  .  .  .  ^jss. 

M.  Sig. — A  teasp.  in  plenty  of  water 

after  each  meal.  (Keyes.) 


R.  Hydrarg.  Chlor.  Mitis.,  .  gij. 

Lycopodii, . %  ij. 

M.  Sig. — Use  as  snuff  thrice  daily,  in 
lesions  of  the  nostrils.  (Diday.) 


R .  Hydrarg.  Iodidi  Rubri,  .  gr.  ij. 
Ammonii  Carbonatis,  .  .  gr.  xx. 

Potassii  Iodidi, . 3  iij. 

Tinct.  Gent.  Comp.,  .  ad 
M.  Sig. — A  teasp.  in  water  after  each 
meal.  (Fox,  for  the  Mixed  Treatment.) 


R  .  Hydrarg.  Iodidi  Rubri,  .  gr.  iij. 
Potassii  Iodidi,  ....  3  iij— vj. 
Tinct.  Aurantii  Cort., 

Syrup.  Aurantii  Cort.,  aa  :|j. 

Aquae, . 3  viij. 

M.  Sig. — A  teasp.  thrice  daily  after 

meals.  ( Gtis,for  the  same.) 


R  .  Hydrarg.  Bichloridi,  .  .  gr.  iv. 

Tinct.  Benzoini,  .  .  .  .  3 ss- 
Aquae  Cologniensis,  .  .  §]■ 

Aquae  Rosae, . 3  iyss- 

M.  Sig. — Apply  locally  with  sponge  to 
skin  for  20  minutes.  For  squamous  syphil- 
ides.  (S.  W.  Gross.) 


Tabes  Mesenterica. 

Lime,  the  chloride  and  phosphate  (R.) ;  the  chloride  is  a  powerful  remedy  if 
kept  up  (Wa.).  [See  Scrofulosis.J  Iodine,  by  inunction  with  cod-liver  oil 
(El.) ;  locally  over  glands  ;  carefully,  lest  inflammation  be  increased  (R.).  Potas¬ 
sium' Iodide  in  small  repeated  doses,  valuable  (Wa.).  Mercury.  Corrosive 
Sublimate  with  bark  (gr.  j  ad  £ij  tinct.  cinchonae)  after  meals,  for  chronic  gland¬ 
ular  disease  (D.).  Phosphates,  for  malnutrition  (B.).  The  hypophosphites  act 
slowly  but  surely  (Wa.).  Iron  and  Iodine,  in  various  forms  are  the  most  useful 
remedies  in  scrofulosis,  but  medicine  is  powerless  without  strict  hygienic  meas¬ 
ures  (A.)  ;  the  Iodide  or  Phosphate  of  Iron  and  Cod-liver  oil,  as  for  tubercle 


TASTE - TEETH - TESTICLES - TETANUS. 


67I 


elsewhere  (El.).  Fel  Bovinum,  is  worthy  of  trial,  though  at  best  a  palliative 
(Wa.).  Cod-liver  Oil,  is  the  best  remedy  to  promote  assimilation  (B.) ;  of  great 
service  (R.).  Chaulmugra  Oil,  is  of  benefit,  used  by  inunction  (Wa.).  Aliment. 
Raw  meat,  cream,  chocolate,  and  cocoa,  are  valuable  nutriments  in  these  cases 
(EL).  Peptonized  foods  are  of  inestimable  value  (Wa.).  Hygiene.  Change  of 
air,  especially  to  sea-air,  is  all-important  (EL).  [Compare  Scrofulosis.] 

Taste,  Disordered. 

Mercury  or  Podophyllin,  as  purgative  for  cankery  taste  unconnected  with 
alcoholism  ;  or  half-glass  of  pure  cold  water  daily  half  an  hour  before  break¬ 
fast  (R.). 

Teeth. 

Potassium  Iodide,  in  doses  of  gr.  x,  thrice  daily,  often  cures  looseness  of 
teeth  from  periostitis  of  alveolar  processes  (Wa.).  Iodine,  tincture  painted  over 
gums  close  to  the  teeth  when  the  gums  begin  to  recede  ;  also  to  remove  tartar 
(R.).  Cinchona,  powdered  bark  often  used  in  tooth-powders  (R.).  Collodion, 
on  cotton,  as  stopping  for  carious  teeth  (P.).  Liquor  Sodae  Chloratae,  ovj  ad 
3 xij  aquae,  a  highly  useful  application  in  fetid  discharges  from  carious  teeth 
(Wa.).  [Compare  Dentition,  Odontalgia.]  ' 

Testicles. 

Mercury,  the  ointment,  locally  in  indurations  and  enlargements  of  testes 
(Wa.).  Corrosive  Sublimate,  with  cinchona  or  sarsaparilla  in  sarcocele  (D.). 
Water,  cold  applications  in  neuralgia  of  testes,  with  tonics  and  neuralgic  treat¬ 
ment  generally  (D.).  Suspensory  Bandage,  with  rest,  in  many  affections  of 
the  testes  (D.).  [Compare  Hydrocele,  Okchitis,  Varicocele.] 

Tetanus. 

Strychnine,  of  decided  service  (P.) ;  cured  8  cases  of  traumatic  form,  in 
doses  of  gr.  -jJg-  to  ^  (S.) ;  is  conclusively  curative,  especially  in  chronic  and 
spontaneous,  rather  than  in  traumatic.  Strychninae  Sulphat.,  gr.  to  (B.). 
Aconite,  has  benefited  many  cases  (P.) ;  its  success  warrants  further  trial  (W.). 
Belladonna,  successfully  used  in  many  cases ;  the  extract,  internally,  and 
locally  to  wound  (Wa.) ;  gr.  atropine  injected  into  muscle  (B.) ;  bleeding, 
vapor-baths,  and  large  doses  of  belladonna  have  cured  tetanus  (Tr.).  Nico¬ 
tine,  by  rectum  or  hypodermically,  appears  to  be  useful  in  many  cases  (R.); 
much  evidence  for  it  as  the  best  remedy  (P.) ;  effective  but  dangerous  (B.). 
Physostigma  better  (Wa.).  Potassium  Bromide,  not  less  than  5SS  during  the 
day,  with  chloral  at  night  as  a  hypnotic  ;  out  of  21  cases  but  3  died.  Its  physio¬ 
logical  action  indicates  it  to  be  the  best  remedy  known  (W.).  Chloral,  in 
large  doses  (gr.  xx)  no  remedy  more  effectual  (B.)  ;  has  sometimes  cured  (R.) ; 
best  used  in  combination  with  potassium  bromide  (W.).  Gelsemium,  cured 
several  cases  (P.).  Hyoscyamine,  gr.  gradually  up  to  gr.  TV,  ameliorates 
(B.).  Cocaine.  A  mixed  solution  of  Cocaine  and  Morphine,  of  each  5  per 
cent.,  3  syringesful  hypodermically,  immediately  relieved  and  finally  cured 
a  bad  case  of  idiopathic  tetanus  unrelieved  for  3  days  by  chloral,  morphine, 
etc.  (Lopez).  Physostigma,  has  been  used  with  excellent  results  (P.) ;  the  fluid 
extract  by  mouth  if  possible,  at  very  beginning,  and  must  be  pushed  until  just 
short  of  arresting  breathing  (B.);  evidence  is  discrepant  (W.).  Apomorphine, 
may  prove  antagonistic  (P.).  Curare,  hypodermically,  has  much  evidence  for 
its  power  (P.).  Cannabis  Indica,  used  with  marked  success  in  traumatic  form 
(P.).  Difficult  to  obtain  an  active  extract  (W.).  Anaesthetics.  Ether,  to  relieve 
pain  (B.).  Chloroform,  in  small  and  frequently  repeated  doses,  also  by  fric¬ 
tion,  has  been  useful  in  many  instances  (Wa.).  Amyl  Nitrite,  used  in  3  cases 
with  marked  benefit  as  spinal  sedative  (W.) ;  has  been  used  with  success  (R  ). 


672 


THIRST - TIC  DOULOUREUX. 


Morphine,  hypodermically,  deeply  into  tetanized  muscles  (B.) ;  of  no  value 
(Wa.).  Conium,  is  indicated,  but  has  not  been  successful  (B.).  Water. 
Warm  baths,  and  cold,  or  ice,  afford  only  temporary  amelioration  (B.).  Spinal 
Ice  Bag,  extremely  useful  (R.).  Division,  or  stretching  of  any  nerve-trunk 
connecting  wound  with  spinal  cord.  [Compare  Spasms. J 


Thirst. 

Acid  Drinks,  promote  secretion  of  saliva  in  fevers  (R.).  Tepid  Drinks,  are 
useful  in  the  thirst  of  diabetes  (R.).  Ice,  sucked,  allays  thirst  (R.). 


Throat,  Sore. 


Aconite,  when  temperature  high,  half-drop  doses  of  tincture,  every  ^  hour 
for  2  hours,  then  every  hour,  will  almost  certainly  prove  efficacious  (R.) ;  valu¬ 
able  in  ordinary  sore  throat  (P.).  Belladonna,  is  very  admirably  adapted  to 
the  treatment  of  ordinary  sore  throat.  When  much  fever,  combine  with  Aco¬ 
nite  (R.,  P.).  [See  Catarrh,  Acute.]  Mercury,  in  acute  tonsillitis,  which 
see  (R.).  Nitre,  dissolved  in  mouth,  to  abort  a  sore  throat  (Wa.).  Tannic 
Acid,  as  powder,  gargle,  spray  (P.).  Glycerin  of  Tannin,  after  acute  inflamma¬ 
tion  ;  in  ulceration  of  aphthous  sore  throat  daily  when  tendency  to  catarrh  (R.). 
Ipecacuanha,  the  wine  as  spray,  in  non-inflammatory  sore  throats  and  hoarse¬ 
ness  from  congestion  of  vocal  cords  (R.).  Capsicum,  3j  of  tincture  to  0)4 
aquae  as  gargle,  in  some  sore  and  malignant  sore  throats  (R.,  P.).  Potassium 
Chlorate,  in  grain  doses  every  half-hour  (A.  A.  Smith).  Alum,  dry,  or  in  solu¬ 
tion  (R.).  Myrrh,  as  gargle  in  ulcerated  sore  throat  (P.).  Cimicifuga,  in 
simple  (R.,  P.),  and  malignant  forms  when  mucous  membrane  dry  and  spotted 
with  inspissated  mucus  (R.).  Arsenic,  in  medicinal  doses,  in  sloughing  of 
throat  or  malignant  sores  (R.).  Iodine,  tincture,  locally  to  sores,  whether 
syphilitic  or  not  (R.).  Rhus  Glabra,  a  very  efficient  gargle,  a  decoction,  ^j- 
ad  Oj,  boiled  to  0)4,  with  Potassium  Chlorate,  ^ss  (W.).  Nitric  Acid,  undi¬ 
luted  to  sloughs  (R.).  Silver  Nitrate,  locally,  in  early  stage  of  inflammation 
may  cut  it  short  (R.).  Sulphurous  Acid,  by  inhalation,  spray,  or  fumigations 
for  malignant  sore  throat,  scarlatinal  or  otherwise  (R.).  Water,  cold  compress 
nightly,  to  harden  the  throat  when  tendency  to  catarrh  (R.).  Ice,  constantly 
sucked  (R.).  [Compare  Tonsillitis,  Pharyngitis,  and  formulae  for  Gargles, 
on  page  460.] 

Prescriptions. 


R .  Hydrarg.  Bichlor.,  .  .  .  .  gr.  iv. 

Alcoholis, . 5  ij. 

Solve,  et  adde — 

Decocti  Cinchonse, 

Mellis  Ros?e, 

Tinct.  Myrrhae,  .  .  .  aa  %  ij. 

M.  ft.  gargarysma.  Gargle,  to  be  di¬ 
luted  if  too  severe.  For  ulcerated  forms 
of  syphilitic  sore  throat.  [Sir  Chas.  Bell.) 


R  .  Tinct.  Guaiaci  Ammon., 

Liq.  Potassae,  .  .  .  .  aa  3  iij. 

Tinct.  Opii, . 3  ij. 

Aq.  Cinnamomi,  .  .  .  ad  3  v i i j . 

M.  ft.  gargarysma.  Sig. — To  be  used 
every  hour,  as  a  gargle,  in  clergyman’s 
sore  throat.  ( Garner .) 


Tic  Douloureux. 

Arsenic,  cures,  influences  nutrition  (B.).  Phosphorus  useful  ;  gr.  to  y1^ 
every  3  hours  (R.).  Belladonna,  Aconite,  Spigelia,  Iodides,  Morphine,  Cimici¬ 
fuga,  Gelsemium,  Turpentine,  Galvanism  (B.).  [See  under  Neuralgia.] 
Croton-Chloral,  palliative  in  doses  of  gr.  v  every  )4  hour  till  gr.  xxx  taken 
(W.).  Salicylates,  in  large  doses,  cured  a  case  of  12  years’  standing.  Stramo¬ 
nium,  gr.  %  to  )4  every  3  or  4  hours  for  4  or  5  doses,  often  affords  decided 
relief ;  stop  if  narcotic  symptoms  appear  (P.).  Laurocerasus,  sometimes 
removes  (P.).  [Compare  Hemicrania,  Neuralgia.] 


TINEA  CIRCINATA - TINEA  TONSURANS. 


673 


Tinea  Circinata — (Ringworm  of  the  Body). 

Mercury,  the  bichloride,  1  part  to  250  of  water,  as  parasiticide  solution,  after 
depilation  (A.).  [See  also  T.  Tonsurans.]  Carbolic  Acid,  a  very  efficient 
application  ;  3j  ad  5J  glycerini,  locally  (B.) ;  or  equal  parts  of  Carbolic  Acid 
and  Glycerin,  is  a  very  efficient  application.  Sulphurous  Acid,  better  and 
safer  (A.);  must  be  fresh  to  be  of  use  (Bulkley).  Cocculus  Indicus,  the  decoc¬ 
tion  locally,  after  washing  the  skin  well  (P.).  Oil  of  Cade,  the  best  depilatory 
known  (A.).  Arsenic  will  not  cure,  but  may  do  service  as  a  nerve  tonic  or  an 
improver  of  nutrition,  in  connection  with  other  remedies  (Bulkley).  Cuprum 
Acetate,  gr.  x  ad  §j  adipis,  as  ointment,  is  very  effective  (B.).  Sodium  Hypo¬ 
sulphite,  gj  ad  3 xij  aquae,  locally,  used  by  Dr.  Tilbury  Fox.  Mercury.  Calo¬ 
mel  ointment  (3j  ad  3j)  useful  (B.).  Hydrarg.  nitrate  as  strong  citrine  oint¬ 
ment,  rubbed  in  twice  daily,  often  effectual.  Hydrarg.  oxid.  rubrum,  as  oint¬ 
ment,  often  cures  ringworm  on  body  or  limbs,  when  other  remedies  fail  (Wa.). 
Cocculus,  ointment  from  kernels,  or  decoction  (P.).  Iodine,  liniment  once 
applied  (R.);  with  oil  of  tar  (1  to  4  of  latter)  locally,  is  excellent  (Wa.). 
Kamala,  used  locally  by  the  Hindoos  (P.).  Tar  Ointment,  is  used  with  good 
effect  (P.).  Acetic  Acid,  applied  to  cut  it  short  (R.).  Cod-liver  Oil,  a  power¬ 
ful  auxiliary  in  weakly  and  cachectic  subjects  (Wa.).  Diet  and  Hygiene,  are 
important.  Food  should  be  nutritive  and  abundant,  especially  animal  fats. 
Daily  baths,  out-of-door  exercise.  Fungus,  is  the  Tricophyton  tonsurans  (A.). 


Tinea  Decalvans — (Alopecia  Areata). 

Parasiticide  Lotions,  must  be  used  after  epilation,  and  washing  of  head 
daily  with  soft  or  black  soap.  Stimulants  (as  Collodium  with  Ether  Cantha- 
ridalis,  equal  parts),  after  fungus  is  destroyed  (A.).  Tonics  are  necessary, 
especially  to  the  nervous  system  (Bulkley).  Fungus — Microsporon  Audouini 
(A.) ;  but  I  have  never  seen  it,  though  having  made  repeated  and  thorough 
searches  (Bulkley). 


Tinea  Favosa — (Favus). 

Mercury.  Hydrarg.  chlor.  corr.  gr.  xx  ;  cerat.  simplicis  ifj ;  efficient  when 
used  early  (B.) ;  or  gr.  ij  ad  §j  aquae  after  each  epilation  (R.).  Sulphurous 
Acid,  Sulphites,  and  Hyposulphites,  as  parasiticides.  R.  Sodii  hyposulphitis 
3 iij  ;  ac.  sulphurosi  dil.  3ss  ;  aquae  q.  s.  ad  ^xvj  (Startin).  Carbolic  Acid,  Cod- 
liver  oil,  locally  (B.).  Oils,  to  facilitate  removal  of  scabs ;  head  to  be  greased 
freely  to  prevent  spreading.  A  mild  mercurial  pomade,  or  quinine  in  glycerin 
best  (R.).  Cleanliness,  and  free  use  of  soap  and  water,  is  a  sine  qua  non , 
and  in  some  cases  of  tinea  may  be  alone  sufficient  to  produce  curative  results. 
Isolation  of  person,  and  brushes,  towels,  etc.,  necessary  to  prevent  infection. 
Fungus — Achorion  Schonleinii  (A.);  a  very  rare  affection  in  this  country 
(Bulkley). 


Tinea  Tonsurans — (Ringworm  of  the  Scalp). 

Mercury.  Hydrarg.  chlor.  corr.  gr.  xx  ad  §j  unguent,  simplicis,  an  effective 
application  when  used  early  (B.) ;  must  be  employed  with  great  caution. 
Sulphurous  Acid,  with  glycerin  (R.).  Carbolic  Acid,  3j  ad  glycerini  (B.). 
Viola  Tricolor,  the  leaves  are  employed  in  Italy  for  tinea  capitis  (P.).  Cocculus 
Indicus  (P.).  [See  T.  Circinata.]  Potassium  Sulpho-cyanide,  3  ss  with  3j 
glycerini,  3  viij  aquae,  as  lotion  (R.).  Iodine,  £ij  ad  3j  of  oil  of  wood  tar  (R.). 
Arsenic  Iodide,  the  best  constitutional  remedy;  gr.  ^  increased  to  gr.  for  an 
adult :  gr.  to  y1^  for  children,  with  alkaline  lotions  locally  (Wa.).  Lead,  in 
chronic  porrigo  capitis;  the  ointment  of  the  iodide  (B.);  will  complete  a  cure 
after  alkaline  lotions  (Wa.).  Fungus — Tricophyton  tonsurans  (A.).  [Compare 
Tinea  Circinata.] 

43 


674 


TONGUE - TONSILLITIS - TONSILS. 


Tongue. 

Potassium  Chlorate,  gr.  v  internally  and  3j-ij  ad  Oj  aquae  locally  ;  in  ulcers 
of  tongue  (Wa.)  ;  also  in  rawness  of  tongue  in  advanced  phthisis.  Potassium 
Iodide,  in  syphilitic  ulcers  of  tongue  (D.)  ;  and  in  hypertrophy  (A.).  Potas¬ 
sium  Bromide,  3j  to  §vj  water  as  wash,  may  soothe  morbid  sensibility  of  the 
tongue  (A.).  Borax,  gr.  xl ;  glycerini  jfj  ;  aquae  %  iv.  As  application  in 
cracked  tongue  (Wa.).  Iodine,  the  tincture  locally  by  a  fine  brush, .or  as  a 
gargle  with  7  or  10  parts  of  water  and  some  honey,  has  given  uniform  success 
in  malignant  ulcers  (Wa.).  Conium,  thought  to  act  specifically  with  benefit 
in  ulcer  of  the  tongue  (Wa.).  Cinnamon,  the  oil  as  a  powerful  stimulant  in 
paralysis  of  tongue  (P.).  Ginger,  Cochlearia,  Pyrethrum,  as  gargle;  Cloves, 
Mezereon,  Pepper,  as  masticatories,  in  paralysis  (P.).  Fraenum,  should  be 
divided  in  tongue-tie  ;  use  blunt-pointed  scissors,  directing  the  points  down, 
close  to  the  jaw,  so  as  to  avoid  wounding  the  ranine  artery  (D.);  better  to 
cut  as  little  as  possible,  and  that  directly  backwards,  as  the  artery  of  the  frae¬ 
num  may  proceed  from  the  sublingual  (Holmes).  [Compare  Glossitis,  Ran- 
ULA.] 

Tonsillitis. 

Aconite,  when  accompanied  by  fever  and  elevated  arterial  tension,  relieves 
greatly;  gtt.  ss-j  every  ]/2 -hour  or  hour  (B.)  ;  every  %-hovLT  for  2  hours, 
then  every  hour,  will  almost  certainly  prove  efficacious  (R.).  Belladonna,  of 
surprising  efficacy  ;  gtt.  v  of  tinct.  every  3  hours  in  5ss  aquae  (P.).  Mercury, 
often  speedily  removes.  Calomel,  gr.  or  hydr.  cum  creta,  gr.  A  every  2 
hours  ;  not  in  chronic  forms  (B.) ;  gr.  ]/$  of  gray  powder  every  hour  when  ton¬ 
sils  almost  meet,  has  marked  effect.  The  oleate  of  mercury  and  morphine  in 
obstinate  and  painful  tonsillitis  (R.).  Silver  Nitrate,  locally  may  abort,  if 
applied  early  (R.) ;  the  solid  stick,  once  thoroughly  applied  in  first  stage,  rarely 
fails  to  prevent  suppuration  (Howard).  Guaiac,  disagreeable,  but  very  effec¬ 
tive  (P.);  3  ss  doses  of  tincture  every  4  hours  has  remarkable  power;  should 
be  given  in  emulsion  with  mucilage  or  yolk  of  an  egg  (B.) ;  makes  an  excel¬ 
lent  gargle,  see  page  460  for  formula.  Tinctura  Guaiaci  and  Glycerin,  equal 
parts,  in  teaspoonful  doses  every  hour  or  two,  gives  excellent  results  in  acute 
tonsillitis.  Opium,  gr.  v-x  of  Dover’s  powder  at  bedtime,  is  in  many  cases 
curative  (Shoemaker).  Cocaine,  in  10  per  cent,  solution,  locally,  at  intervals  of 
15  minutes,  removes  pain  at  once  and  promotes  resolution.  A  very  efficient 
application  in  5  or  10  per  cent,  solution,  but  causes  temporary  paralysis  of  pala¬ 
tal  muscles,  so  that  liquids  regurgitate  through  nose  (Boeckel).  Alum,  dry  or 
in  solution  (R.).  Potassium  Iodide,  locally  (gr.  j-v-3),  is  useful  (B.).  Potas¬ 
sium  Chlorate,  in  grain  doses  every  half-hour,  very  efficient  (A.  A.  Smith). 
Capsicum,  the  dilute  tincture  in  a  gargle,  or  in  powder  applied  on  a  swab,  is 
useful  in  severe  tonsillitis,  especially  in  that  accompanying  scarlatina  (W.). 
Quinine,  gr.  x-xv  will  sometimes  abort  (B.).  Tannic  Acid,  is  useful  (P.)  ;  as 
gargle,  see  page  460.  Ice  and  wet  pack,  extremely  grateful  (B.).  Cold  Wet 
Compress,  nightly,  useful  (R.).  Incision,  of  the  tonsils  gives  immediate  and 
marked  relief  in  all  cases,  especially  those  which  are  not  amenable  to  ordinary 
treatment.  Sodium  Bicarbonate,  locally  by  wetted  finger  to  surface  of  tonsils 
every  five  minutes  for  J^-hour,  then  every  hour  during  the  same  day,  will  pre¬ 
vent  necessity  for  lancing  (Lyon  Medical). 


Prescription. 

R.  Tinct.  Aconiti, . 7,  ss.  M.  Sig. —  3  ss-ij,  every  2  hours  accord  - 

Tinct.  Guaiaci,  .  .  .  ,  .  ,3  ss.  ing  to  age.  In  severe  cases,  with  high 

Syr.  Zingiberis, . 5  ss.  fever,  bounding  pulse,  severe  headache. 


Syr.  Simplicis, . ^ij.  |  ( Shoemaker .) 

Tonsils,  Enlarged. 

Ammonium  Iodide,  £ss  in  3j  glycerin,  applied  every  night  by  a  camel’s  hair 
brush,  very  efficacious  (Wa.).  Baryta  Iodide,  in  hypertrophy  of  the  tonsils, 


TONSILS - TYMPANITES. 


675 

effects  a  rapid  diminution  in  their  size,  even  when  indurated  for  years  (Hale). 
Liquor  Ferri  Perchloridi,  3j-ij  ad  %j,  painted  over  tonsils  twice  daily,  is  one 
of  the  most  effective  astringents  (Mackenzie).  Aluminium  Sulphate,  a  satu¬ 
rated  solution  applied  daily  by  a  brush,  as  a  mild  caustic  (W.).  Ergot  or  Ergc- 
tine,  injections  into  tonsils  (Meigs).  Zinc  Chloride,  as  caustic,  the  most  efficient 
and  least  annoying  method  ;  a  saturated  solution  applied  on  a  wire  cotton- 
holder  to  each  crypt  and  held  there  a  few  seconds;  a  few  applications  will 
shrink  the  gland  in  a  week.  Tannin,  a  strong  solution  touched  daily  to  tonsils 
(H.) ;  a  few  sips  of  a  saturated  solution  (3 ss  in  ^iij  aquae)  slowly  sipped,  will 
stop  bleeding,  if  profuse  (A.);  gr.  xx  to  §j  aquae,  hypodermically,  as  in  nasal 
polypus.  Silver  Nitrate,  touched  daily  to  tonsils,  will  sometimes  make  them 
shrink  (H.).  Catechu,  a  serviceable  astringent  gargle ;  the  infusion  §vj  with 
tincture  of  kino  oij.  as  gargle  (Wa.).  Oxgall,  locally,  is  praised  (Wa.)  ;  is  of 
real  utility  (W.).  Citric  Acid,  rubbed  daily  to  tonsils,  is  highly  praised  in 
enlargement  thereof.  Excision  of  a  part  of  tonsil  (H).  Mackenzie’s  double 
guillotine  removes  both  tonsils  at  once.  Hemorrhage  seldom  happens ;  ice 
will  generally  check  it  (A.).  Surgical  measures  should  receive  unprejudiced 
consideration,  as  the  medical  treatment  is  tedious  in  the  extreme. 

Tonsils,  Ulcerated. 

Coptis,  the  infusion  as  a  gargle  (B.).  Sulphurous  Acid,  dilute,  locally  by 
spray,  or  a  solution  of  sulphite  of  sodium  in  water  (Sj~Sj)  (B.).  Potassium 
Iodide,  will  arrest  syphilitic  ulcerations  at  once  (B.).  Carbolic  Acid,  a  5  per 
cent,  wash  with  tincture  of  myrrh,  a  good  application  by  sponge  to  throat  (Wa.). 
Cimicifuga,  a  decoction  of  the  root  as  a  gargle  (Wa.). 

Torticollis. 

Cimicifuga,  has  curative  efficacy  (P.).  Capsicum,  a  handful  of  the  crushed 
pods  infused  for  36  hours  in  a  pint  of  hot  or  cold  water,  and  applied  on  lint 
covered  with  gutta-percha  (R.)  gives  striking  results  (Wa.).  Opium,  as  lini¬ 
ment  with  friction,  or  an  opium  plaster,  is  often  serviceable  (Wa.).  Galvaniza¬ 
tion  of  affected  muscles,  and  faradization  of  opposed  ones  quickly  relieves  (B.). 

Trismus. 

Aconite  (A.),  Atropine  (R.),  hypodermically.  Cannabis  Indica,  has  been  used 
successfully  in  trismus  neonatorum  (B.).  Opium,  doses  of  laudanum,  with 
castor  oil  and  warm  bath,  in  trismus  infantum.  Treatment  of  any  kind  seldom 
effectual  (D.),  never  (El.).  Ether,  Chloral,  Gelsemium,  Physostigma  (B.).  [See 
Tetanus.] 

Tumors. 

Mercuric  Bromide,  in  gr.  doses,  has  benefited  abdominal  tumors  (Wa.). 
Chloroform,  in  diagnosis  of  abdominal  tumors  when  deep-seated,  and  when 
walls  of  the  belly  are  hard  and  rigid ;  also  in  phantom  tumors  (R.).  Pepsin, 
hypodermically,  to  dissolve.  Hyoscyamus,  the  leaves  as  cataplasm  or  fomenta¬ 
tions  to  painful  tumors,  afford  great  relief  (Wa.).  Electrolysis,  employed  with 
more  or  less  benefit  in  sebaceous,  lipoma,  bronchocele,  enlarged  glands,  etc. 
(Wa.).  Iron,  the  liquor  ferri  perchloridi  is  found  to  be  valuable  as  a  curative 
application  to  fungous  or  hemorrhoidal  tumors  (Wa.).  Galbanum,  as  plaster  to 
indolent,  non-malignant  tumors,  to  diminish  or  cause  their  absorption  (Wa.). 
[Compare  Cancer,  Cysts,  Glandular  Enlargement,  Goitre,  Polypus, 
Uterine  Tumors,  Wen.] 

Tympanites. 

Turpentine,  often  greatly  benefits  (P.,  Wa.);  £j  every  6  hours  in  tympanites 
of  typhoid,  with  prostration  but  without  diarrhoea  (R.).  Asafcetida,  in  hysteri¬ 
cal,  internally  or  as  enema,  beneficial  (P.) ;  also  in  that  of  fever  (Wa.).  Capsi- 


6y6 


TYPHLITIS - TYPHOID  FEVER. 


cum,  gr.  ss-ij,  every  4 hours  (P.).  Cocculus  Indicus,  a  few  doses  of  tincture  will 
often  succeed  in  the  tympanites  of  peritonitis  and  enteric  fever  (P.).  Ginger, 
with  drastic  purgatives  (P.).  Aspiration,  in  extreme  cases  and  as  a  last  resort. 
[Compare  Typhoid  Fever,  Peritonitis.] 

Typhlitis. 

Opium,  of  undoubted  curative  power  (B.).  Purgatives,  are  inadmissible; 
Epsom  salts  may  be  used,  but  no  drastics  (B.).  Leeches,  should  never  be 
omitted  when  tenderness  and  fever  begin  (B.).  Ice-bag,  over  the  swelling  (B.). 

Typhoid  Fever. 

Baptisia,  is  very  useful  in  the  early  stage  (W.).  Mineral  Acids,  are  very 
useful  generally,  especially  HC1  acid  (Wa.).  Nitro-hydrochloric  Acid,  is  to  be 
preferred  over  all  other  plans  of  treatment,  20-drop  doses  in  simple  elixir ;  Sul¬ 
phuric  is  useful  for  intestinal  hemorrhage  (Da  Costa).  Sulphurous  Acid,  is 
highly  praised  by  Dewar,  and  has  real  antidotal  power;  rr\,ijss-n\,xx  every  4 
hours  according  to  age,  continued  for  a  week  or  ten  days,  until  the  patient’s 
complaints  show  him  to  be  saturated.  If  diarrhoea  be  present,  add  Sulphuric 
Acid  and  Opium  (Wilks).  [See  formulae  below.]  Opium,  small  doses  at  night, 
for  insomnia  with  delirium  ;  also  as  injection  for  the  diarrhoea  (R.) ;  in  one  case, 
when  vital  powers  seemed  hopelessly  depressed,  gr.  ]/2  opii  caused  improve¬ 
ment  (Wa.) ;  for  spreading  tenderness  (peritonitis),  give  10-minim  doses  of  the 
deodorized  tincture,  also  gr.  j  in  suppository  every  four  hours  (Da  C.).  Vera- 
trum  Viride,  to  reduce  temperature  (R.) ;  delirium  ferox  (B.)  ;  strongly  recom¬ 
mended  (Wa.) ;  its  efficacy  difficult  to  believe  (S.).  Cinnamon,  efficiently 
used  to  abort  the  disease.  [See  ante ,  page  183.]  Potassium  Bromide,  is  as 
much  a  specific  for  typhoid  fever  as  quinine  sulphate  is  for  ague,  aborting  the 
fever  in  8  or  10  days  (Hawkins).  Carbolic  Acid,  3j,  with  Tincture  of  Iodine 
3 i j ,  of  which  rr\j-iij  every  2  or  3  hours  is  a  very  good  plan  of  treatment  (Da  C.). 
Turpentine,  invaluable,  when  hemorrhage  and  extreme  tympanites  (P.,  R.)  ; 
ttlxxx-1x  in  starch  mucilage,  tt\,x  of  liquor  opii  (P.) ;  trbv-x  frequently  for  hemor¬ 
rhage  or  TAx  every  2  hours  in  advanced  stage,  with  dry  tongue  (R.) ;  coma, 
stupor,  etc.;  often  arouses  the  vital  powers  (Wa.) ;  rrbvij  with  gr.  4V  °f  morphine  ; 
of  especial  value  when  marked  fever  and  congested  lungs,  as  well  as  for  the 
tympany  (Da  C.).  Chloral,  is  the  best  drug  for  nervous  symptoms,  but  must 
not  be  used  when  the  heart  is  weak  (Da  C.).  Arnica,  highly  extolled:  its 
“picture”  shows  definite  powers  in  this  disease  (P.);  small  doses  in  asthenic 
conditions  (B.)  ;  when  vital  powers  greatly  depressed  (Wa.).  Belladonna,  con¬ 
tracted  pupils  ;  low,  muttering  delirium  (B.) ;  thought  to  counteract  the  poison 
of  typhoid  (Wa.).  Mercury,  corrosive  sublimate  gr.  Tj^  every  2  or  3  hours  for 
the  diarrhoea.  Calomel  in  small  doses  at  onset  (R.) ;  gr.  x  in  one  dose  the  first 
day,  gr.  iij  per  diem  for  3  or  4  days,  the  German  “specific  treatment”  (B.). 
Bismuth,  gr.  x-xxv  of  the  subnitrate  with  gr.  y2- j  of  Opium  every  3  hours  for 
the  severe  diarrhoea  (Da  C.).  Ergotin,  gr.  ij-vj  hypodermically,  or  Zj  of  the 
fluid  extract  of  Ergot,  for  intestinal  hemorrhage  (Da  C.).  Tartar  Emetic,  with 
opium,  when  wakefulness  and  delirium.  Minute  doses  (gr.  tl),  frequently,  are 
of  great  service  (B.).  Digitalis,  of  value  in  many  cases  as  a  sustainer  of  heart 
power,  but  may  be  dangerous  in  the  later  stages  (Anstie,  Murrell).  Quinine, 
may  have  efficacy  in  typho-malarial ;  is  less  effective  as  the  typhoid  element 
predominates  ;  useless  in  purely  continued  fevers  (B.)  ;  isjustly  abandoned,  but 
may  be  used  to  maintain  the  circulation,  in  tonic  doses,  gr.  vj-x  in  the  24  hours 
(Da  C.).  Antipyrine,  for  hyperpyrexia,  also  Thymol,  gr.  ss-ij  in  solution  (Da 
Costa).  Digitalis,  used  by  the  Germans  when  there  is  no  cardiac  weakness. 
Gr.  xj-xxij,  as  antipyretic,  over  a  period  of  36  hours  (P.).  Serpentaria,  useful 
when  much  depression  exists.  Cautiously,  if  intestines  at  all  irritable  (B.). 
Hydrastine,  when  copious  sweats  (P.).  Lead  Acetate,  with  opium  for  the  purg¬ 
ing  (R.).  Also  Alum  (R.).  Ergot,  for  intestinal  hemorrhage,  hypodermically, 
if  symptoms  urgent  (R.).  Sodium  Chloride,  should  not  be  withdrawn  from  the 


TYPHUS  FEVER. 


6/7 


food  (Wa.).  Aromatic  Spirit  of  Ammonia,  for  great  accumulation  of  mucus  in 
the  throat  (Da  C.).  Copper  Sulphate,  gr.  ^ ,  with  Opium,  gr.  for  the  diar¬ 
rhoea  (Da  C.).  Strychnine,  is  the  remedy  for  the  functional  palsies  (Da  C.). 
Purgatives,  only  the  very  mildest,  and  they  with  the  greatest  caution  (Wa.). 
Water,  a  most  important  agent.  Cold  baths  when  temperature  above  102°  (B.) ; 
in  mild  cases,  cold  wet  compresses  or  wet  sheets,  or  washing  with  cold  water  ; 
in  severe  cases,  affusion,  shower,  or  general  cold  bath,  50°  to  550  Fah.,  or  better 
950  cooled  gradually  to  6o°  (R.).  Medicine  will  never  abort  a  case  of  true 
typhoid  ;  its  natural  duration  is  from  28  to  30  days  (Sir  William  Jenner).  Stimu¬ 
lants,  freely,  with  quinine,  for  pysemic  cases,  showing  joint  complications.  See 
under  Synovitis.  Aliment.  Milk  alone,  or  alcohol  with  milk,  eggs,  broth 
(B.).  Coffee,  a  better  stimulant  than  alcohol  (P.).  Alcohol  is  needed  to  sustain 
the  heart’s  action  (Da  C.).  Milk  must  be  used  with  great  caution,  if  the  curd 
be  undigested  great  evils  arise  ;  give  essence  of  meat  alone  (Sir  William  Jen¬ 
ner).  Avoid  the  extremes ;  an  absolute  milk  diet  required  if  intestinal  symp¬ 
toms  are  grave  ;  no  solid  food  until  health  is  restored  fully  ;  a  scalded-milk  diet 
exclusively  may  be  depended  on.  Adjuvants,  water,  especially  the  abdominal 
compress,  cleanliness,  ventilation,  absolute  rest  and  quiet.  Discharges  should 
be  received  in  vessels  containing  carbolic  acid  or  a  solution  of  corrosive  subli¬ 
mate,  and  buried  instantly.  [Compare  Hemorrhage,  Intestinal,  Rectal 
Ulceration,  Tympanites.] 


Prescriptions. 


R .  Tinct.  Iodi, 

Ac.  Carbolici,  .  .  . 

.  aa  p.  aeq. 

M.  Sig. — gtt.  j-ij  every  4  or  6  hours. 

In  typho-malarial  fever. 

r 

(Bartholow.) 

R.  Quininae  Sulphatis,  . 

.  .  .  gr.  x. 

Ac.  Hydrochlor.  Dil. 

,  .  .  ,3  ss. 

Vel  Ac.  Sulphur.  Dil.,  . 

.  .  .  ASS. 

Syr.  Aurantii,  .  .  . 

•  -  •  lY 

Aquae  Carui,  .  .  . 

.  .  ad  gvj. 

M.  Sig. — A  tablesp.  in 

an  equal  quan- 

tity  of  water,  every  3  or  4 

hours. 

(Murchison.) 

R .  Ac.  Sulphurosi,  .  . 

.  .  .  Flxv- 

Ac.  Sulphur.  Dil.,  . 

Tinct.  Opii  Deodor., 

-  -  .  rrtfj. 

Syr.  Aurantii,  .  . 

.  .  .  ^ iv. 

Aquae, . 

.  .  ad £j. 

M.  Sig. — For  infants, 

one-sixth  to  be 

taken  every  4  hours. 

( Wilks.) 

R.  Ant.  et  Potassii  Tartrat.,  .  gr.  j-ij. 
Morphinae  Sulphat.,  .  .  .  gr.  jss. 
Aquae  Laurocerasi,  .  .  .  ,3  j. 

M.  Sig. — A  teasp.  every  2,  3  or  4 


hours.  (Bartholow .) 


R.  Ac.  Sulphurosi, . 3  ij. 

Ac.  Sulphur.  Dil.,  .  .  .  .  gij. 

Tinct.  Opii  Deodor.,  .  .  .  rrpxx. 

Syr.  Aurantii, . 3  iij. 

Aquae, . ad^vj. 

M.  Sig. — One-sixth  to  be  taken  every 
4  hours.  (  Wilks.) 


R.  Ac.  Sulphurosi, . %  ij. 

Syr.  Aurantii . 3  iij. 

Aquae, . ad  A  vj . 


M.  Sig. — One- sixth  every  4  hours. 

(Wilks.) 


R .  Ac.  Sulphurosi,  ....  Trpxv. 

Syr.  Aurantii,  .  .  .  .  3  iij. 

Aquae, . ad%). 

M.  Sig. — For  infants,  one-sixth  every  4 
hours.  ( Wilks.) 


Typhus  Fever. 

Baptisia,  is  said  to  have  proved  very  useful  (W.).  Belladonna,  to  cleanse 
and  moisten  the  tongue  ;  controls  the  delirium,  shows  and  strengthens  the  pulse, 
reduces  the  temperature,  shortens  course  of  disease  (R.,  P.).  In  the  early 
stages,  relieves  severity  of  symptoms  (P.)  ;  contracted  pupils  (B.,  Wa.).  Arnica, 
very  highly  extolled  (P.,  Wa.).  Hyoscyamus,  mild  brain  symptoms  (P.).  Opium, 
fulfils  many  important  indications  ;  never  when  contracted  pupil  (Wa.).  Mineral 
Acids.  Hydrochloric,  nitric,  sulphuric;  their  use  recommended  in  all  countries 
(Wa.).  Tartar  Emetic,  with  opium  in  the  delirium  with  insomnia  (R.).  [See 
Typhoid.]  Chloral,  to  produce  sleep,  and  allay  violent  delirium  (R.,  Wa.) ; 


6yS 


ULCERS  AND  SORES. 


its  use  has  often  been  followed  by  amelioration  of  the  symptoms  (Wa.).  Anti- 
pyrine  or  Quinine,  as  antipyretics,  it  being  more  necessary  than  in  typhoid  to 
keep  the  temperature  within  safe  limits  (B.).  Podophyllin,  gr.  ^  as  mild 
laxative  at  onset,  when  constipation,  congestive  headache,  biliary  derangement 
(P.).  Digitalis,  in  large  doses,  a  favorite  remedy  in  Germany  (P.).  Rhatany, 
as  tonic,  in  advanced  stages  (P.).  Serpentaria,  in  low  stages,  delirium,  watch¬ 
fulness;  tongue  dry  and  brown,  or  black.  Combine  with  ammonium,  sesqui- 
carbonate  (P.)  ;  given  occasionally  to  excite  diaphoresis,  and  support  the  vital 
powers  (Wa.).  Camphor,  a  remedy  of  considerable  value  ;  contra-indicated 
when  flesh-red  tongue,  tender  abdomen,  diarrhoea  (Wa.).  Purgatives.  [See 
Typhoid  Fever.]  Coffee,  better  than  alcohol  for  the  adynamia  (P.).  Stimu¬ 
lants,  are  not  needed  under  the  use  of  mineral  acids  and  a  supporting  diet,  in 
many  cases  (Wa.) ;  are  needed  sooner  than  in  typhoid,  as  the  adynamia  is  more 
profound  and  appears  sooner  (B.).  Diet,  nutritious  persistently.  Beef-tea, 
egg-nog  ;  nutrient  enemata.  Isolation,  imperative,  as  the  disease  is  eminently 
contagious  (B.).  [Compare  Delirium,  Typhoid  Fever.] 

Ulcers  and  Sores. 

Arsenic,  improves  rodent  ulcer  (B.).  Belladonna,  has  a  remarkable  influ¬ 
ence  over  various  ulcerative  processes  (P.).  Mercury,  Calomel  ointment  or 
black  wash  in  scrofulous  or  tuberculous  lupus,  and  in  open  scrofulous  sores 
(R.)  ;  corrosive  sublimate,  i  per  cent,  solution,  as  application  to  syphilitic  ulcers 
(Fox)  ;  the  Ung.  Hydrarg.  Nitratis,  for  serpiginous  ulcerations,  diluted  one-half, 
or  the  iodide,  gr.  xx-xl  ad  5j  Vaselini,  in  syphilitic  ulcerations  (Keyes).  Lime, 
as  carbonate  or  lime-water  to  check  discharge  ;  the  sulphide  when  thin  ichorous 
discharge  ;  the  phosphate  has  influence  on  scrofulous  sores  (R.).  Phytolacca, 
as  a  local  application  (B.).  Hamamelis,  employed  with  satisfaction  in  varicose 
ulcers  (Pf.).  Opium  or  Morphine,  with  glycerin,  as  an  application  to  relieve 
pain  (R.) ;  gr.  j-ij,  daily,  also  locally,  has  a  decidedly  curative  value  in  phage¬ 
denic  and  indolent  ulcers;  not  so  useful  in  so-called  “irritable”  ulcers  (Pf.,  P.). 
Tannin,  or  glycerite  of  Tannin,  to  coat  over  wounds,  or  discharging  sores  (R.). 
Potassium  Chlorate,  in  solution  as  a  wash  to  clean  and  stimulate  foul  ulcers 
(R.) ;  in  impalpable  powder,  a  better  application  than  is  Iodoform  (B.).  Cin¬ 
chona,  powdered  bark  dusted  over  foul,  indolent,  sloughing,  and  gangrenous 
ulcers,  promotes  healing  (R.).  Conium,  locally,  by  means  of  a  poultice,  will 
ease  pain  and  improve  the  sore  (R.).  Chlorine  Solution,  as  a  wash  for  slough¬ 
ing  and  indolent  sores  (R.).  Iodide  of  Starch,  cold  as  a  poultice  (R.).  Lead, 
the  soluble  salts  as  lotions  to  unhealthy,  over-secreting  sores  (R.).  Pyrogallic 
Acid,  an  excellent  application  in  venereal  ulcers  (Vidal).  Chloral,  in  lotion, 
gr.  v-xx  ad  5j  aquae,  for  sluggish  sores  (Keyes).  Nitric  Acid,  as  escharotic, 
applied  with  a  glass  rod  ;  oil  to  protect  surrounding  tissues  ;  arrest  by  alkaline 
wash.  5J-Oj  is  a  good  acid  lotion  for  washing  (B.) ;  the  lotion  to  indolent  and 
painful  ulcers  (R.).  Hydrastis,  internally  and  externally,  employed  with  excel¬ 
lent  results  in  rodent  ulcer,  and  ulcers  of  legs,  rectum,  and  uterus  (R.).  San- 
guinaria,  locally,  to  repress  fungous  granulations  of  indolent  ulcers,  i  to  80 
parts  glycerini  (P.).  Carbolic  Acid,  and  Salicylic,  locally  (B.).  The  glycerin 
of  carbolic  acid  a  good  application  to  fetid  sores  (R.).  Balsams  of  Peru  and 
Tolu,  excellent  (P.).  Camphor,  dusted  over  indolent  sores  (R.).  Charcoal, 
locally  to  sloughing  sores  (R.).  Alcohol,  to  cover  sores  with  thin  protecting 
layer  of  coagulated  albumen  (R.).  Alum,  dry  or  in  solution  to  relaxed  and 
abundantly-secreting  sores  (R.).  Turpentine,  internally  for  ulceration  of 
bowels  (P.).  Collodion,  as  protective  covering  (P.).  Capsicum,  a  weak  solution 
useful  as  a  stimulant  in  scrofulous  or  fistulous  sores  (P.).  Savine,  as  acrid  (not 
chemical)  caustic  (P.).  Potassa  Fusa,  or  the  milder  Vienna  paste,  as  escharotic  ; 
to  arrest,  dilute  acid  (B.).  Zinc  Chloride,  the  most  efficient  escharotic  consistent 
with  safety  (B.).  Zinc  Sulphate,  dried,  dusted  over  (R.).  Iodoform,  dusted 
over  surface  (B.)  ;  prevents  granulation  in  all  ulcers,  and  does  no  good  except 
to  relieve  pain  (Gross).  See  Potassium  Chlorate  above.  Silver  Nitrate,  as 
caustic,  quickly  rubbed  over  (B.).  Applied  to  unhealthy  ulcers,  also  ulcers  of 


UR/EMI A - URETHRITIS - URETHRAL  STRICTURE. 


679 


the  mouth  (R.).  Copper  Sulphate,  to  indolent  ulcers.  Touch  with  a  crystal, 
or  frequently  apply  a  solution,  gr.  ij-x  ad  §j  (B.,  R.).  Coptis,  the  infusion  has 
high  reputation  (B.).  Chimaphila,  Copaiba,  Catechu,  Myrrh,  Rhatany,  Rhu¬ 
barb,  Storax,  Benzoin,  Tar  water,  locally,  are  useful  (P.).  Oxygen,  to  atonic, 
painful  ulcers  (R.).  Galvanic  Couplet  (B.).  [See  Bedsores.]  Yeast,  as  poul¬ 
tices  (R.).  Section  of  exposed  nerve-filament,  in  irritable  ulcer,  by  bistoury 
passed  beneath  the  sore  (Hilton  on  Rest  and  Pain).  Cod-liver  Oil,  especially 
for  ulcerations  of  the  glands,  or  indolent  ulcers  with  excoriated  edges,  lupus, 
etc.  Water,  is  sufficient  as  dressing  in  the  majority  of  cases.  Rest  and  support 
of  great  value.  Cleanliness,  bandaging  and  recumbent  position  in  ulcer  of  legs 
facilitate  recovery  ;  also  daily  washing  to  restore  the  lost  vitality  of  parts  ;  elastic 
stockings,  and  the  Esmarch  bandage  in  chronic  cases.  [Compare  Chancre, 
Chancroid,  Bedsores,  Throat,  Gastric,  Intestinal,  and  Uterine  Ulcera¬ 
tion,  Syphilis.] 

Prescriptions. 


R .  Iodoformi,  .  .  . 

....  3  ij- 

Mucil.  Acaciae, 

....  rn,xv. 

01.  Menthae- Pip.,  , 

. "lii- 

Glycerini,  .  .  .  . 

....  n\xx. 

M.  Sig. — For  unhealthy  ulcers. 

(Bronson.) 

R  .  Emplas.  Plumbi,  , 

. ST 

Ung.  Hydrargyri,  , 

. 5  ss- 

Olei  Cadini,  .  .  . 

.  .  .  .  3ij. 

M.  Sig. — Spread  on 

linen,  and  apply  to 

inflamed  patches  on  palms  from  syphilis. 

(Bumstead  and  Taylor.) 

R.  Hydrarg.  Chlor.  Corr.,  .  .  .  gr.  xv. 

Ac.  Carbolici, . rrpxxv. 

Aquae, . q.  s.  ad  3  iv. 

M.  Sig. — For  syphilitic  ulcers,  pack  on 
cotton,  and  renew  daily.  (Pox.) 


R.  Ung.  Petrolei, . j|ij. 

Ung.  Hydrargyri,  .  .  .  .  3  iv. 

Olei  Cadini, . 3  ij. 

M.  Sig. — Apply  after  removing  scales 
to  chronic  palmar  and  plantar  lesions. 

(Bumstead  and  Taylor.) 


Uraemia. 


Digitalis,  the  infusion,  or  a  poultice  of  leaves  to  abdomen  and  back  (B.). 
Jaborandi,  diaphoretic  ;  eliminates  urea  (B.)  ;  or  Pilocarpine  hypodermically. 
Opium.  Scanzoni  and  Loomis  urge  morphine,  hypodermically,  as  the  most 
efficacious  agent  (B.)  ;  in  acute,  not  in  chronic  uraemia  (Pf.).  Colchicum,  as 
diuretic  (B.).  [See  Dropsy. J  Saline  Cathartics,  active  are  required  (B.). 
Hydragogue  Cathartics.  01.  tiglii  (gtt.  i- ij ) ,  or  elaterium  (gr.  ^  to  ^),  to 
procure  free  watery  evacuations.  Cautiously  (B.).  Transfusion,  in  uraemic 
eclampsia  (B.).  Water,  the  vapor  bath,  or  hot  wet-pack  to  induce  powerful 
diaphoresis  (B.).  [Compare  Bright’s  Disease,  Puerperal  Convulsions, 
Scarlatina,  and  the  list  of  Diuretics  and  Diaphoretics,  on  pages  43  and  46.] 

Urethritis. 


Aconite,  is  used  to  advantage  in  urethral  fever  ;  also  for  prevention  of  chill 
after  passage  of  sound  (Pf.,  W.).  Silver  Nitrate,  locally,  very  efficient  in 
chronic  urethritis  in  females  (Wa.).  Tannin,  on  bougies,  once  a  week  for  15 
minutes,  most  efficient  for  urethritis  in  the  female  (Wa.).  Zinc  Sulphate,  cast 
in  sticks,  for  introduction  into  the  urethra  (Wa.).  Potassium  Bicarbonate, 
with  Potassium  Acetate,  aa  gr.  x  in  a  large  cup  of  flaxseed  tea  or  a  glass  of 
Vichy  water,  every  4  to  6  hours  ;  with  absolute  rest  in  bed,  a  calomel  purge, 
and  urination  under  hot  water,  sufficient  for  most  cases  of  urethritis,  which 
may  arise  from  lithiasis,  leucorrhcea  in  females,  etc.  Many  cases  of  aborted 
gonorrhoea  (so-called)  were  really  simple  urethritis  (Otis).  [Compare  Gonor¬ 
rhoea.] 

Urethral  Stricture. 

Aconite,  is  of  great  service  in  spasmodic  stricture  (P.).  Cocaine,  locally  by 
catheter  (Smith).  Buchu,  in  irritable  urethra,  spasmodic  stricture,  and  gleet 
(P.).  Opium,  in  full  dose  or  an  opiate  suppository,  with  fomentations  and  a 
warm  bath,  will  often  suffice  in  spasmodic  stricture  (CL).  Catheterization, 


68o 


URINARY  DISORDERS. 


under  an  anaesthetic  in  spasmodic  stricture  if  other  measures  fail  to  relieve. 
Also  for  gradual  dilatation  in  organic  stricture,  the  safest  and  most  generally 
applicable  treatment  (Cl.).  Oil,  injected  before  dilatation  (Wa.).  Thorough 
Division,  by  a  dilating  urethrotome  the  best  operation  for  a  radical  cure  ;  600 
cases  thus  treated  without  a  death  or  permanent  disability  (Otis). 


Urinary  Disorders. 

Aconite,  of  great  service  in  retention  from  chill,  sub-inflammatory  (P.).  Tur¬ 
pentine,  in  hematuria  and  chronic  catarrh  of  the  bladder,  incontinence  from 
atony,  etc.  (B.).  Strychnine,  sometimes  employed  with  marked  benefit  in 
retention  or  incontinence  of  the  old  (P.).  Cantharis,  frequent  or  involuntary 
micturition,  especially  when  coughing,  in  women  from  weakness  of  sphincter; 
one  or  two  drop  doses  (R.).  Cannabis  Indica,  in  retention  from  spinal  dis¬ 
eases  (R.).  Digitalis,  holds  high  as  a  diuretic,  3j  or  ij  of  the  infusion  night  and 
morning,  or  oftener  if  necessary  ;  in  sudden  suppression  from  cold  or  damp  or 
after  scarlatina,  if  danger  threatens  (P.).  Benzoic  Acid,  or  the  Benzoate  of 
Sodium,  in  10-1 5-grain  doses,  to  render  alkaline  urine  acid,  and  check  the 
formation  of  phosphates  (B.).  Nitro-hydrochloric  Acid,  dilute,  gtt.  x-xv  thrice 
daily  in  water,  for  phosphatic  deposits  (Mears).  Ammonium  Carbonate,  in 
6-grain  doses,  3  or  4  times  a  day,  to  make  acid  urine  alkaline.  Triticum 
Repens,  a  favorite  remedy  with  Sir  Henry  Thompson,  in  pint  doses  daily  of  its 
infusion  or  decoction  ( 3 i j — i v  ad  Oj),  for  strangury,  cystitis,  and  many  other 
complaints,  connected  with  the  urinary  apparatus.  Alkalies,  to  neutralize  acid 
urine,  and  control  chronic  cystitis  ;  the  liquor  potassae  preferable  to  the  bicar¬ 
bonates,  tartrates,  and  citrates,  which  all  have  diuretic  action  and  increase  the 
frequency  of  micturition  ;  Liquor  Potassae  mixed  with  the  tinctures  of  Hyoscy- 
amus  or  Belladonna,  may  undergo  chemical  changes,  but  it  materially  controls 
painful  and  frequent  micturition  in  bladder  troubles  (Thompson).  Buchu, 
renders  more  help  than  any  drug  known  in  incontinence  or  retention  from 
catarrh  of  bladder  implicating  the  ureters,  and  even  the  kidneys  (P.).  Water, 
copious  injections  are  beneficial  in  some  cases  of  suppression  (R.).  [Compare 
the  list  of  diuretics  on  page  43  ; — and  in  this  section  see  Bladder  Irrita¬ 
ble,  and  Paralysis  of;  Cystitis,  Diabetes  Insipidus,  Dysuria,  Dropsy, 
Enuresis,  Hematuria,  Lithiasis,  Nephritis,  Oxaluria,  Uraemia,  Ure¬ 
thral  Stricture.] 

Prescriptions. 


R .  Pulv.  Scillae, 

Pulv.  Digitalis, 

Hydrarg  Chlor.  Mitis,  .  aa  gr.  xij. 
M.  ft.  pil.  no.  xij.  Sig. — One  pill  as  a 

diuretic  twice  daily.  ( A .  Clark. ) 


R  .  Potassii  Bicarb., . 5  iijss. 

Acidi  Acetici, . £vj. 

Aquae, .  Jiij. 

M.  Sig. — Teasp.  doses  as  required,  as 
a  diuretic.  Each  contains  about  gr.  x  of 
Potassium  Acetate. 


R  .  Acidi  Benzoici, . 3  ij. 

Sodii  Boratis, . %  iij. 

Aquae, . 5  xij. 

M.  Sig. — A  teasp.  in  water,  thrice 
daily,  to  keep  urine  acid.  ( Emmett .) 


R .  Ext.  Belladon.  FI.,  .  ...  %  ss-j. 

Ext.  Buchu  FI., . %j. 

Spt.  zEtheris  Nitrosi,  .  .  .  3  ij. 

M.  Sig. — A  teasp.  3  or  4  times  daily, 
for  dysuria  in  women. 


R.  Potassii  Citratis, . £j. 

Sodii  Bicarbonat.,  .  .  .  .  5J  v. 

Syr.  Limonis, . 3 j. 

Aquae, . q.  s.  ad  %  iv. 


M.  Sig. — A  teasp.  every  2  hours,  to 
render  the  urine  alkaline. 

[Roberts.) 


R .  Tinct.  Digitalis, . 5  ss-j. 

Spt.  zEtheris  Nitrosi,  .  .  .  %  iij. 
Liq.  Ammon.  Acetat.,  .  .  .  j^ss. 

Aquae, . •  q.  s.  ad  %  vj. 

M.  Sig. — One-sixth  every  3  hours,  to 

re-establish  the  renal  secretion. 

( Good  eve.) 


URTICARIA - UTERINE  CONGESTION. 


68  I 


Urticaria. 

Chloroform,  as  ointment  to  allay  itching  (R.).  Potassium  Cyanide,  or  Hy¬ 
drocyanic  Acid  (R  ).  [See  Prurigo.]  Nitric  Acid,  a  dilute  wash,'  controls 
itching  and  prevents  wheals  (R.).  Benzoin,  the  compound  tincture  painted 
on  the  skin  for  itching  (R.).  Sodium  Salicylate,  gr.  ij  every  hour,  is  re¬ 
markably  efficient  (A.  A.  Smith)  ;  gr.  xx  thrice  daily  is  effective.  Copaiba,  in 
full  doses  will  produce  urticaria,  but  drop-doses  every  ]/z  hour  will  sometimes 
control  it  (A.  A.  Smith).  Strychnine,  with  emetics  and  purgatives,  when  the 
affection  is  chronic  (Guibout).  Colchicum,  in  gouty  persons  (R.).  Lead, 
lotions  to  ease  itching  (R).  Alkalies  (R.).  [See  Prurigo.]  Warm  Baths, 
may  be  employed  with  benefit. 


R .  Acidi  Benzoici, 
Aquae, 


M.  Sig. — Lotion  for  urticaria. 


Prescriptions. 

gr.  viij.  R.  Atropinae  Sulphat., 

5  iv.  Aq.  Destil.,  Glycerini, 

Pulv.  Tragacanthae,  q.  s. 
(Squire.)  Ft.  pil.  no.  x.  Sig. — One  bis  die. 


aa 


gr. 

3ss. 


Uterine  Cancer. 

Conium,  useful  as  a  palliative,  ^iij-iv  ad  Oj  aquae,  as  injection  for  extreme 
pain  of  uterine  cancer  (Wa.).  Arsenic,  small  doses  for  a  long  time,  with  a 
strong  iodine  solution  and  glycerin  locally  (Atlee).  Opium,  stands  first  in  the 
list  of  palliatives,  quieting  irritation,  allaying  pain  (Wa.).  Morphine,  the  spe¬ 
cific  action  of  morphine  upon  the  uterine  circulation  should  be  utilized  in  hope¬ 
less  cases  of  this  disease  (Lutaud).  Carbolic  Acid,  a  weak  solution  as  injection, 
an  excellent  cleanser,  healer,  disinfector  and  allayer  of  pain  (R.).  Bromine, 
the  best  escharotic  for  destruction  of  the  mass  (E.).  Glycerite  of  Tannin,  checks 
discharge  and  stench.  Better  still  if  mixed  with  glycerite  of  carbolic  acid  (R.). 
Iodoform,  with  cocoa  fat  as  bolus  inserted  into  excavation  produced  by  cancer 
(R.)  ;  gr.  v-x  in  each  bolus  (W  ).  Iodine,  the  saturated  tincture  thoroughly 
applied  to  the  entire  surface  of  the  mass,  is  frequently  of  great  use  in  checking 
hemorrhage,  and  seems  to  temporarily  check  the  extension  of  the  disease  (E.). 
Chloral,  as  anodyne,  will  agree  with  most  persons  (E.) ;  relieves  the  pains 
(W.).  Chloroform  Spray,  for  some  minutes  (R.).  Cannabis  Indica,  to  allay  the 
pain  (Wa.).  Surgical  Measures,  advisable  ;  medicine  can  only  palliate. 

Uterine  Congestion  and  Hypertrophy. 

Aurum,  salts  of,  often  beneficial  in  chronic  metritis  with  scanty  menstruation 
(B.).  Ergotine,  long  continued,  successful  in  chronic  metritis ;  lessens  con¬ 
gestion  (B.) ;  long  continued  has  produced  remarkable  results  in  fibroids  and 
polypi  and  chronic  metritis;  large,  spongy,  subinvoluted  uterus  (P.)  ;  by  inter¬ 
stitial  injection  into  the  cervix,  has  been  of  great  benefit  (Goodell).  Carbolic 
Acid,  undiluted,  on  cotton-wrapped  probe.  No  better  treatment  for  uterine 
catarrh  (B.).  Iodine,  has  proved  the  most  valuable  of  all  remedies,  as  local 
stimulant,  and  a  reliable  alterative  (Thos.,  E.) ;  and  excitant  of  uterine  con¬ 
traction.  Use  a  saturated  tincture  to  any  part  not  exposed  to  the  air  (E.) ; 
may  be  injected  into  cervix  (G.).  Iodo-tannin,  or  Iodoformi  3j,  Ac.  Tannici 
^j  ;  a  serviceable  application  in  many  inflammatory  and  hypertrophic  condi¬ 
tions.  Iodoform  suppositories  in  chronic  metritis  (P.).  Potassium  Bromide, 
our  main  stand-by  in  uterine  troubles  ;  apart  from  its  soothing  properties  it 
seems  to  divert  the  blood  from  the  womb,  and  to  lessen  uterine  congestion 
(Goodell)  ;  a  specific  cure  for  simple  subinvolution,  the  benefit  being  derived 
from  the  potash  (Tait).  Digitalis,  in  subinvolution  (B.).  Glycerin,  on  cotton 
tampon  to  cervix  as  local  hydragogue  (Thos.).  Caustic  Potash,  and  Potassa 
cum  Calce,  said  to  be  effective  in  chronic  metritis;  must  be  used  cautiously 
(B.).  Chromic  Acid,  a  strong  solution  to  interior  of  uterus,  a  very  useful  ap¬ 
plication.  Ipecacuanha,  in  subacute  metritis  of  the  puerperal  state  (Tr.). 
Iron,  locally  in  uterine  catarrh  (R.)  ;  as  tonic,  Iron  and  other  restoratives,  a 


682 


UTERINE  DISEASES - UTERINE  DISPLACEMENTS. 


cardinal  rule  in  the  treatment  of  all  uterine  disorders,  with  Ergot,  Quinine, 
Arsenic  or  Potassium  Bromide,  whenever  the  womb  as  a  whole  is  congested 
or  hypertrophied.  Syr.  Ferri  Iodidi,  with  Cod-liver  Oil,  wins  half  the  battle 
(G.).  Zinc  Valerianate,  in  2-  to  4-grain  doses  thrice  daily,  is  one  of  the  best 
nervines  in  these  cases  (G.).  Scarification,  after  dry  cupping,  in  chronic  metritis 
(Thos.).  Electricity,  in  chronic  congestive  enlargement,  a  galvanic  current  of 
moderate  intensity,  slowly  interrupted  (B.).  Water,  hot  injections  or  douche, 
also  cold  alternately  ;  one  of  the  most  effective  measures  ;  a  gallon  very  hot,  ter 
die  (R.) ; — especially  valuable  in  congestion,  which  is  generally  venous  ; — ele¬ 
vated  hips  a  necessary  part  of  treatment  (E.).  Cold  water  is  often  better  than 
hot  (G.).  Rest,  to  the  patient  and  the  organ,  is  of  prirfte  importance.  Abdomi¬ 
nal  bandage,  skirt-supporters,  pessary  if  anteversion  or  retroversion,  abstinence 
from  sexual  intercourse  (Thos.). 


Prescriptions. 


B  .  Ext.  Humuli, . ^j. 

Elix.  Ammon.  Valerianat., 

Syr.  Lactucarii,  .  .  .  .  aa  3  ss. 

M.  Sig. — A  dessertsp.  at  bedtime,  or 
during  the  day  when  needed,  as  an  anti- 
spasmodic.  (Goodeii.) 


R.  Iodi, 

Potas.  Bromidi,  .  .  .  .  aagr.  xx. 

Tinct.  Iodi, . gj. 

Aq.  Destillat.,  .  .  .  .  adgiv. 

M.  Sig. — Tr^xxx  to  be  injected  into  cer¬ 
vix  by  3-5  punctures.  ( Goodell. ) 


Uterine  Diseases. 

Cimicifuga,  to  prevent  miscarriage  in  irritable  uterus  and  prolapsus  (R.)  ; 
promises  to  be  a  valuable  remedy  in  uterine  affections  (Wa.) ;  is  remarkably 
efficient  in  neuralgia  and  sympathetic  pains  arising  from  an  irritable  uterus,  no 
matter  what  their  precise  character  (P.).  Belladonna,  with  tannin,  as  supposi¬ 
tory  in  uterine  neuralgia  (R.) ;  as  vaginal  or  rectal  injections,  in  neuralgic  or 
inflammatory  pains  (Tr.).  Arsenic,  in  irritable  uterus,  of  decided  benefit ;  gr. 
2*0  ter  die,  after  meals  (Wa.).  Carbonic  Acid,  injection  up  vagina  for  neuralgia 
(R.,  Wa.).  Opium,  with  starch  as  injection  into  the  rectum  will  subdue  the 
pain  of  uterine  diseases  (R.)  ;  gives  more  speedy  relief  than  any  other  remedy 
in  irritable  uterus,  but  long-continued  is  one  of  the  worst  (Wa.).  Iodized  Phenol, 
has  proved  the  most  generally  efficient  agent  for  intra-uterine  use  during  eight 
years’  experience,  applied  by  hard-rubber  probes  wound  with  cotton-wool.  It 
removes  cervical  mucus,  gives  freedom  from  pain,  softens  and  dilates  the  cervix, 
heals  abrasions,  removes  induration,  removes  villosities,  regulates  the  menses, 
improves  appetite  and  digestion,  acts  as  a  general  alterative,  overcomes  barren¬ 
ness,  etc.,  if  used  long  enough,  but  rapid  results  are  not  attainable  by  any 
method  of  treatment  (Battev).  Lead,  as  plaster  for  pain  in  the  back  due  to 
uterine  disease  (R.).  Chloroform,  spray,  in  neuralgia  (R.).  Aqua-puncture, 
has  had  extraordinary  success  in  uterine  colic  (B.).  Baths  of  warm  salt  water 
remarkably  useful  in  nervous  or  inflammatory  hysteralgia  (Tr.).  [See  Abor¬ 
tion,  Amenorrhcea,  Climacteric,  Dysmenorrhcea,  Endometritis,  Hem¬ 
orrhage,  POST-PARTUM,  LeUCORRHCEA,  MENORRHAGIA,  MENSTRUAL  DIS¬ 
ORDERS,  Metritis,  Metrorrhagia,  Prolapsus  Uteri,  etc.] 


Uterine  Displacements. 

Anteversion  without  prolapse,  not  a  mal-position  (E.).  Ice,  locally  when 
parts  inflamed  (R.).  Hot-water  injections,  to  give  tone  to  the  vessels,  essential. 
Also  valuable  after  reduction  of  mal-positions  (E.).  Mechanical  Means,  only 
reliable  or  safe  in  retroversion  and  prolapse  ;  the  sound,  as  a  means  to  restore 
a  retroverted  uterus  to  position,  cannot  be  regarded  as  free  from  risk,  even  in 
skillful  hands  (E.).  Pessaries,  harmful  unless  expertly  fitted  ;  should  be  adjusted 
so  as  to  restore  the  uterus  to  the  normal  line,  where  the  circulation  will  be  least 
obstructed;  not  too  high.  Should  never  be  employed  while  cellulitis  exists  (E.). 
Cotton  Roll,  as  a  substitute  for  the  orthodox  pessary,  is  far  superior.  Use  the 


UTERINE  TUMORS - VAGINISMUS. 


683 


Borated  cotton  in  flat  sheets,  rolling  it  into  a  roll  2  inches  long  by  1  inch 
diameter,  and  saturating  it  in  Boroglyceride  §j,  Aluminii  Acetatis  3 j ,  Glycerini 
Pur.  q.  s.  ad  Oj.  If  an  astringent  is  required,  the  Acetate  is  replaced  by  Alum¬ 
inii  Sulphas  (Wylie).  [Compare  Prolapsus  Uteri.] 

Uterine  Tumors. 

Mercury,  the  bichloride  in  small  doses,  long  continued,  of  undoubted  value 
in  treatment  of  fibrous  or  polypoid  growths  ;  gr.  Txg-  every  6  hours,  sometimes 
restrains  the  hemorrhage,  when  other  remedies  fail  (Wa.j.  Calcium  Chloride, 
in  30-gr.  doses  thrice  daily,  has  by  prolonged  use  cured  uterine  fibroids, 
(Hewitt) ;  calcifies  uterine  arteries,  also  those  of  the  body  generally,  and  is 
dangerous  thereby  (Tilt,  Wells).  Ergotin,  hypodermically  for  fibrous  tumor 
(R.) ;  gr.  ij-vj,  on  alternate  days,  give  excellent  results  (B.) ;  nine  cases  of 
fibroid  treated  by  Hildebrandt  with  good  results  (P.) ;  this  method  often  causes 
great  pain  and  severe  local  inflammation  (W.) ;  one  grain  each  of  Ergotin  and 
Ferri  Sulphas  Exsiccat.,  in  pill  thrice  daily,  persistently,  for  uterine  fibroids, 
using  for  the  hemorrhages  a  tampon  saturated  with  Tincture  of  Iodine  or  Monsel’s 
Solution  (Parvin).  Opium,  has  specific  action  upon  the  uterine  circulation,  and 
in  bleeding  from  hopeless  cases  of  cancer  or  from  fibroid  tumors,  should  be  used 
freely,  regardless  of  danger  of  opium  habit.  (Editorial,  N.  Y.  Med.  Rec.,  Dec. 
10,  1887.)  Ammonium  Chloride,  in  fibrous  tumors,  gives  more  benefit  than 
any  other  remedy,  gr.  x,  twice  or  thrice  daily,  for  weeks  and  months  consecu¬ 
tively  (Atlee).  Ferric  Subsulphate,  injected  to  restrain  bleeding.  Cautiously  ! 
(B.).  Saline  Mineral  Waters,  especially  those  at  St.  Catherine’s  Canada,  are 
useful  (B.).  Aliment,  carefully  regulated,  chiefly  of  animal  food  ;  with  recum¬ 
bent  posture  while  flowing,  and  long-continued  use  of  Ergot  in  small  doses,  may 
accomplish  something  (E.).  [Compare  Cysts.] 

Uterine  Ulceration. 

Hydrastis,  quickly  improves  ;  the  fluid  extract  undiluted  as  topical  application 
in  uterine  and  vaginal  leucorrhoea,  ulcerations  and  erosion  of  cervix  (B.). 
Carbolic  Acid,  pure,  over  the  surface  twice  a  week  in  simple  ulceration  (R.). 
Silver  Nitrate,  a  serviceable  application,  but  is  often  abused  (B.).  The  solid 
stick  applied  to  surface,  after  cleansing,  and  drying  with  cotton-wool  (Wa.). 
Alum,  as  hip-bath,  ifej  ad  Cj,  and  vaginal  injection  is  of  great  utility  in 
ulcerations  of  the  os  uteri,  or  of  the  uterine  cavity  (Recamier).  Glycerin  25, 
Alcohol  12^.  and  pure  Creasote  1  part,  an  excellent  application  to  ulcers  of 
the  neck.  Bismuth  Subnitrate,  with  enough  Glycerin  to  make  a  thick  cream, 
is  the  best  of  all  applications  for  ulceration  of  the  os  and  cervix  uteri  (Suesse- 
rott).  Vegetable  Astringents,  Infusions  or  decoctions  of  galls,  oak-bark, 
hamamelis,  geranium,  alum-root,  etc.  The  glycerite  of  tannin,  tannin  and 
iodoform,  packed  around  cervix  (B.). 

Uvula. 

Tannin,  Rhatany  or  Zinc,  as  astringent  lozenges,  for  relaxed  uvula  (A.). 
Amputation,  of  elongated  part  (A.). 

Vaccination. 

Aconite,  with  Belladonna  ointment  for  erysipelatous  redness  after  vaccination 
(R.).  Zinc  Oxide,  dusted  over,  to  allay  the  subsequent  local  irritation  (Wa.) ; 
with  Pulv.  Amyli,  equal  parts,  over  the  surface.  Lead  Acetate,  3j  to  Oj  water, 
as  lotion  for  irritable  pock  (Foster).  Carbolic  Acid,  3j  to  Oj  water,  as  lotion 
for  excessive  redness,  with  burning  and  itching. 

Vaginismus. 

Ether,  to  ascertain  cause;  usually  a  displacement,  fissure,  or  cellulitis  (E.). 
Hygiene,  sun-baths,  hot-water  injections,  fresh  air,  removal  from  husband,  etc. 


684 


VAGINITIS - VARIOLA. 


(E.).  Operation  (Sims’),  removal  of  hymen  with  scissors  and  insertion  of  glass 
plug  till  parts  are  healed,  when  the  cicatrix  is  to  be  divided,  etc.  (E.).  Tents  to 
gradually  dilate  vagina,  may  be  impregnated  with  various  sedatives  (Gallard). 
Iodoform  in  a  suppository,  when  redness  and  excoriation.  Belladonna,  the 
extract,  i  part  with  8  or  9  of  fresh  lard,  if  only  pain  (Gallard). 

Vaginitis. 

Tannin,  the  glycerin  of  tannin  in  chronic  vaginitis  of  children  (R.).  Silver 
Nitrate,  gr.  xl-^j  aquae,  applied  within  cervical  canal,  and  over  the  vaginal 
mucous  membrane  (E.).  Emollient  Injections,  with  Opium  (Goodsell).  [Com¬ 
pare  Gonorrhcea,  Leucorrhcea.]  Pinus  Canadensis.  The  concentrated 
extract  (colorless),  locally,  has  a  very  soothing  influence  in  acute  vaginitis. 

Varicella. 

Diet,  no  animal  food,  milk  best;  which,  with  careful  attention  to  the  bowels, 
patient  to  be  kept  cool  with  light  covering,  and  use  of  a  mattress  rather  than  a 
feather  bed,  is  all  the  treatment  required  (A.).  Saline  Mixture,  if  high  fever. 
Quinine,  during  convalescence.  Complications  to  be  treated  symptomatically. 

Varicocele. 

Hamamelis,  appears  to  have  permanently  cured  one  case  (R.).  Ergot,  gr. 
ij-vj  of  Ergotin  hypodermically,  the  needle  to  be  inserted  among  the  affected 
veins,  care  being  taken  not  to  puncture  a  vein,  is  effective;  severe  pain  follows 
for  a  few  hours  (R.).  Water,  cold  douche  to  the  perineum  and  buttocks,  with 
suspension  of  testicles  in  cold  water  (R.).  Radical  Cure,  consists  in  obliterat¬ 
ing  the  veins  by  wire  ligatures,  etc.  (Cl.). 

Varicosis. 

Hamamelis,  is  employed  with  satisfaction  in  varicose  veins  and  ulcers  (Pf.). 
Digitalis,  by  fomentation,  in  acute  inflammation  from  varicose  ulcers  (R.). 
Ergotin,  injected  along  side  of  vein,  but  not  within  it,  has  cured  (B.).  Bandage, 
or  elastic  stocking;  with  cold  sponging,  and  rubbing  upwards,  as  palliatives 
(CL).  [Compare  Hemorrhoids,  Ulcers.] 

Variola. 

Cimicifuga,  is  given  internally  by  some,  who  assert  that  it  prevents  pitting 
(R.).  Mercury,  in  ointment  or  plaster,  to  prevent  pitting  in  semi-confluent,  or 
barely  confluent  cases  (Wa.) ;  formerly  used  (R.).  Camphor,  is  said  to  restore 
the  eruption,  if  retrocedent ;  in  confluent  malignant  smallpox,  camphor 
alone,  or  with  Opium,  may  be  used  for  great  depression  of  the  vital  powers 
(Wa.).  Belladonna,  successfully  used  both  as  prophylactic  and  curative  agent 
(Erasmus  Wilson).  Gr.  yz- j  every  3,  4  or  6  hours,  to  dilatation  of  pupil  and 
some  stupor;  found  effectual  (Wa.).  Carbolic  Acid,  is  used  with  decided  ad¬ 
vantage  (Wa.).  [See  Measles.]  Has  been  much  used  on  theoretical  grounds, 
but  not  with  success  (B.).  Ammonium  Carbonate,  has  had  cheering  success 
(Wa.).  [See  Scarlatina.]  Quinine,  small  doses  in  adynamic  states,  larger 
in  hyperpyrexia  (B.).  Chloral,  temperature  high,  much  delirium,  and  restless¬ 
ness  (B.).  Opium,  low,  muttering  delirium  ;  not  so  much  used  now  as  formerly 
(B.) ;  morphine  in  the  insomnia  of  the  advanced  stage,  once  or  twice  only,  but 
not  when  copious  salivation  or  mucous  expectoration  (Wa.).  Silver  Nitrate, 
on  a  sharp-pointed  stick,  inserted  into  each  vesicle  after  rupture,  to  prevent 
pitting  (B.) ;  or  simply  paint  skin  with  a  solution  of  gr.  xx  to  the  3  (R.).  Iodine, 
the  tincture  to  prevent  pitting,  is  painted  ten  times  over  face  if  on  first  day  of 
eruption,  12  if  on  the  second  day,  12-16  times  if  on  third  day  (B.).  Collodion, 
or  solutions  of  India  rubber  or  gutta  percha  in  chloroform,  to  prevent  pitting  ; 
or  cotton-wool  dipped  into  lime  liniment,  applied  to  face  or  neck(R.).  Water, 


VERTIGO — VOMITING. 


685 


Cold  baths  and  cold  pack  of  great  utility  (B.).  Packing  especially  on  retro¬ 
cession  of  rash  (R.).  External  Applications,  as  powdered  starch,  flour;  zinc 
carbonate,  3  parts  to  1  of  zinc  oxide  with  olive  oil ;  cold  or  tepid  water  with 
vinegar,  sponged  over  body  twice  or  thrice  daily  (Wa.).  Diet.  Tea  and  dry 
toast,  raw  eggs  beaten  in  cold  milk,  beef-tea,  grapes,  roasted  apples,  ripe  fruits 
in  season.  Cold  water  may  be  drank  freely.  Fats.  Bacon-fat  smeared  over 
the  face,  to  allay  itching  and  prevent  pitting.  [Compare  Vaccination.] 

Vertigo. 

Digitalis,  in  small  doses,  alternately  month  by  month  with  tincture  of  larch, 
and  with  a  long  course  of  the  citrate  of  iron  and  strychnine,  in  essential  ver¬ 
tigo,  without  any  other  head  symptoms,  and  with  general  depraved  nutrition, 
the  most  effectual  treatment  (Wa.).  Potassium  Bromide,  often  controls  par¬ 
oxysmal  vertigo,  without  coexistent  spasm,  or  organic  brain-disease  (Wa.). 
Ammonium  Bromide,  in  an  effervescing  form  with  cascarilla,  for  vertigo  from 
overwork,  where  there  is  usually  restlessness,  insomnia,  depression  of  spirits, 
with  a  sense  of  impending  evil  (Wa.).  Alkalies  and  Bitter  Tonics,  give  the 
best  results  in  vertigo  of  gastric  origin.  Sodium  Bicarbonate,  after  meals, 
tonics  before  meals.  Strychnine  with  Iron,  thrice  daily,  gives  good  results. 
Corrosive  Sublimate,  in  small  doses,  with  attention  to  the  bowels  and  diet. 
Cod-liver  Oil,  giddiness  of  the  aged,  when  no  serious  brain-disease  (R.).  Is 
mostly  symptomatic  of  disorder  of  the  stomach,  or  of  the  liver  (choloemia) ; 
sometimes  of  general  debility  ;  rarely  of  disease  of  the  brain  (H.). 

Vomiting. 

Ipecacuanha,  in  small  doses,  will  arrest  certain  kinds — a  curious  fact ;  espe¬ 
cially  useful  in  certain  forms  ;  rt\j  of  vinum  ipecac.,  every  y2  hour  or  more 
(B.,  R.,  P.) ;  in  sick  stomach  of  nervous  origin,  minute  doses  are  of  undoubted 
value  (W.).  Arsenic,  in  many  forms  of  stomach  vomiting,  especially  that  of 
alcoholism,  and  chronic  ulcer  (B.),  and  in  the  vomiting  of  cholera  (R.)  ;  gtt.  ss 
of  Fowler’s  solution,  every  y2  hour  for  6  or  8  doses,  often  relieves  vomiting 
after  a  debauch,  the  a.m.  vomiting  of  drunkards,  and  that  of  pregnancy  (A.  A. 
Smith).  Nux  Vomica,  stands  next  to  arsenic;  is  useful  in  many  ways  (B.)  ; 
may  be  given  with  Ipecac.,  especially  when  tongue  coated  (R.).  Iris,  in 
vomiting  with  blinding  right  supraorbital  pain  ;  liver  deranged  (P.).  Bismuth, 
in  many  forms  of  vomiting  in  children,  especially  when  from  gastric  catarrh 
(R.).  Carbolic  Acid,  with  or  without  bismuth  (B.)  ;  in  nervous  vomiting  (W.). 
Creasote,  in  the  vomiting  of  cancer,  gastric  ulcer,  etc.  (R.)  ;  gtt.  j-ij  (W.). 
Cocaine,  in  doses  of  gr.  y  thrice  daily,  controlled  the  vomiting  of  gastric  car¬ 
cinoma,  after  all  other  means  failed  (Meigs)  ;  10-minim  doses  of  a  4  per  cent, 
solution  every  hour,  of  inestimable  value  in  the  vomiting  of  yellow  fever  (Jen¬ 
nings).  Potassium  Nitrate,  one  of  the  surest  remedies  against  vomiting  and 
nausea,  gr.  y  in  3SS  of  cold  water  every  4  or  5  minutes,  until  relieved,  in  all 
cases,  except  reflex  ones,  and  those  due  to  irritant  poisons  (Moore).  Mercury, 
gr.  y$  of  gray  powder  every  two  hours,  especially  in  children  with  clayey  stools 
(R.) ;  Calomel,  gr.  j  to  Oj  aquae,  first  dissolved  in  5j  of  lime  water — a  teasp. 
every  ten  minutes  for  the  regurgitation  of  food  in  nursing  children  (A.  A. 
Smith).  Sulphurous  Acid,  Hbv_3j i  well  diluted,  or  less  effectively,  sodium  sul¬ 
phite.  Sulphites  often  curative  in  vomiting  of  sarcinae,  and  acid  matter,  due  to 
acid  fermentation  of  starchy  elements  (B.).  Cocculus  Indicus,  efficient  in 
cephalic  vomiting  (P.).  Opium,  will  arrest  many  kinds  ;  best  in  that  of  biliary 
or  renal  calculi,  dysmenorrhoea,  sea-sickness,  pregnancy.  Morphine,  hypoder. , 
gr.  to  l/e  (P.).  Bryonia,  bilious  vomiting  and  headache  (P.).  Veratrum 
Album,  in  vomiting  and  purging  of  summer  diarrhoea  (R.).  Hydrocyanic  Acid, 
often  very  serviceable  in  nervous  vomiting;  acts  promptly  if  at  all  (R.).  Hy- 
drobromic  Acid,  3ss  in  §j  of  water,  four  times  daily,  useful  for  the  vomiting 
due  to  gastric  ulcer.  Chloroform,  rt\jj-v,  on  sugar,  for  non-inflammatory 
vomiting  (R.);  see  Yellow  Fever  for  formula.  Bromides,  in  cerebral  vomit- 


686 


VOMITING  OF  PREGNANCY. 


ing  only ;  not  in  the  gastric  form  (B.)  ;  potassium  bromide  in  that  of  uterine 
disease  (W.).  Cinnamon  or  Cloves,  will  check  vomiting  (P.).  Calumba,  in 
vomiting  from  kidney  disease  and  renal  caculi ;  frequently  allays  that  of  preg¬ 
nancy  and  dentition  (P.).  Serpentaria,  for  bilious  vomiting  (P.).  Cerium 
Oxalate,  in  that  of  pregnancy  and  from  cancer  (B.)  ;  gr.  j  every  three  hours 
(R.).  Sodium  Bicarbonate,  gss-j  to  a  pint  of  milk,  for  infants  especially  if 
constipated  (R.).  Ammonium  Carbonate,  may  relieve  when  vomited  matter 
is  acid  (B.).  Milk  and  Lime  water,  often  relieves  when  other  methods  fail  ; 
also  the  effervescing  soda  powders  in  the  vomiting  of  acute  diseases,  and 
the  exanthemata  (B.).  Alcohol.  Iced  brandy  or  champagne  in  spoonful  doses 
every  hour  in  vomiting  of  cholera,  pregnancy,  and  delir.  trem.  (B.). 
Counter-Irritation,  at  epigastrium  (R.).  Nutrient  Enemata  (B.).  [See  Ene- 
mata.]  Ice,  sucked,  with  horizontal  posture,  absolute  rest  and  quiet  (Wa.). 
Iced  champagne,  ^ss  every  y  hour  (B.).  Pepsin,  for  vomiting  of  food  after 
meals  ;  gr.  x-xv  before  or  during  meals.  Kumyss,  has  proved  efficacious  when 
no  other  food  would  remain  on  the  stomach.  [Compare  the  List  of  Anti¬ 
emetics,  on  page  37,  also  the  articles  entitled  Hematemesis,  Nausea,  Sea¬ 
sickness,  Vomiting  of  Pregnancy.] 


Prescriptions. 


R.  Ac.  Hydrocyan.  Dil.,  .  .  .  gj. 

Aquae  Laurocerasi,  .  .  .  3  ij. 

M.  Sig. — A  teasp.  every  2  hours,  for 
nervous  vomiting. 


R.  Ac.  Hydrobromici  Diluti,  .  ij. 

Sig. —  Half  a  teasp.  in  a  winegl.  of 
water,  4  times  daily. 


Vomiting  of  Pregnancy. 

Ipecacuanha,  or  Nux  Vomica,  either  will  generally  succeed  where  the  other 
fails  (R.) ;  no  other  remedy  of  equal  value  to  Ipecacuanha  (P.).  Nux  Vomica, 
is  useful  but  often  fails  ;  gtt.  ss-j  every  hour  or  two  in  water  (R.) ;  in  very 
minute  doses  (S.) ;  gtt.  ij-iij  of  the  tincture  every  two  or  three  hours,  or  gtt.  x 
before  each  meal,  with  very  hot  water  as  a  drink,  is  the  best  treatment  (Parvin). 
Arsenic,  Fowler’s  solution,  gtt.  j  before  each  meal,  will  often  relieve,  when 
vomiting  of  food,  retching  and  straining,  with  blood  and  pain  (B.).  Creasote, 
checks  the  vomiting  (R.).  Carbolic  Acid,  drop-doses  of  crystals  liquefied  by 
heat,  in  mucilage  ter  die  (Wa.).  Staphisagria,  has  subdued  when  other  reme¬ 
dies  failed  (P.).  Cerium  Oxalate,  gr.  j  every  three  hours  (R.)  ;  ordinary  doses 
far  too  small,  give  as  high  as  10  grains  (B.).  Morphine,  hypodermically  in 
severe  vomiting  (R.).  Pepsin,  has  been  used  with  success.  Ingluvin,  seems 
almost  specific  (B.).  Potassium  Bromide,  is  often  efficacious  (W.)  ;  3ss  doses 
thrice  daily,  exceedingly  effective  in  the  combined  diarrhoea  and  vomiting  of 
pregnancy.  The  first  dose  should  be  given  an  hour  before  rising.  Hydrocy¬ 
anic  Acid,  often  the  best  remedy  (P.).  [See  ante ,  Vomiting.]  Copper  Sul¬ 
phate,  sometimes  effective,  not  more  than  gr.  ^  ter  die  (B.).  Iodine,  hbv  of 
the  tincture  in  5SS  of  sweetened  water,  repeated  in  hour,  of  magical  effect 
in  a  bad  case  which  had  resisted  every  other  treatment.  Is  often  useful  (B.). 
Cocaine,  locally  to  cervix,  promptly  cured  a  most  intractable  case  of  several 
months’  duration,  though  it  failed  when  used  internally  (Bois).  Has  given 
excellent  results  when  used  internally.  See  formula  below  ;  or  may  use  tablet 
triturates  of  gr.  each.  Calumba,  as  tincture  often  useful ;  drop-doses  every 
hour  or  two  (B.).  Bismuth,  and  Carbolic  Acid,  are  effective  (B.).  Atropine, 
frequently  effective  (R.)  ;  never  failed  to  give  relief  in  many  years  of  using  it 
(Boys).  Ether,  sprayed  over  the  epigastric  region  and  the  corresponding  part 
of  the  spinal  column,  for  3  to  5  minutes  every  3  hours,  gives  immediate  relief 
(Lubelsky).  Pop-corn,  is  a  god-send  in  this  complaint,  having  acted  marvel¬ 
lously  in  several  cases  in  which  I  have  used  it  (Sweringen).  Aconite,  in  full 
doses,  is  often  very  successful  (W.).  Dilatation  of  the  cervical-  canal,  by  the 
index  finger,  is  regarded  as  extremely  efficient,  and  reasonably  safe.  It  may 
bring  on  abortion,  if  too  extensive,  but  from  records  of  several  cases  since  1875, 


VULVA - VULVITIS - WARTS.  687 


it  may  be  said  that  it  is  a  safe  and  sure  remedy  (Copman).  Ice-bag  to  spine, 
an  efficient  measure  (R.). 


R.  Atropin?e  Sulphatis,  .  .  .  gr.  j. 
Morphine  Sulphatis,  .  .  .  gr.  iv. 
Acidi  Sulph.  Aromat.,  .  .  ^  iij. 

Aquae, . 3  v. 

M.  Sig. — Ten  to  twenty  drops,  thrice 
daily.  {Boys.) 


R .  Cocainae  Muriatis,  .  .  .  .  gr.  xv. 

Acidi  Carbolici, . trpx. 

Aq.  Cinnamomi,  .  .  .  .  ^ss. 

Syr.  Zingib.,  .  .  .  q.  s.  ad  ^  j. 

M.  Sig. — 10  drops,  gradually  increased 
to  20,  in  a  little  water  every  hour  until  re¬ 
lieved,  then  every  2  or  3  hours.  {Potter.) 


Cerii  Oxalatis, . gr.  xij. 


Ipecacuanha, . gr.  xv. 

Creasoti, . gr.  xxiv. 


M.  ft.  pil.  no.  xij.  Sig. — One  every  hour. 

( Goode  It.) 


R  .  Cerii  Oxalatis, . gr.  xxiv. 

Ext.  Hyoscyami,  .  .  .  .  gr.  xxxvj. 
M.  ft.  pil.  no.  xij.  Sig. — One  pill  twice 
daily.  ( Goodell.) 


R.  Bismuthi  Subnitrat.,  .  .  .  gr.  clx. 

Cerii  Oxalatis, . gr.  xl. 

Morphinae  Sulphatis,  .  .  .  gr.  jss. 
Syrupi,  et  Acaciae,  .  .  ad  £  ij. 

M.  ft.  emulsio.  Sig. — A  teasp.  every 

hour  until  vomiting  ceases.  {VanValzah.) 


Prescriptions. 

R. 


Vulva. 

Sodium  Hyposulphite,  an  unfailing  remedy  in  lotion  for  aphthae  of  the  vulva 
(R.).  Arsenic,  much  used  for  eczema  (T.).  Lead  Acetate,  a  concentrated  solu¬ 
tion  in  glycerin,  for  eczema  of  vulva  (T.).  [Compare  Pruritus,  Prurigo.] 

Vulvitis. 

Alum,  as  lotion  in  vulvitis  of  children  ;  gr.  lx-Oj  aquae,  or  less  strong  if  found 
to  increase  discharge  (R.).  Lead,  solutions  of  the  acetate  or  the  diacetate  as 
wash,  after  the  acute  stage  has  subsided.  Lime  Water,  as  wash  (R.).  [Com¬ 
pare  Vaginitis.] 

Warts. 

Thuja,  worthy  of  recommendation  in  the  highest  terms,  for  the  cure  of  warts 
with  a  narrow  base  and  pendulous  body.  A  strong  tincture  locally  three  times 
a  day,  for  one  or  two  weeks,  with  5  drops  in  a  wineglassful  of  water  internally, 
night  and  morning  (P.).  Iron,  tincture  of  the  chloride  and  dilute  HC1  acid, 
applied  night  and  morning,  equal  parts,  very  effective  (Bulkley).  Nitric  Acid, 
3j-ij  of  the  dilute  acid  to  a  pint  of  water,  as  wash,  to  keep  small  syphilitic  warts 
constantly  moist  (R.).  Sabina,  as  caustic  (P.) ;  j-ij  of  alum  (Wa.).  Rue,  the 
oil,  with  honey,  locally  (P.).  Arsenious  Acid,  as  a  caustic ;  enough  to  be  used 
to  excite  active  inflammation.  Liq.  arsenicalis  painted  over  warts  (R.)  ;  may 
be  taken  internally  (B.).  Mercurial  Ointment,  containing  5  per  cent,  of 
Arsenic,  or  a  plaster  having  in  each  8  square  inches  154  grains  of  Arsenic  and 
77  grains  of  Mercury  (Unna).  Tannin,  and  Burnt  Alum,  equal  parts,  pow¬ 
dered  over  warts  twice  daily,  gives  good  results.  Chromic  Acid,  gr.  100  to 
aquae,  with  a  glass  rod,  to  saturate  diseased  growth.  Remove  any  superfluous 
acid  ;  dress  with  dry  lint  (R.,  Wa.).  Mercuric  Nitrate,  locally  (R.).  Silver 
Nitrate,  as  caustic,  but  is  usually  too  superficial  (R.).  Dermal  Curette,  is  much 
used  in  Vienna  to  remove  warts  by  enucleation.  Strangulation,  by  tying  a 
string  tightly  around  the  base,  will  cause  them  to  drop  off  in  a  few  days.  Heat, 
is  a  most  thorough  measure  for  their  radical  removal ;  it  may  best  be  applied 
by  touching  the  wart  3  or  4  times  daily  with  the  hot  end  of  a  cigar ;  the  first 
few  applications  only  give  pain.  Caustic  Alkalies,  locally  (R.)  ;  a  saturated 
solution  of  potassa  fusa,  carefully  applied  by  a  brush  or  sponge  fastened  to  the 
end  of  a  stick,  is  to  be  preferred  (E.  Wilson).  [Compare  Condylomata.] 


688 


WEN - WORMS. 


Wen. 

Extirpation,  the  least  troublesome  and  most  speedily  effective  method.  Run 
a  scalpel  through  it,  seize  the  cut  edge  of  the  cyst,  and  gently  tear  it  out  with  a 
touch  or  two  from  the  knife.  Dressing  of  lint  and  carbolic  oil  to  cause  suppu¬ 
ration  and  contraction  (D.). 

Worms. 

Filix  Mas,  Brayera  (Kousso),  Rottlera  (Kamala),  Pepo,  Granati  Fructus 
Cortex,  as  taeniafuges  (B.).  Filix  Mas  to  be  taken  on  an  empty  stomach,  for 
tape-worm,  and  followed  by  a  purge  (R.,  P.).  Pepo,  gij  as  emulsion,  taken 
fasting,  one  of  the  most  efficient  remedies  against  taenia  (B.).  Santonin,  the 
best  anthelmintic  ;  laxative  in  morning,  fasting  all  day,  a  dose  (gr.  ss-  v)  of 
santonin  and  calomel,  or  troches  of  santonin  ( j-x),  at  bedtime,  a  senna  draught 
next  morning.  For  ascarides  (B.,  P.).  For  round  and  thread-worms,  in 
castor  oil  by  mouth,  or  as  injection  (R.).  Iron,  the  Syrup  of  the  Iodide  in¬ 
ternally  and  a  solution  of  the  tincture  locally,  for  ascarides  (B.) ;  the  tincture 
ferri  sesquichlor.  £ss  ad  Oj  aquae,  a  good  injection  for  thread-worms;  coagu¬ 
lates  albumen  (R.).  Quassia,  the  infusion  an  effectual  injection,  conjoined 
with  simple  bitters  internally,  for  ascarides  (R.).  Pelletierine,  the  alkaloid 
of  Granatum,  is  by  far  the  best  vermifuge  for  a  tape-worm,  repeated  after  a 
week  for  a  second  worm,  as  many  as  3  having  been  found  in  one  patient  (Da 
C.) ;  gr.  xv-xx  of  the  tannate,  followed  in  a  few  hours  by  Castor  Oil  (R.). 
Chloroform,  a  very  efficient  taeniafuge,  3j  in  §j  of  mucilage,  after  20  hours’ 
fasting,  followed  one  hour  later  by  §j  of  Castor  Oil ;  this  is  an  adult  dose,  Sj 
should  never  be  exceeded  (Wilde).  Lime  Water,  as  injection  for  thread¬ 
worms  (R.)  ;  3 i ij — i v  repeated,  for  ascarides  (Wa.).  Sodium  Chloride,  in  £ss 
doses  on  empty  stomach,  expels  ascarides  and  prevents  reproduction  (Wa.). 
Quinine,  as  a  tonic;  also  cold  sponging,  out-door  exercise  and  judicious  diet. 
Useful  probably  by  preventing  the  production  of  the  abundant  mucus  which 
favors  the  growth  of  worms  (R.) ;  especially  useful  for  ascarides ;  also  as  injec¬ 
tion  for  thread-worms  and  taenia  (Wa.).  Ignatia,  for  convulsive  symptoms 
(P.).  Kamala  (Rottlera),  excellent  for  taenia,  requires  no  purge  (P.) ;  gr.  cl-clxxx 
for  an  adult  (Wa.).  Eucalyptus,  as  injection,  for  ascarides  (B.).  Aloes,  are 
efficacious  for  ascarides  (P.).  Ailanthus,  decoction  of  fresh  bark,  for  taenia  (B.). 
Tonics,  as  cod-liver  oil  and  iron  to  restore  intestinal  canal  to  healthy  condition 
(R.).  Turpentine,  as  poison  to  tape  and  thread-worms  (R.) ;  also  for  taenia 
(Wa.).  Scammony,  for  thread-worms  in  rectum  (R.) ;  with  calomel,  effective 
(Wa.).  Tannin,  as  catechu,  kino,  red-gum,  rhatany,  haematoxylum,  in  injec¬ 
tions  to  destroy  thread-worms  (R.).  Alum,  as  solution  for  injection  (R.).  Am¬ 
monium  Chloride,  to  prevent  formation  of  thick  mucus  which  serves  as  nidus 
for  worms  (R.).  Valerian,  especially  when  convulsions  (R.).  [Compare  the 
List  of  Anthelmintics  on  page  40.] 


R .  Chloroformi, 

Ext.  Filicis  Maris,  .  .  aa  v)). 
Emuls.  01.  Ricini  (50  per 

cent.), . 3  iij- 

M.  Sig. — One  dose  after  24  hours’  fast¬ 
ing.  Does  just  as  well  if  Male  Fern  be 
omitted.  _  ( Smith .) 

R.  Ext.  Spigelise  FI.,  ....  y)). 

Ext.  Sennse  FI., . ^ss. 

M.  Sig. — A  teasp.  to  a  child  of  3  to  5 

years.  _  {Smith.) 

R.  Ext.  Spigeliae  et  Sennas  FI.,  gj. 

Santonini, . gr.  viij. 

M.  Sig. — A  teasp.  to  a  child  of  5  years. 

{Smith.) 


Granati  Corticis,  .  .  .  .  ^ij. 

Ft.  infusum.  Sig. — To  be  taken  before 
11  A.  M. — and  followed  after  2  hours  by  — 


R  .  01.  Ricini, . 3  iij. 

01.  Terebinth., . £j. 

Ext.  Filicis  Maris  Aether.,  7>). 

M.  ft.  haustus. 

Fasting  unnecessary.  (  Wilde.) 


R.  Magnesii  Sulphat.,  .  .  .  .  ^ij. 
Sodii  Chloridi, . 3  ss. 


M.  Sig. — A  fluid  ounce  in  half  a  glass 
of  water,  with  gtt.  v  of  Carbolic  Acid,  night 
and  morning,  for  ascarides.  Persevere. 

{Barkley.) 


Prescriptions. 

R. 


WOUNDS - YELLOW  FEVER. 


689 


Wounds. 

Arnica,  very  useful  for  external  bruises  and  cuts,  also  for  internal  injuries  ; 
unites  surfaces  very  rapidly  after  amputations.  The  infusion  or  decoction  best 
(P.);  very  effectual  (Wa.).  Aconite,  valuable  in  surgical  fever  (P.).  Carbolic 
Acid,  solutions  check  suppuration,  and  correct  fetor  (B.).  The  “antiseptic” 
treatment  of  wounds  (Lister),  especially  surgical  wounds.  See  Ag.  vol.  1, 
page  187.  Bismuth  Subiodide,  dusted  into  a  wound,  one  of  the  most  effi¬ 
cient  antiseptics,  non-irritant,  and  a  prompt  stimulant  of  granulation.  An 
excellent  dressing  for  wounds  after  approximation  of  the  edges,  the  powder 
to  be  dusted  thickly  over  the  edges,  and  thoroughly  smeared  with  Flexi¬ 
ble  Collodion  (Potter).  Sulphurous  Acid,  in  solution,  diluted  or  not,  con¬ 
stantly  applied  (R.) ;  in  .solution  or  by  fumigation,  is  regarded  by  some  as 
superior  in  efficacy  to  carbolic  acid,  and  less  irritant  (Wa.).  Salicylic  Acid, 
Thiersch  prefers  to  Carbolic  ;  may  be  applied  pure  in  powder  to  gangrenous 
and  sloughing  wounds  (B.).  Mercury,  the  bichloride,  gr.  vijss  to  quart  j  of  hot 
water,  stirred  with  a  stick,  makes  a  solution  of  1  to  2000;  the  best  of  all  anti¬ 
septics  for  washing  a  wound  or  cavity,  and  for  saturating  the  dressings.  See 
List  of  Antiseptics  on  page  51.  Boracic  Acid,  also  applicable  as  Carbolic  Acid 
(B.).  Balsam  of  Peru,  excellent  for  closing  recent  wounds  (P.).  Benzoin,  the 
basis  of  healing  “  balsams  ”  (P.).  Aloes,  topically  as  a  slight  stimulant ;  often 
purges  (R.).  Gum  Tragacanth,  a  thick  aqueous  solution  to  granulating  sur¬ 
faces,  to  protect  them  from  the  air  (Wa.).  Opium,  to  quiet  intestinal  move¬ 
ments  in  wounds  of  the  abdomen  (R.);  forwards  the  reparative  processes  (P.). 
Tannin,  or  glycerin  of  tannin  to  coat  over  wounds  (R.).  Collodion  or  Liquor 
Gutta-perchae,  to  secure  primary  union  of  incised  wounds  (B.);  as  protective 
covering  (P.).  Iodoform,  powdered  and  dusted  over  sloughing  wounds,  irri¬ 
table  and  ill-conditioned  ulcers,  sores  (B.).  Iodoform  1,  Collodion  9  parts, 
painted  on  a  superficial  wound  while  edges  are  held  together  (Gross);  may  be 
painted  over  edges  when  stitched  together:  gives  excellent  results.  Galvanic 
Couplet,  to  wounds  of  indolent  form  (B.).  [See  Bedsores.]  Nitric  Acid,  as 
escharotic  for  gangrene  (B.).  Turpentine,  one  of  the  most  efficient  applica¬ 
tions  in  hospital  gangrene  (B.).  Aloes,  pulverized  fine,  as  a  dressing  for  wounds, 
favoring  cicatrization  and  closing  them,  also  relieving  the  pain  at  once  ;  re¬ 
quires  removal  only  at  long  intervals  (Millet).  Poultices,  are  often  abused. 
Yeast  or  Charcoal  best  for  foul  wounds  (B.).  Alcohol,  an  excellent  antiseptic 
dressing  when  suppurating;  also  favors  cicatrization  of  open  wounds  (B.). 
Water,  in  universal  use  as  dressing.  Cold  water  often  abused.  Hot-water 
dressing  as  advocated  by  Hamilton,  of  New  York,  promises  better  results  (B.). 
Turkish  Baths,  for  pain  in  the  seat  of  old  wounds  (R.).  Ice  and  Salt,  applied  to 
wound  prevents  inflammation  (R.).  [Compare  Hemorrhage,  Inflammation, 
Pyemia,  Surgical  Fever,  Gangrene,  Ulcers.] 


R .  Acidi  Tannici,  .  ,  . 
Alcoholis  Absolut.,  .  . 

vEtheris, . 

Collodii, . 

M.  Sig. — Styptic  Colloid. 


Prescriptions. 

|ij-  I  R-  Collodii, . |j. 

5  ss.  |  Olei  Ricini, . 5  ss. 

jpjss.  Acidi  Carbolici, . ^  ss. 


5  xij.  M.  Sig. — Carbolized  Collodion,  for 

;  wounds. 


Yellow  Fever. 

Treatment  must  all  be  done  at  the  beginning,  no  time  to  be  lost.  Cold 
sponging  early  and  frequently  repeated.  Calomel,  Quinine  and  Salines  at  the 
start.  Potassium  Acetate  for  the  kidneys.  Morphine  for  gastric  irritation,  the 
feet  to  be  in  mustard  water  (Da  Costa).  Diaphoretics  and  Diuretics,  also  Lax¬ 
atives,  are  very  important  throughout  the  disease  (Da  Costa).  Pilocarpine,  in 
dose  of  gr.  %  hypodermically,  in  first  stage,  carried  to  the  induction  of  emesis 
and  catharsis,  as  well  as  that  of  diaphoresis,  the  most  efficient  treatment  known, 
absolutely  jugulating  the  paroxysm  (Habersmith).  Mercury,  a  calomel  purga- 

44 


690 


YELLOW  FEVER. 


tive,  gr.  ss,  2  or  3  times  on  the  first  day,  followed  by  a  warm-water  enema,  is 
good  treatment  (B.) ;  has  many  advocates,  and  many  opponents  (Wa.) ;  should 
generally  be  abstained  from  (S.).  Duboisine,  gr.  g1^,  subcutaneously,  the  most 
efficient  hypnotic  and  calmative  (B.).  Turpentine,  when  cardiac  weakness, 
depression  of  vaso-motor  system,  dissolved  state  of  the  blood  ;  rr^x-^ss  ;  small 
doses,  with  tinctura  ferri  chloridi,  in  hemorrhagic  form  (B.).  Quinine,  has 
some  strong  evidence  in  its  favor  as  an  abortive  agent,  one  large  dose  (gr. 
xxx-xl)  with  opium  at  outset  (Wa.) ;  is  not  a  specific  ;  may  hasten  recovery  in 
mild  cases  (S.)  ;  gr.  xx  per  rectum,  to  reduce  temperature  (B.).  Liquor  Calcis, 
with  milk,  has  been  found  efficient  for  the  vomiting  (Wa.).  Capsicum,  to  obvi¬ 
ate  the  black  vomit,  is  highly  spoken  of  (Wa.).  Cocaine,  for  the  vomiting, 
nothing  equals  it  in  efficiency,  it  also  acting  as  a  diuretic,  10-minim  doses  of  a 
4  per  cent,  solution,  by  mouth,  every  hour  for  2  or  3  doses,  acts  like  a  charm 
(Jennings).  Chloroform,  for  the  vomiting,  a  few  drops  to  prepare  the  stomach 
for  reception  and  retention  of  food  ;  effects  transitory,  has  to  be  repeated  before 
each  meal  (Wa.) ;  the  Ammoniated  Chloroform  in  zymotic  pyrexia ;  its  action 
is  sedative,  analgesic  and  antipyretic  (Richardson).  Carbolic  Acid,  by  stomach 
and  hypodermically,  remarkably  efficacious,  even  after  the  ominous  “  coffee- 
grounds  ”  vomit  (Lecaille).  Chlorodyne,  is  excellent  for  restlessness,  insomnia, 
irritability  of  stomach  (A.).  Veratrum  Viride,  gtt.  j-x  hourly,  according  to 
age,  till  pulse  and  temperature  subdued ;  successfully  used  in  connection  with 
mercury,  etc.  (White  and  Ford).  Stimulants,  only  in  typhus  form  (B.) ;  in  3d 
stage  must  be  bold,  prompt  and  continued  (Da  C.).  Diet,  of  the  blandest 
description  (A.)  ;  milk  and  lime-water,  half  and  half,  in  small  quantities,  is  the 
best  aliment.  In  convalescence,  the  utmost  care  is  necessary  in  giving  aliments 
(B.).  Rest  is  very  important  (Da  C.).  Iced  Champagne,  in  tablespoonful  doses 
every  %  hour,  for  the  vomiting  (B.).  Purgation,  throughout  the  disease 
(Da  C.).  [Compare  Remittent  Fever.] 


Prescriptions. 


R.  Potassii  Carbonat.,  .  .  .  .  gr.  xx. 
Tiuct.  Opii  Camphorat.,  .  .  gj. 


Aquae, . 3  -viij. 

M.  Sig. —  p)]  every  hour  or  two,  as  a 
diaphoretic.  [Dickson.) 


R  .  Chloroform i, 

Tinct.  Camphorae,  .  .  .  aa  ^ss. 

M.  Sig. — Two  drops  as  required  for  the 
vomiting. 


APPENDIX. 


LIST  OF  LATIN  WORDS,  PHRASES,  ETC.,  USED  IN  WRITING 
PRESCRIPTIONS;  WITH  THEIR  CONTRACTIONS,  AND 
THE  CORRESPONDING  ENGLISH  EQUIVALENTS. 


Word  or  Phrase. 

Contraction. 

English  Equivalent. 

Abdomen 

Abd. 

The  belly. 

Absente  febre 

Abs.  feb. 

Fever  being  absent. 

Accurate 

Acc. 

Accurately. 

Ad 

Ad 

To,  or  up  to. 

Ad  duas  vices 

Ad  2  vie. 

At  twice  taking. 

Ad  secundum  vicem 

Ad  sec.  vie. 

To  the  second  time. 

Ad  tertiam  vicem 

Ad  3  tiam  vie. 

For  the  third  time. 

Adde 

Add. 

Add. 

Addantur 

Add. 

Let  (them)  be  added. 

Addendus 

Add. 

To  be  added. 

Addendo 

Add. 

By  adding. 

Ad  defectionem  animi 

Ad  def.  an. 

To  fainting. 

Ad  gratam  aciditatem 

Ad  grat.  acid. 

To  an  agreeable  sourness. 

Adhibendus 

Adhib. 

To  be  administered. 

Adjacens 

Adjac. 

Adjacent. 

Ad  libitum 

Ad  lib. 

At  pleasure. 

Admove 

Admov. 

Apply. 

Admoveatur 

Admov. 

Let  (it)  be  applied. 

Admoveantur 

Admov. 

Let  (them)  be  applied. 

Adstante  febre 

Adst.  feb. 

The  fever  being  on. 

Adversum 

Adv. 

Against. 

Aggrediente  febre 

Aggr.  feb. 

While  the  fever  is  coming  on. 

Agitato  vase 

Agit.  vas. 

The  vial  being  shaken. 

Aliquot 

Aliq. 

Some. 

Alter 

Alt. 

The  other. 

Alternis  horis 

Alt.  hor. 

Every  other  hour. 

Aluta 

Aluta 

Leather. 

Alvo  adstricta 

Alv.  adst. 

The  bowels  being  confined. 

Alvus 

Alv. 

The  belly. 

Amplus 

Amp. 

Large. 

Ampulla 

Ampul. 

A  large  bottle. 

Ana 

A.  or  aa 

Of  each. 

Aqua 

Aq. 

Water. 

Aqua  astricta 

Aq.  astr. 

Frozen  water. 

Aqua  bulliens 

Aq.  bull. 

Boiling  water. 

Aqua  communis 

Aq.  com. 

Common  water. 

Aqua  fervens 

Aq.  ferv. 

Flot  water. 

Aqua  fluviatilis 

Aq.  fluv. 

River  water. 

Aqua  fontalis 

Aq.  font. 

Spring  water. 

Aqua  fontana  or  fontis 

Aq.  iont. 

u  ii 

Aqua  marina 

Aq.  mar. 

Sea  water. 

Aqua  nivialis^r  nivalis 

Aq.  niv. 

Snow  water. 

691 


692 


LIST  OF  LATIN  WORDS,  PHRASES,  ETC. 


Word  or  Phrase. 

Contraction. 

English  Equivalent. 

Aqua  pluvialis,0r  pluvia- 

Aq.  pluv. 

Rain  water. 

tilis 

Aqualis 

Aqualis 

Pertaining  to  water. 

Aut 

Aut. 

Or. 

Balneum  arenae 

B.  A. 

Sand-bath. 

Balneum  marise,  or  maris 

B.  M. 

Salt-water  bath. 

Balneum  vaporosum,  or 

B.  V. 

Vapor  bath. 

vapor  is 

Balsamum 

Bals. 

Balsam. 

Barbadensis 

B.  B. 

Barbadoes. 

Bene 

Bene 

Well. 

Bibe 

Bib. 

Drink  (thou). 

Biduum 

Bid. 

Two  days. 

Bis 

Bis 

Twice. 

Bis  in  die,  or  dies 

Bis  die 

Twice  a  day. 

Bolus 

Bol. 

A  large  pill. 

Bulliat  or  Bulliant 

Bull. 

Let  boil. 

Butyrum 

But. 

Butter. 

Caeruleus 

Caerul. 

Blue. 

Calefactus 

Calef. 

Warmed. 

Calomel  or  Calomelas 

Cal. 

The  mild  chloride  of  mercury. 

Cape 

Cap. 

Take  (thou). 

Capiat 

Cap. 

Let  him  take. 

Capsula 

Capsul. 

A  capsule. 

Caute 

Caute 

Cautiously. 

Charta 

Chart. 

Paper. 

Chartula 

Chartul. 

A  small  paper. 

Cibus 

Cib. 

Food. 

Cochlear,  or  Cochleare,  or 

Coch.,  Cochleat. 

A  spoonful,  By  spoonfuls  (  gj). 

Cochleatim 

Cochleare  amplum 

Coch.  amp. 

A  dessertspoonful  (^ij). 

Cochleare  magnum 

Coch.  mag. 

A  tablespoonful  (3  ss). 

Cochleare  medium,  or 

Coch.  med.  or  mod. 

A  dessertspoonful  (  3  ij). 

modicum 

Cochleare  parvum 

Coch.  parv. 

A  teaspoonful  (3j). 

Coctio 

Coct. 

Boiling. 

Cola 

Col. 

Strain. 

Colaturae 

Colatur. 

To  the  strained  liquor. 

Col  at  us 

Colat. 

Strained. 

Coletur 

Colet. 

Let  it  be  strained. 

Colentur 

Colent. 

Let  them  be  strained. 

C'ollutorium 

Collut. 

A  mouth- wash. 

Collyrium 

Collyr. 

An  eye-wash. 

Coloretur 

Coloret. 

Let  it  be  colored. 

Compositus 

Comp. 

Compounded. 

Concisus 

Concis. 

Cut. 

Confectio 

Conf. 

Confection. 

Congius 

Cong. 

A  gallon. 

Conserva 

Cons. 

A  conserve,  also  Keep  (thou). 

Continuantur  remedia 

Cont.  rem. 

Let  the  medicines  be  continued. 

Contusus 

Contus. 

Bruised. 

Coque,  Coquantur 

Coq. 

Boil,  let  them  be  boiled. 

Coque  ad  medietatis  con- 

Coq.  ad.  med.  con- 

Boil  to  the  consumption  of  half. 

sumptionem 

sump. 

Coque  secundem  artem 

Coq.  S.  A. 

Boil  according  to  art. 

Coque  in  sufficiente  quan- 

Coq.  in  S.  A. 

Boil  in  sufficient  water. 

titate  aquae 

Cor,  cordis 

Cor. 

The  heart. 

Cortex,  corticis 

Cort. 

The  bark. 

LIST  OF  LATIN  WORDS,  PHRASES,  ETC. 


693 


( 

Word  or  Phrase. 

Contraction. 

English  Equivalent. 

Coxa 

Cox. 

t 

The  hip. 

Cras,  Crastinus 

Crast. 

To  morrow. 

Cras  mane  sumendus 

Cras  mane  sumend. 

To  be  taken  to-morrow  morning. 

Cras  nocte 

Cras  nocte 

To-morrow  night. 

Cras  vespere 

Cras  vesp. 

To-morrow  evening. 

Crastinus 

Crast. 

For  to-morrow,  early. 

Cujus,  Cujus-libet 

Cuj. 

Of  which,  of  any. 

Cum 

C. 

With. 

Cyatho  theae 

Cyatho  theas 

In  a  cup  of  tea. 

Cyathus,  vel  Cyathus  vina- 

Cyath.,  C.  vinar. 

A  wine-glass  (  Jj-ij). 

rius 

Da,  detur 

D.,  det. 

Give,  let  be  given. 

De 

De 

Of,  or  from. 

Deaurentur  pilulae 

Deaur.  pil. 

Let  the  pills  be  gilded. 

Debita  spissitudo 

Deb.  spiss. 

A  proper  consistence. 

Debitus 

Deb. 

Due,  proper. 

Decanta 

Dec. 

Pour  off. 

Decern,  Decimus 

Decern. 

Ten,  The  tenth. 

Decoctum 

Decoct. 

A  decoction. 

Decubitus 

Decub. 

Lying  down. 

De  die  in  diem 

De  d.  in  d. 

From  day  to  day. 

Dein  vel  Deinde 

Dein. 

Thereupon. 

Deglutiatur 

Deglut. 

Let  be  swallowed. 

Dejectiones  alvi 

Dej.  alv. 

Stools. 

Detur  in  duplo 

Det.  in  dup. 

Let  twice  as  much  be  given. 

Dexter,  Dextra 

Dext. 

The  right. 

Diebus  alternis 

Dieb.  alt. 

Every  other  day. 

Diebus  tertiis 

Dieb.  tert. 

Every  third  day. 

Diluculo 

Diluc. 

At  break  of  day. 

Dilue,  Dilutus 

Dil. 

Dilute  (thou),  Diluted. 

Dimidius 

Dim. 

One-half. 

Directione  propria 

D.  P.,  or  Direct,  prop. 

With  a  proper  direction. 

Dividatur  in  partes 

D.  in  p.  aeq. 

Let  it  be  divided  into  equal  parts. 

aequales 

Dividendus,  -a,  -um 

Divid. 

To  be  divided. 

Dolor 

Dolor 

Pain. 

Donee 

Donee 

Until. 

Donee  alvus  bis  dejicia- 

Donee  alv.  bis  dejic. 

Until  the  bowels  have  been  twice 

tur 

evacuated. 

Donee  alvus  soluta  fuerit 

Donee  alv.  sol.  ft. 

Until  the  bowels  shall  be  opened. 

Donee  dolor  nephriticus 

Donee  dolor  neph. 

Until  the  nephritic  pain  is  removed. 

exulaverit 

exulav. 

Dosis 

D. 

A  dose. 

Drachma 

Dr.  or  3 

A  drachm  (60  grains). 

Durante  dolore 

Dur.  dolor. 

While  the  pain  lasts. 

Eadem  (fern.) 

Ead. 

The  same. 

Eburneus 

Eburn. 

Made  of  ivory. 

Ejusdem 

Ejusd. 

Of  the  same. 

Electuarium 

Elect. 

An  electuary. 

Emesis 

Emesis 

Vomiting. 

Enema 

En. 

A  clyster  or  enema. 

Enemata 

Enem. 

Clysters. 

Et 

Et 

And. 

Evanuerit 

Evan. 

Shall  have  disappeared. 

Exhibeatur 

Exhib. 

Let  it  be  exhibited. 

Extende 

Ext. 

Spread. 

Extende  super  alutem 

Ext.  sup.  alut.  moll. 

Spread  upon  soft  leather. 

Extractum 

Extr. 

An  extract. 

694 


LIST  OF  LATIN  WORDS,  PHRASES,  ETC. 


Word  or  Phrase. 

Contraction. 

English  Equivalent. 

Extrahe 

Extrahe 

Extract  thou. 

Fac 

F. 

Make. 

Fiat 

Ft. 

Let  be  made  (sing.). 

Fiant 

Ft. 

Let  be  made  (pi.). 

Fac  pilulas  duodecim 

F.  pil.  xij 

Make  12  pills. 

Farina 

Farina 

Flour. 

Fascia  lintea 

Fas.  lint. 

A  linen  bandage. 

Fasciculus 

Fascic. 

A  bundle  which  can  be  carried 
under  the  arm. 

Febre  durante 

Febr.  dur. 

During  the  fever. 

Febris 

Febr. 

Fever. 

Femoribus  internis 

Fern,  intern. 

To  the  inner  thighs. 

Fervens 

Ferv. 

Boiling. 

Fac  cataplasmatem 

Ft.  cataplasm. 

Make  a  poultice. 

Fiat  ceratum 

Ft.  cerat. 

Let  a  cerate  be  made. 

Fiant  chartulre  xij 

Ft.  chart,  xij 

Let  12  powders  be  made. 

Fiat  collyrium 

Ft.  collyr. 

Let  an  eye-wash  be  made. 

Fiat  emplastrum  vesica- 
torium 

Ft.  emp.  vesic. 

Let  a  blister  be  made. 

Fiat  emulsio 

Ft.  emuls. 

Let  an  emulsion  be  made. 

Fiat  enema 

Ft.  en 

Let  an  enema  (an  injection  for  the 
rectum)  be  made. 

Fiat  injectio 

Ft.  inject. 

Let  an  injection  (for  the  urethra)  be 
made. 

Fiat  lege  artis 

F.  L.  A. 

Let  it  be  made  by  the  rules  of  art. 

Fiat  massa,  et  divide  in 

Ft.  mas.  div.  in  pil. 

Let  a  mass  be  made,  and  divide  it 

pilulas  xij 

xij 

into  12  pills. 

Fiant  pilulae  xij 

Ft.  pil.  xij 

Let  12  pills  be  made. 

Fiat  pulvis 

Ft.  pulv. 

Let  a  powder  be  made. 

Fiant  pulveres  xij 

Ft.  pulv.  xij 

Let  12  powders  be  made. 

Fiat  pulvis  in  chartulas 

Ft.  pulv.  in  chart,  xij 

Let  a  powder  be  made  to  be  divided 

xij  dividenda 

div. 

into  xij  little  papers. 

Fiat  solutio 

Ft.  sol. 

Let  a  solution  be  made. 

Fiant  suppositoria  iv 

Ft.  suppos.  iv 

Let  4  suppositories  be  made. 

Fiant  trochisci  xxiv 

Ft.  troch.  xxiv 

Let  24  troches  be  made. 

Fiat  unguentum 

Ft.  ung. 

Let  an  ointment  be  made. 

Fiat  venesectio 

Ft.  venesec. 

Let  a  bleeding  be  done. 

Fictilis 

Fict. 

Earthen. 

Filtra 

Filtra 

Filter  (thou). 

Filtram,  Filtrum 

Filt. 

A  filter. 

Fistula  armata 

Fistul.  arm. 

A  syringe  ready  for  use. 

Fluidus 

Fluid.,  FI. 

Liquid. 

Formula 

Form. 

A  prescription. 

Frustillatim 

Frust. 

In  small  pieces. 

Fuerit 

Fuerit. 

Shall  have  been. 

Gargarysma 

Garg. 

A  gargle. 

Gelatina  quavis 

Gelat.  quav. 

In  any  kind  of  jelly. 

Gingivas  incide 

Ging.  incid. 

Lance  (or  cut)  the  gums. 

Gradatim 

Grad. 

By  degrees,  gradually. 

Grana  sex  pondere 

Gran,  vj  pond. 

Six  grains  by  weight. 

Granum,  Grana 

Gr. 

Grain,  Grains. 

Gramme 

Grm. 

Gram. 

Gratus 

Grat. 

Pleasant. 

Grumus 

Grum. 

A  clot  (of  blood.) 

Gutta,  Guttae 

Gtt. 

A  drop,  Drops. 

Guttatim 

Guttat. 

By  drops. 

Guttis  quibusdam 

Gtt.  quibusd. 

With  a  few  drops. 

Flarum  pilularum  suman- 
tur  tres 

Flar.  pil.  sum.  iij 

Let  three  of  these  pills  be  taken. 

LIST  OF  LATIN  WORDS,  PHRASES,  ETC. 


695 


Word  or  Phrase. 

Contraction. 

English  Equivalent. 

Haustus 

Haust. 

A  draught. 

Haustus  purgans  noster 

H.  p.  n. 

A  purgative  draught  after  my  own 
(formula). 

1  Hebdomad  a 

Ilebdom. 

A  week. 

Herba 

Herb. 

An  herb. 

Herbarum  recentium 

Herb,  recent. 

Of  fresh  herbs. 

Heri 

Heri 

Yesterday. 

Hie,  Haec,  Hoc 

Hie,  Haec,  Hoc 

This. 

Hirudo 

Hirudo 

A  leech. 

Hirudines  appone 

Hirud.  app. 

Apply  leeches. 

Hora 

H. 

An  hour. 

Hora  somni 

Hor.  som. 

At  the  hour  of  sleep. 

Hora  undecima  matutina 

Hor.  xj  matut. 

At  the  eleventh  hour  of  the  morning. 

Horse  decubitus 

Hor.  decub. 

At  bedtime. 

Horae  unius  spatio 

Hor.  j  spat. 

After  one  hour. 

Horis  intermediis 

Hor.  interm. 

In  the  intermediate  hours. 

Idem 

Id. 

The  same. 

Idoneus 

Idon. 

Proper. 

Imprimis 

Impr. 

First. 

Incide,  Incisus 

Inc. 

Cut  (thou),  Being  cut. 

In  dies 

Ind. 

Daily,  or  From  day  to  day. 

Infunde 

Infun. 

Pour  in. 

Infusum 

Infus. 

An  infusion. 

Injectio 

Injec. 

An  injection. 

Injiciatur  enema 

Injic.  enera. 

Let  a  clyster  be  given. 

In  pulmento 

In  pulm. 

In  gruel. 

Instar 

Instar. 

As  big  as. 

Inter 

Inter 

Between. 

Internus,  -a,  -um 

Int. 

Inner,  or  Internal. 

Intus 

Intus 

Inwardly. 

Tam 

Jam 

Now. 

Julepus,  Julepum,  Julap- 
ium 

Jul. 

A  julep. 

jusculum 

Juscul. 

A  broth. 

luxta 

Juxta 

Near  to. 

Ivali  praeparatum 

Kal.  ppt. 

Prepared  Potash,  or  the  Carbonate 
of  Potassium. 

Lac,  Lactis 

Lac. 

Milk,  of  Milk. 

Lagena 

Lag. 

A  flask,  or  bottle. 

Lana 

Lana. 

Flannel. 

Languor 

Lang. 

Faintness. 

Lateri  dolenti 

Lat.  dol. 

To  the  painful  side. 

Lectus 

Lect. 

A  bed. 

Libra 

Lb.  or  lb 

A  pound. 

Ligatura 

Lig. 

A  ligature. 

Linimentum 

Linim. 

A  liniment. 

Linteum 

Lint. 

Lint. 

Liquor 

Liq. 

A  solution. 

Lotio 

Lot. 

A  lotion. 

Mac  era 

Mac. 

Macerate. 

Magnus 

Mag. 

Large. 

Mane 

Mane 

In  the  morning. 

Mane  primo 

Mane  primo 

In  the  very  early  morning. 

Manipulus 

M.  or  Man. 

A  handful. 

Manus 

Manus 

The  hand. 

1  Massa 

Mass. 

A  mass,  or  pill  mass. 

Matutinus 

Matut. 

In  the  morning. 

Medius 

Med. 

Middle. 

Mensura 

Mensur. 

By  measure. 

696 


LIST  OF  LATIN  WORDS,  PHRASES,  ETC. 


Word  or  Phrase. 

Contraction. 

English  Equivalent. 

• 

Mica  pan  is 

Mic.  pan. 

Crumb  of  bread. 

Minimum 

M.  or  Min. 

A  minim. 

Minutum 

Minut. 

A  minute. 

Misce 

M. 

Mix. 

Mistura 

Mist. 

A  mixture. 

Mitte 

Mit. 

Send. 

Mittatur 

Mit. 

Let  (it)  be  sent. 

Mittantur 

Mit. 

Let  (them)  be  sent. 

Mitte  sanguinem  ad  uncias 

Mit.  sang,  ad  uncias 

Take  away  blood  to  12  ounces  at 

duodecim  saltern. 

xij  salt. 

least. 

Modicus 

Modic. 

Middle-sized. 

Modo  praescripto 

Mod.  praesc. 

In  the  manner  prescribed. 

Mora 

Mora 

Delay. 

More  dictu 

Mor.  diet. 

In  the  manner  directed. 

More  solito 

Mor.  sol. 

In  the  usual  manner. 

Morturarium 

Mort. 

A  mortar. 

Ne  trades  sine  nummo. 

Ne  tr.  s.  num. 

Do  not  deliver  without  the  money. 

Necnon 

Necn. 

Also. 

Nisi 

Nisi 

Unless. 

|  Non 

Non 

Not. 

Non  repetatur 

Non  repetat. 

Let  it  not  be  repeated. 

Noc,  Noctis 

Noc,  Noct. 

The  night,  of  the  night. 

Nocte  maneque 

Noct.  maneq. 

At  night,  and  in  the  morning. 

Nucha 

Nucha 

The  nape  of  the  neck. 

Numero 

No. 

In  number. 

Numerus 

No. 

Number. 

Nux  Moschata 

Nux  Mosch. 

A  nutmeg. 

Octarius 

O.,  Oct. 

A  pint  (gxvj). 

Octavus 

Octav. 

Eighth. 

Octo 

Octo 

Eight. 

Oleum  Lini  sine  igne 

01.  Lini  sine  ig. 

Cold-drawn  Linseed  Oil. 

Oleum  olivae  optimum 

01.  O.  opt. 

Best  olive  oil. 

Omni  hora 

Omn.  hor. 

Every  hour. 

Omni  bihorio 

Omn.  bih. 

Every  two  hours. 

Omni  quadrante  horae 

Omn.  quadr.  hor. 

Every  hour. 

Omni  mane 

Omni  mane 

Every  morning. 

Omni  nocte 

Omn.  noct. 

Every  night. 

Opus 

Opus 

Need,  or  occasion. 

Ovum 

Ov. 

An  egg. 

Pannus 

Pan. 

A  rag.  . 

Pars,  Partis 

Par.,  Pt. 

A  part,  Of  a  part. 

Partes  aequales 

Pt.  aeq. 

Equal  parts. 

Partitis  vicibus 

Part.  vie. 

In  divided  doses. 

Parvulus 

Parvul. 

An  infant,  A  parvule. 

Parvus 

Parv. 

Little. 

Pastillus,  Pastillum 

Pastil. 

A  Pastille. 

Pediluvium 

Peduliv. 

A  foot-bath. 

Penicillum  camelinum 

Penicil.  cam. 

A  cameks-hair  pencil  or  brush. 

Per 

Per 

Through,  By. 

Peracta  operatio  emetici 

Peract.  operat.  emet. 

When  the  action  of  the  emetic  is 
finished. 

Per  deliquium 

Per  deliq. 

By  deliquescence. 

Per  fistulam  vitream 

Per  fistul.  vit. 

Through  a  glass  tube. 

Pergo,  Pergere 

Perg. 

To  go  on  with. 

Phiala  prius  agitata 

P.  P.  A. 

The  bottle  having  been  first  shaken. 

!  Phiala 

Phil. 

A  vial,  or  bottle. 

Pilula 

Pil. 

A  pill. 

Poculum 

Pocul. 

A  cup. 

Poc  ilium 

Pocill. 

A  little  cup. 

LIST  OF  LATIN  WORDS,  PHRASES,  ETC. 


6  97 


Word  or  Phrase. 

Contraction. 

English  Equivalent. 

Pond  ere 

P. 

By  weight. 

Pondus  civile 

P.  civ. 

Civil  weight  (avoirdupois). 

Pondus  medicinale 

P.  med. 

Medicinal  weight. 

Pone  aurem 

Pone  aur. 

Behind  the  ear. 

Postsingulassedesliquidas 

Post  sing.  sed.  liq. 

After  every  loose  stool. 

Pot  us 

Potus 

Drink. 

Praeparata 

Praep. 

Prepared. 

Primo  mane 

Primo  mane 

Very  early  in  the  morning. 

Primus 

Primus 

The  first. 

Pro 

Pro 

For. 

Pro  ratione  aetatis 

Pro  rat.  set. 

According  to  the  age  of  the  patient. 

Pro  re  nata 

P.  r.  n. 

Occasionally.  According  to  circum¬ 
stances. 

Pugillus 

Pug. 

A  pinch. 

Pulmento 

Pulm. 

Gruel. 

Pulvis 

Pulv. 

A  powder. 

Pulverizatus 

Pulvz. 

Powdered. 

Pyxis 

Pyxis 

A  pill-box. 

Quadrans, — antis 

Quad. 

A  quart. 

Quantum  libet 

Q.  lib. 

As  much  as  you  please. 

Quantum  placet 

Q.  p. 

<<  u  u  u  u 

Quantum  vis 

Q.  v. 

44  44  <4  4  4  44 

Quantum  volueris 

Q.  vol. 

t<  <<  U  ii  <( 

Quantum  sufficiat 

Q.  s. 

As  much  as  is  sufficient. 

Quantum  satis 

Q.  s. 

44  44  44  44  44 

Quaqua  hora 

Qq.  hor. 

Every  hour.  { 

Each,  or  Every. 

Quaque 

Qq. 

Quart  us 

Quart. 

Fourth. 

Quater 

Quater 

Four  times. 

Quatuor 

Quat. 

Four. 

Quibus 

Quibus 

From  which. 

Quinque 

Quinq. 

Five. 

Quintus 

Quint. 

The  fifth. 

Quoque 

Q.q. 

Also. 

Quorum 

Quor. 

Of  which. 

Quotidie 

Quotid. 

Daily. 

Ratio 

Ratio 

Proportion. 

Recens,  -entis 

Rec. 

Fresh. 

Recipe 

R 

Take. 

Redactus  in  pulverem 

Red.  in  pulv. 

Let  it  be  reduced  to  powder. 

Redigatur  in  pulverem 

Redig.  in  pulv. 

44  44  44  44 

Regio  umbilici 

Reg.  umbil. 

The  umbilical  region. 

Reliquus 

Reliq. 

Remaining. 

Repetatur 

Rept. 

Let  it  be  repeated. 

Repetantur 

Rept. 

Let  them  be  repeated. 

Respondere 

Respond. 

To  answer. 

Retinere 

Retin. 

To  keep. 

Saltern 

Saltern 

At  least. 

Saltim 

Saltim 

By  leaps. 

Saturatus,  -a,  -um 
Scarificare 

Sat. 

Saturated. 

Scar  if. 

To  scarify. 

Scarificatione  explicata 

Scarif.  expl. 

Scarification  having  been  effected. 

Scatula 

Scat. 

A  box. 

i  Scilicet 

Scil. 

Namely. 

Scrupulum 

Scrup.  or  7) 

A  scruple  (20  grains). 

Secundum  artem 

S.  A. 

According  to  art. 

Secundum  naturam 

S.  N. 

According  to  nature. 

Secundus 

Secund. 

Second. 

Sedes 

Sed. 

The  alvine  evacuation. 

698 


LIST  OF  LATIN  WORDS,  PHRASES,  ETC. 


Word  or  Phrase. 

Contraction. 

English  Equivalent. 

Semel 

Semel 

Once. 

Semis,  or  Semissis 

Ss. 

A  half. 

Semi-drachma 

Semidr. 

Half  a  drachm. 

Serai-hora 

Semih. 

Half  an  hour. 

Septem 

Sept. 

Seven. 

Septimana 

Septim. 

A  week. 

Sesuncia 

Sesunc. 

An  ounce  and  a  half. 

Sesquihora 

Sesqh. 

An  hour  and  a  half. 

Sex 

Sex 

Six. 

Sextus 

Sext. 

Sixth. 

Si 

Si 

If. 

Signa 

Sig. 

Write,  or  Mark  (thou). 

Signatur  nomine  proprio 

Sig.  nom.  prop. 

Let  it  be  written  upon  with  its 
proper  name. 

Simul 

Simul 

Together. 

Sine 

Sin. 

Without. 

Singularum 

Sing. 

Of  each 

Singulorum 

Sing. 

Of  each. 

Si  non  valeat 

Si  non  val. 

If  it  does  not  answer. 

Si  opus  sit 

Si  op.  sit 

If  necessary. 

Si  veres  permittant 

Si  vir.  perm. 

If  the  strength  will  bear  it. 

Sit 

Sit 

Let  it  be. 

Solus 

Sol. 

Alone. 

Solve 

Solv. 

Dissolve. 

Sol vo,  Solvere 

Solv. 

To  dissolve. 

Solutus 

Solut. 

Dissolved. 

Somnus 

Somnus 

Sleep. 

Spiritus,  -us 

Spt. 

Spirit. 

Spiritus  vini  rectificatus 

Spt.  vin  rect. 

Rectified  spirit  of  wine  (i.e.  Alco¬ 
hol). 

Spiritus  vini  tenuis 

Spt.  vin.  ten. 

Proof  spirit. 

Spiritus  vinosus 

Spt.  vinos. 

Ardent  spirit  (of  any  strength). 

Statim 

Stat. 

Immediately. 

Stet,  or  Stent 

St. 

Let  it  (or  them)  stand. 

Stratum  superstratum 

S.  S.  S. 

Layer  upon  layer. 

Subactus 

Subact. 

Subdued. 

Sub  finem  coctionis 

Sub  fin.  coct. 

When  the  boiling  is  nearly  fin¬ 
ished. 

Subin  de 

vSubind. 

Frequently. 

Sumat  talem 

Sum.  tal. 

Let  him  take  one  like  this. 

Sume 

Sum. 

Take. 

Sumat 

4< 

Let  him  take. 

Sumatur 

u 

Let  it  be  taken. 

Sumantur 

(< 

Let  them  be  taken. 

Sumendus 

u 

To  be  taken. 

Summitates 

Summit. 

The  summits. 

Superbibendo  haustum 

Sup.  bib  haust. 

Drinking  afterwards  this  draught. 

Supra 

Supra 

Above. 

Syrupus,  -i 

Syr. 

Syrup. 

Tabella 

Tab. 

A  lozenge. 

Talis 

Tal. 

Such  a  one. 

Tempori  dextro 

Tempor.  dext. 

To  the  right  temple. 

Tempus,  -oris 

Temp. 

Time,  or  Temple. 

Ter 

Ter 

Thrice,  or  Three  times. 

Ter  in  die,  or  Ter  die 

T.  i.  d.,  or  T.  d. 

Thrice  daily. 

Tere 

Tere 

Rub. 

Tere  simul 

Tere  sim. 

Rub  together. 

Tero 

Tero 

I  rub. 

Tertius 

Tert. 

Third. 

LIST  OF  LATIN  WORDS,  PHRASES,  ETC. 


699 


. 

Word  or  Phrase. 

Contraction. 

English  Equivalent. 

Tinctura 

Tinct.  or  Tr. 

Tincture. 

Tincturae  Herbarum  Re- 

Tinct.  Herb.  Recent. 

Tinctures  of  Fresh  Herbs. 

centium 

Tres 

Tres 

Three. 

Triduum 

Trid. 

Three  days. 

Tritura 

Trit. 

Triturate. 

Trochiscus,  Trochisci 

Troch. 

A  lozenge  or  troche,  Lozenges  or 
troches. 

Tussis 

Tus 

A  cough. 

Ultimo  (or  Ultima)  prae- 

Ult.  praesc. 

The  last  ordered. 

scriptus 

Una 

Una 

Together. 

Uncia 

Unc.  or  3 

An  ounce. 

Ut  dictum 

Ut  diet. 

As  directed. 

Utendum 

Utend. 

To  be  used. 

Uto,  Uti 

Uto,  Uti 

To  make  use  of. 

Vas  vitreum 

Vas  vit. 

A  glass  vessel. 

Vehiculum 

Vehic. 

A  vehicle,  or  menstruum. 

Vel 

Vel 

Or. 

Venaesectio  brachii 

Venaesec.  brach. 

Bleeding  in  the  arm. 

Vesper,  -eris 

Vesp. 

The  evening. 

Vices 

Vic. 

Turns. 

Vinum 

Vin. 

Wine. 

Vires 

Vir. 

Strength. 

Vitellus 

Vitel. 

Yolk. 

Vitello  ovi  Solutus 

Vitel.  ovi  Sol. 

Dissolved  in  the  yolk  of  an  egg. 

Vitellus  ovi 

Vitel.  ovi 

Yolk  of  egg. 

Vitreum,  Vitrum 

Vitr. 

Glass. 

Vomitione  urgente 

Vom.  urg. 

Vomiting  being  severe. 

Note. — For  the  dangerous  abbreviations,  see  an/e ,  page  443,  under  the  title  Pre¬ 
scription  Writing. 


Pronunciation. 

Attention  is  particularly  directed  to  the  accentuation  of  words  commonly  mispronounced  ; 
as,  for  example,  ac£tas,  atropa,  chimaphila  ( kitna ),  chloridum,  codeia,  conium,  enema, 
iodidum,  radicis,  ricinus,  sinapis,  syrupus,  eczema,  umbilicus,  abdomen,  bromidum,  pare¬ 
sis. 


Verbs. 


The  Verbs  used  in  prescription  writing  are  nearly  all  in  the  imperative  mood,  giving 
directions  to  the  compounder,  and  having  their  object  in  the  accusative  case.  Such  are — 


Adde,  add. 

Cola ,  strain. 
Divide ,  divide. 
Extende,  spread. 


Fac,  make. 

Filtra ,  filter. 
Afacera,  macerate. 
Mi  see,  mix. 


Recipe ,  take. 
Signa ,  write. 
Solve,  dissolve. 
Tere,  rub. 


A  few  verbs  are  found  in  the  subjunctive  mood,  taking  their  subject  or  predicate  in  the 
nominative  case.  The  most  usual  are — 


Fiat,  let  be  made. 

Fiant ,  let  be  made. 
Coletur ,  let  be  strained. 
Color etur,  let  be  colored. 
Sumatur ,  let  be  taken. 


Bulliat,  let  boil. 

Capiat,  let  take. 

Detur,  let  be  given. 
Dividatur ,  let  be  divided. 
Sit,  let  it  be. 


700 


PARTICIPLES - GENITIVE  CASE  ENDINGS. 


Participles. 

Participles  or  Verbal  Adjectives  are  occasionally  used,  and  should  agree  with  their 
respective  nouns  in  gender,  number  and  case.  Such  are  the  following,  viz.: — 

Dividendus,  - a ,  —um,  to  be  divided. 

Sumendus,  -a,  -um,  to  be  taken. 

Adhibendus,  -a,  -um,  to  be  administered. 


Prepositions. 

Those  in  the  first  column  require  the  noun  following  to  be  in  the  accusative  case, — 
those  in  the  second  column  require  the  ablative  case. 

Ad,  to,  up  to.  Cum,  with. 

In.  into  Pro,  for. 

Supra,  upon.  Sine,  without. 

Ana,  of  each, — governs  the  genitive  case. 


Sundry  Words  and  Phrases,  in  most  frequent  use. 


Bene,  well. 

Bis,  twice. 

Dein,  thereupon. 

Et,  and. 

Gradatim ,  gradually. 
Guttatim,  by  drops. 
In  dies,  daily. 

Da,  give. 


Non,  not. 

ATumerus,  number. 
Octarius,  a  pint. 
Se/nel,  once. 

Simul,  together. 
Statim,  at  once. 
Ter,  thrice. 

Quater,  four  times. 


Ad  saltirandum,  to  saturation. 

Numero ,  to  the  number  of. 

Quantum  sujjficiat,  as  much  as  necessary. 
Pro  re  na/d,  according  to  need. 

In  partes-czquales,  into  equal  parts. 
Redactus  in  pulveretn,  let  be  pulverized. 
Secundum  artem,  according  to  art. 

Non  Repetatur,  let  it  not  be  repeated. 


GENITIVE  CASE  ENDINGS,  ETC. 


Nom. 

Gen. 

Exceptions. 

a 

se 

Cataplasma,  Eneina,  Physostigma,  Aspidosperma  and  Gargarysma,  all  have  the 
genitive  in  -atis.  Coca  is  unchanged,  though  the  genitive  Cocae  is  written  by 
some  authorities.  Folia  is  plural,  gen.  Foliorum. 

us 

um 

os 

on 

i 

Rhus,  Rhois ;  Flos,  Floris ;  Bos,  Bovis;  Linton,  Lintonis ;  Erigeron,  -ontis. 
Fructus,  Cornus,  Quercus,  Spiritus,  Haustus,  Potus,  do  not  change,  being  of 
4th  declension. 

as 

atis 

Asclepias,  -adis  ;  Mas,  Maris. 

is 

idis 

Pulvis, -eris  ;  Arsenis,  -itis ;  Phosphis,  -itis;  Sulphis,  -itis,  and  all  salts  ending 
'n  -is,  have  genitive  in  -its. 

o 

onis 

Mucilago,  -inis;  Ustilago,  -inis  ;  Solidago,  -inis. 

1 

-lis 

Fel,  Fellis;  Mell,  Mellis  ;  Sumbul,  Sumbuli. 

en 

ps 

rs 

r 

X 

inis 

pis 

rtis 

ris 

cis 

Words  which  do  not  change  in  the  Genitive. 

*Amyl.  Catechu.  Digitalis.  Kino. 

Azedarach.  *Coca.  Fructus.  Matico. 

Berberis.  Cundurango.  Haustus.  Quercus. 

Buchu.  Cornus.  Hydrastis.  Sassafras. 

Cannabis.  Curare.  Jaborandi.  Sago. 

Sinapis.  Potus.  Spiritus. 

*  But  some  authorities  give  Apiolum,  -i ;  Sumbul, -i  ;  AmyI,Amylis;  Coca, -ae. 

HYPODERMIC  FORMUL/E. 


701 


HYPODERMIC  FORMULAE. 


Apomorphine. 

R  .  Apomorphinae  Muriat..  .  .  gr.  j. 

Div.  in  pulv.  xvj.  One  to  four  in  TTpxx 
of  water  as  required. 


Aqua-puncture. 

R.  Aquae  Destillatae,  .  .  .  .  3j. 
Sig. —  oss-3j  as  an  injection. 


Arsenic. 

R.  Liq.  Potassii  Arsenitis,  .  .  q.  s. 
Sig. — rrpij-x,  hypodermically. 


R  .  Liq.  Arsen,  et  Hydr.  Iodidi,  q.  s. 
Sig. — rrpv-xx,  hypodermically. 


Amyl  Nitrite. 

R  .  Amyli  Nitrit., . 3  j. 

Sig. — rrpiij-v  at  a  dose,  which  may  be 
repeated  in  x/2  an  hour  if  necessary. 


Atropine. 

R.  Atropinae  Sulphatis,  .  .  .  gr.  ij. 
Aquae  Destillatae,  .  .  .  .  ^j. 

Solve.  Sig. —  For  hypodermic  use,  trpiij 

=  8r-  "lb  =  Sr-  tzo- 


Caffeine. 

R .  Caffeinae  Citratis,  .  .  .  .  gr.  xxiv. 
Aquae  Destillatae,  .  .  .  .  3j. 
Solve.  Sig. — trpxx  contain  gr.  j. 


Carbolic  Acid. 


R  .  Ac.  Carbol.  Purif.,  .  .  .  .  gr.  x. 

Aquae  Destil.,  . ^j. 

M.  Sig. — bbviij  contain  gr.  of  the 


acid,  which  may  be  given  up  to  gr.  ij  or  iij. 


Chloral. 

R .  Chloralis  Hydratis,  .  .  .  3  iv. 

Aquae  Destil., . 3  j. 

M.  Sig. — tibxxx  contain  gr.  xv  of 

Chloral  Hydrate. 


Chloroform. 

R .  Chloroformi  Purif.,  .  .  .  ^  ss. 

Sig. — trpv-xv  can  be  used  as  one  deep 
injection.  (See  ante ,  page  623.)  The 
spirit  is  safer,  in  somewhat  larger  doses. 


Coniine. 

R.  Coniinae  Hydrobromat  ,  .  gr.  j. 

Aquae  Destillat., . ^j. 

M.  Sig. — rrpx  contain  gr. 


Cocaine. 

R  .  Cocainae  Hydrochlorat.,  .  gr.  v. 
‘  Aquae  Destillatae,  ....  3j. 
Solve.  Sig. — trpvj  contain  gr.  ss. 


Curare. 

R .  Curarae  (Merck),  .  .  .  .  gr.  j. 

Acidi  Acetici . npv. 

Aquae  Destillatae,  .  .  .  ad  rrpc. 

M.  et  filtra.  Sig — rrpx  contain  gr.  T^. 


R.  Curarinae  Sulphat.,  .  .  .  .  gr.  j. 

Aquae  Destillat., . 3  ss. 

M.  Sig. — trpiv  contain  gr.  ^L. 


Daturine. 

IJ  .  Daturinae . gr.  ss. 

Aquae  Destil., . ^j. 

Solve.  Sig. — rr\qv  contain  gr. 
Dose,  trpiv-x. 


Digitaline. 


R  .  Digitalinae, . gr.  ss 

Alcoholis, 

Aquae  Destil., . aa^ij. 


Solve.  Sig.  —  rrpiv  contain  gr. 
Dose,  rrpiv-viij. 


Duboisine. 

i 

!  R.  Duboisinae  Sulphat.,  .  .  .  gr.  j. 

Aquae  Destil., . 3j. 

M.  Sig. — trpiv  contains  gr.  yiy. 


Ergot  and  Ergotine. 

R.  Extr.  Ergotae  Fluid.,  .  .  .  3  ss. 
Filtra.  Sig. — Dose,  rrpx. 


R.  Extracti  Ergotae  (Squibb),  .  3j. 

Aquae  Destillat., . 3j. 

Solve  et  filtra.  Sig. — rrpx  contain  gr.j. 

Dose,  rrpx-xx. 


Eserine. 

R.  Eserinae  Hydrochlor.,  .  .gr.j. 

Aquae  Destil., . 3  iv. 

Solve.  Sig. — npiv  contain  gr. 


702 


HYPODERMIC  FORMULAE. 


Hydrocyanic  Acid. 

R.  Acidi  Hydrocyan.  Dil.,  q.  s. 
Sig. — rrpiv,  a  maximum  dose. 


Hyoscyamine. 


R .  Hyoscyaminae, . gr.  j. 

Ac.  Sulphur.  Dil.,  ....  Trpv. 
Aquae  Destil., . 3J. 


M.  Sig. — IT^v  contain  gr. 


Mercury. 

R.  Hydrarg.  Chlor.  Corr.,  .  .  gr.  j. 

Aquae  Destillat., . ^j. 

M.  Sig. — rrpx  contain  gr.  Hg. 


R  .  Hydrarg.  Chlor.  Corrosivi, 

Ammonii  Chloridi,  .  .  aagr.  iij. 
Misce  et  solve  in — 

Aquae  Destillatae,  ....  £jss. 
Dein  adde — 

Albuminis  Ovi, . ^jss. 

Aquae  Destillatae,  .  .  .  .  3  v. 
Filtra,  et  adde — 

Aquae  Destil.,  .  .  .  q.s.  c^^x. 

Sig. — try  contains  gr.  ^o-  Dose,  rryij-x. 


R  .  Hydrarg.  et  Sodii  Iodidi,  .  gr.  iij. 
Aquae  Destillatae,  ....  3  iijss. 
Solve.  Sig. — trpx  contain  gr.  Dose, 
tr^x  every  second  day. 


Morphine. 

R.  Morphinae  Sulphatis.  .  .  .  gr.  xvj. 
Aquae  Destillatae,  .  .  .  .  §j- 
Solve  et  filtra.  Sig. — rrpvijss  contain 

gr.  {Magendie's.) 


R .  Morphinae  Sulphatis,  .  .  .  gr.  xvj. 

Acidi  Carbolici, . rryiij . 

Aquae  Destillat., . ^ j. 

Solve  et  filtra.  Sig. — rqvijss  contain 
gr.  y(.  {Antiseptic ,  A/agendie's.) 


Morphine  and  Atropine. 


R.  Morphinae  Sulphatis,  .  .  .  gr.  xvj. 
Atropinae  Sulphatis,  .  .  .  gr.  ss. 

Acidi  Carbolici, . rryiij . 

Aquae  Destillat., . j 

Solve  et  filtra.  Sig. — trpvijss  contain  gr. 
of  Morphine  Sulph.,  and  gr.  of 
Atropine  Sulphate.  {Potter.') 


R .  Morphinae  Sulphatis,  .  .  .  gr.  xxiv. 
Atropinae  Sulphatis,  .  .  .  gr.  j. 

01.  Amygdalae  Amar.,  .  .  git.  j. 
Aquae  Destillat., . ^ij. 


Solve.  Sig. — rr^x  contain  gr.  of 
Morphine  Sulphate,  and  gr.  ^  of  Atropine 
Sulphate.  {Didama' s  Solution .) 


Pilocarpine. 

R.  Pilocarpinae  Nitratis,  ,  .  .  gr.  xvj. 
Aquae  Destillat.,  ....  ^j. 

M.  Sig. — rqv  contain  gr.  *4- 


Potassium  Iodide. 


R.  Potassii  Iodidi, . 3  j. 

Aquae  Fontanae, . ^iv. 


Solve.  Sig. — Dose,  rrpvj-xx. 


Quinine. 

R.  Quininae  Disulph.,  .  .  .  .  gr.  1  ( 50). 
Ac.  Sulphurici  Dil.,  .  .  .  rqc(ioo). 

Ac.  Carbolici . rrpv  (5). 

Aquae  Fontanae, . p>). 


Solve.  Sig. —  ^j  contains  gr.  vj.  {Lente). 
Is  irritant.  (B.) 


R.  Quininae  Hydrobrom.,  .  .  gr.  xlviij. 
Aquae  Destillat.,  ....  ^iv. 
Solve.  Sig. — rtqxx  contain  gr.  iv. 


R.  Quininae  Bimur.  Carbamidat., 

Aquae  Destillatae,  .  .  .  aa^iv. 
Solve.  Sig. — Ttpx  contain  gr.  v. 


Strychnine. 

R.  Strychninae  Sulphat.,  .  .  .  gr.  j. 
Aquae  Destillatae,  .  .  .  .  j|j. 

Solve  sine  alcohol.  Sig. — TTLx  contain 

gr-  ?V 


R  .  Strychninae  Sulphatis,  .  .  gr.  j. 
Aquae  Destillatae,  ....  trpccl. 
Solve.  Sig. — rrpv  contain  gr.  Dose, 
rr^v-viij. 


Notes. — Solutions  for  hypodermic  use  should  be  neutral  in  reaction,  neither  acid  nor 
alkaline;  and  freshly  prepared,  especially  solutions  of  the  alkaloids,  which  develop  a 
penicillium ,  which  grows  at  the  expense  of  the  alkaloid.  Aqua  Fontana ,  if  filtered,  is  a 
better  menstruum  than  Aqua  Destillata  which  has  been  kept  for  a  week,  and  frequently 
exposed  to  the  atmosphere.  To  run  the  least  risk  of  producing  a  sore  at  the  point  of 


CHLORODYNE. 


703 


injection,  use  very  fine  needles,  and  deliver  the  injection  into  the  areolar  tissue  beneath 
the  skin,  instead  of  into  the  skin,  as  lay  parties  generally  do  for  themselves.  I  have  given 
injections  of  Morphine  and  Atropine  to  a  dying  girl  3  and  4  times  daily  for  two  months, 
and  never  produced  a  sore.  Always  force  out  all  fluid,  and  wipe  the  needle-point  dry 
between  the  fingers,  before  returning  it  to  the  case ;  the  sebaceous  matter  on  the  fingers 
keeping  it  free  from  rust.  There  is  an  area  of  several  inches  square,  on  the  upper  and 
exterior  aspect  of  the  thigh,  just  below  the  great  trochanter  of  the  femur,  which  is 
remarkably  insensible,  being  sparingly  supplied  with  cutaneous  nerves.  (See  Fig.  307, 
Gray’s  Anatomy,  10th  English  edition.)  An  injection  delivered  in  this  area  will  not  be 
felt  by  the  patient.  Avoid  puncturing  a  vein  ;  if  you  do  so,  watch  the  patient  and  pre¬ 
pare  an  injection  containing  gr.  Jg-  of  Atropine  Sulphate,  to  administer  if  dangerous 
symptoms  arise.  Never,  except  under  special  circumstances,  administer  the  salts  of  Mor¬ 
phine  or  Atropine  hypodermically  to  children  less  than  15  years  of  age. 


CHLORODYNE. 

A  COMPARISON  OF  ITS  INGREDIENTS,  ACCORDING  TO  TEN  FORMULAE 
THEREFOR,  THE  QUANTITIES  BEING  CALCULATED  FOR  EACH 
FORMULA  TO  A  FOUR-OUNCE  MIXTURE,  OR  rq,  1920. 


Articles. 

Quantity  of  each  article 

in  a  5iv  mixture  as  per  the  formula  of 

Squire,  P.* 

Smith,  Edw.f 

Chandler. J 

U.  S.  Disp. 

Nat’l  Disp. 

* 

■in 

o’ 

0 

& 

G 

Oh' 

d 

$ 

Bartholow. 

Gilman. 

Brit  Phar.ff 

Morphine  Muriate,  .  .  . 

gr. 

1 

l6 

l6 

32 

33/4 

14 

16 

I31u 

4Fs 

4 

Chloroform, . 

m 

236 

192 

240 

372 

375 

207 

240 

247 

62 

240 

Chloral, . 

gr- 

.  . 

Ether, . 

m 

59 

96 

. 

. 

120 

62 

60  , 

Cannabis  Indica,  Tinct.,  . 

in 

. 

00 

250 

207 

20 

•  • 

,  # 

Cannabis  Indica,  Extr.,  . 

gr. 

, 

.  , 

32 

Hydrocyanic  Acid,  2  p.  c., 

in 

118 

192 

50 

50 

42 

90 

123 

62 

120 

Ol.  Menthae  Pip  ,  .  .  .  . 

m 

2 

6 

l6 

10 

8 

7 

7 

2 

2 

Capsicum,  Fluid  Extr.,  . 

m 

. 

. 

4 

Capsicum,  Tinct.,  .... 

in 

290 

.  . 

.  . 

37 

7 

120 

,  . 

62 

.  . 

Capsicum,  Oleo-res.,  .  . 

m 

. 

. 

4 

Alcohol, . 

m 

236 

810 

994 

IOIO 

690 

. 

247 

495 

240 

Hydrochloric  Acid,  .  .  . 

in 

. 

.  j. 

126 

62 

. 

30 

.  , 

Sugar,  Burnt, . 

gr. 

20 

Glycvrrhizae,  Extr.,  .  .  . 

gr. 

*47 

154 

240 

Acacia,  Mixture,  .  .  . 

HI 

.  . 

384 

Tragacanth,  Mucil.,  .  .  . 

in 

9°3 

Theriaca,  or  Syr.  Fusci,  . 

in 

236 

760 

. 

150 

247 

240  ; 

Syrup., . 

m 

.  . 

760 

.  . 

992 

744 

q.  s 

Glycerin, . 

in 

1033 

.  . 

818 

760 

. 

495 

Aqua, . 

m 

*  * 

126 

128 

*  * 

240 

•  • 

Total  No.  of  Minims,  .  . 

•  • 

1920 

1920 

• 

1920 

1920 

1920 

1920 

1920 

1920 

1920 

1920 

Adult  Dose, . 

m 

5-10 

5-3° 

*  * 

3_I° 

5-5 

5-30 

5-30 

5-15 

60 

5-io 

Morphine  in  Tflxv,  .... 

gr. 

1 

T55 

V& 

Ls 

x/4 

Iff 

Vs 

1 

T2S 

35 

!S5 

Note. — See  ante,  page  169,  for  remarks  on  this  preparation,  and  the  number  of  formulae  representing  it_ 
*  Author  of  “  A  Companion  to  the  Br.  Pharmacopoeia.” 
f  See  Hartshorne’s  “  Essentials,”  5th  ed.,  p.  625. 

\  Made  by  Eli  Lilly  &  Co.,  Indianapolis.  **  Parke,  Davis  &  Co.,  Detroit. 

'[2d  ed.,  page  430.  ff  Tinct.  Chloroformi  et  Morphinae,  B.  P. 


704 


PATENT  MEDICINES. 


PATENT  MEDICINES. 

Note. — These  formulae  have  been  published  from  time  to  time  in  various  journals  and 
formularies,  and  are  supposed  to  represent  the  preparations  designated.  The  name  of 
the  author  is  appended  in  each  case  when  known. 


Alcoholic  Strength  of  Quack  Bitters. 


Hostetter, . 43-20 

Drake  Plantation, . 30.24 

Rush, . 34-20 

Peruvian, . 22.40 

Hoofland, . 20.85 

Oxygenated . 19 .23 

California  Wine  Bitters,  ....  18.20 

Walker’s  Vinegar  Bitters, . 7.20 


Ayer’s  Ague  Cure. 

This,  according  to  Churchill’s  analysis,  is 
alleged  to  consist  of  a  syrupy  tincture  of 
Peruvian  Bark  with  Aromatics,  each  bottle  | 
holding  six  fluid  ounces,  and  each  fluid 
ounce  containing  3.2  grains  of  amorphous 
Cinchona  alkaloids,  3  grains  Cinchonia,  0.7 
grain  Cinchonidia,  0.8  grain  Quinia,  and 
I  grain  of  Quinidia. 


Ayer’s  Cherry  Pectoral. 

R.  Morphnue  Acetat.,  .  .  .  .  gr.  iij. 
Vini  Antim.  et  Potass.  Tartrat., 
Vini  Ipecacuanhae,  .  .  aa^iij. 
Tinct.  Sanguinariae  .  .  .  3  ij. 
Syr.  Pruni  Virginian.,  .  .  ^  iij. 


Ayer’s  Pills. 

Consist  of  Colocynth.  Gamboge  and 
Aloes,  coated  with  Starch  and  Sugar. 


Ayer’s  “  Recamier  Balm.” 

Zinc  Oxide, . lbs.  5. 

Glycerin, . dr.  2. 

Alcohol,  . oz.  2. 

Mercuric  Chloride,  .  .  oz.  4. 

Distilled  Water,  ....  qts.  64. 

(. Boston  He?' a  Id.') 


Ayer’s  “  Recamier  Cream.” 

Rice  Flour, . oz.  48. 

Zinc  Oxide, . oz.  60. 

Glycerin, . oz.  640. 

Cocoa  Butter, . oz.  48. 

Lard, .  oz.  48. 

Mercuric  Chloride,  .  .  .  oz.  4 

Make  32  pints.  [Boston  He?'ald.') 


Ayer’s  Sarsaparilla. 

Alcohol,  . fl.  oz.  3 

Pluid  Extr.  of  Sarsaparilla,  fl.  oz.  3 
Fluid  Extr.  of  Stillingia,  .  fl.  oz.  3 
P'luid  Extr.  of  Yellow  Dock,  fl.  oz.  2 
Fluid  Extr.  of  Podophyllum,  fl.  oz.  2 


Sugar, .  oz.  I 

Iodide  of  Potassium,  .  .  grs.  90, 

Iodide  of  Iron, . grs.  10. 

Mix. 


Ayer’s  “Vita  Nuova.” 

Cocaine,  . gr.  8. 

Pepsin  (golden  scale),  .  .  gr.  48. 

Port  Wine, . gall.  1. 

[Bosto?i  Herald.') 


Brandreth’s  Pills. 

R  .  Podophylli  Radicis,  .  .  gr.  x. 
Extracti  Podophylli,  .  .  gr.  x. 
Extr.  Phytolacca;  Baccse,  gr.  xxx. 


Pulv.  Caryophylli,  .  .  .  gr.  x. 

Cambogiae, . gr.  ij-v. 

01.  Mentha;  Piperitse,  .  .  npiij. 
Croci,  gr.  ij. 


Misce,  fiat  masse,  et  div.  in  pil.*xxiv. 

[Hager.) 

Castoria 

is  a  mixture  of  Senna,  Pumpkin-seed, 
Anise,  Levant  Wormseed,  Rochelle  Salts, 
Sodium  Bicarbonate,  Sugar,  Od  Gaultheria, 
Oil  Peppermint,  and  Water. 

[Deutsch  Am.  Apothek.  Zeil.) 


“  Double  Chloride  of  Gold.” 

For  drunkenness  and  the  opium  habit. 
The  composition  is  said  to  be  as  follows: — 

R.  Chloride  of  Ammonium,  .  gr.  1. 

Aloin, . gr.  2. 

Compound  Tincture  of 

Cinchona . fl.  5  3. 

Water,  sufficient  to  make,  fl.  5  4. 


Ely’s  Cream  Balm 

consists  of  Vaseline,  1  ounce  ;  Thymol,  3 
grains;  Carb.  Bismuth,  15  grains;  Oil  Win- 
tergreen,  2  minims.  The  directions  are  to 
dip  the  little  finger  into  the  balm  and  insert 
up  the  nostrils,  giving  two  or  three  full  in¬ 
halations.  [Medical  Record.) 


PATENT  MEDICINES.  705 


Hamburg  Tea. 


$ .  Sennae  Foliorum, . pt.  viij. 

Mannae, . pt.  iv. 

Coriandri, . pt.  j. 


Hamlin’s  Wizard  Oil. 


R.  Spt.  Camphorae, . ^j. 

Spt.  Ammonia, 

Olei  Sassafras,  ....  aa  ^  ss. 

Olei  Caryophylli, . 3  ij. 

Chloroformi, 

Olei  Terebinthinae,  .  .  aa  3  ss. 
Alcoholis,  ......  ad  ^  v. 


Helmbold’s  Buchu. 

Said  to  resemble  the  genuine. 


Short  Buchu, . oz.  9. 

Uva  Ursi, . oz.  4^. 

Licorice  root, . dr.  10. 

Macerate  in  9  pints  of  boiling  water, 

strain  and  add — 

Caramel, . .  .  oz.  2. 

Molasses, . oz.  8. 

Mix  well  and  add  — 

Cubeb  (fluid  extract)  .  .  .  oz.  5. 

Alcohol, . pts.  2. 

Peppermint  Oil, . oz.  1. 

Water,  sufficient  to  make  .  pts.  12. 


( Lillard's  Prac.  Hints  and  Formula.} 


Holloway’s  Pills. 

R  Aloes,  powdered, . gr.  36. 

Jalap,  powdered, 

Ginger,  powdered, 

Myrrh,  powdered,  of  each,  gr.  18. 
Mix. 


Hostetter’s  Bitters. 

R .  Sacchari  Albi, 

Aurantii  Corticis, 


Calami, 

Cinchona?, 

Gentianae, 

Calumbae, . aa  Ihj. 

Rhei  Pulv., . 3  iv. 

Cinnamomi,  . ^  ij. 

Caryophylli, . 3  j. 

Alcoholis  Diluti, . C  ij. 


( Med .  Bulletin ,  1884.) 


Laville’s  Gout  Mixture. 

Calcium  Chloride,  Chinoi- 


din,  each . grm.  5- 

Extract  Colocynth,  .  .  .  grm,  2.5 

Water, . grm.  85. 

Alcohol, . grm.  100. 

Spanish  Wine, . grm.  800. 

Made  into  a  solution.  A  pill  of  very 
complicated  composition  is  used  in  connec¬ 
tion  with  the  gout  remedy.  ( Hager .) 

See  also  page  185,  ante. 


Morrison’s  Pills. 


Powdered  Colocynth,  . 

•  •  gr- 

3- 

Powdered  Gamboge.  . 

.  .  gr. 

6. 

Powdered  Aloes,  .  . 

•  -  gr- 

9- 

Cream  of  Tartar,  .  .  . 

.  •  gr- 

12. 

Syrup  enough  for  12  pills.  Serious  re¬ 
sults  are  often  produced  by  large  doses  of 
these  pills. 


Orange  Blossom. 


Zinc  Sulphate, . gr.  60. 

Alum, . gr-  15- 

Oil  Almond  Exp.,  .  .  .  .  gr.  90. 

Extract  Hyoscyamus,  .  .  .  gr.  1. 

White  Wax, . gr.  30. 

Oil  Theobroma, . gr.  180. 


Made  into  oblong  suppositories,  one  inch 
long,  one  and  a  half  wide  and  half  an  inch 
thick,  weighing  32  grains  each. 


Perry  Davis’s  Pain  Killer. 


Tinct.  Capsici, 

. 3J- 

Spt.  Camphorae,  . 

. 3'j- 

Guaiaci  Resinae,  . 

•  -  -  •  3SS- 

Alcoholis,  .  .  , 

. 1  iij 

Tinct.  Myrrhae,  q. 

s.  ad  coloret. 

Pierce’s  Favorite  Prescription. 

R  .  Sabinae,  Cinchonce, 

Agarici  Albi,  ....  aa  ^ij. 

Cinnamomi, . gr.  xv. 

Coq.  in  aq.  suff.,  ut  ft.  decoct.  5  viij. 
Deinde  cola,  et  adde — 


Sacchari  Albi, . 3SS. 

Acaciae, . 3J- 


Solve,  et  addantur — 

Tinct.  Opii  Deodorat., 

Tinct.  Digitalis,  ...  aa  3  ss. 

01.  Anisi,  gtt.  viij,  in  Alco¬ 
holis,  . 5jss‘ 

Misce.  (Hager.) 


45 


7  o6 


PATENT  MEDICINES. 


Pierce’s  Golden  Discovery. 


R.  Ext.  Lactuci, . g  j. 

Mellis, . .  .  .  ^j. 

Tinct.  Opii  Deodorat.,  .  .  %  ss. 

Alcoholis  Diluti . g  iij. 

Aquae, . 5  iij. 

{Hager.') 


Radam’s  “Microbe-Killer.” 

Oil  of  Vitriol  (impure),  .  .  dr.  4. 
Muriatic  Acid  (impure),  .  .  dr.  1. 

Red  Wine, . oz.  1. 

Water, . gall.  1. 

(. Eckels .) 

Radway’s  Ready  Relief. 

R .  Tinct.  Capsici, 

Aquae  Ammoniae, 

Alcoholis, . aa  ijj. 

Linimenti  Saponis,  .  .  .  .  Jiij. 

M.  ( Hager .) 


Radway’s  Resolvent. 

R .  Vini  Zingiberis, 

Vini  Cardamomi,  ...  aa  3  iij. 


Sacchari  Albi, . q.  s. 

M.  ( Hager .) 


Sage’s  Catarrh  Remedy. 

R  .  Salis  Culinaris(Sodii  Chlor.),  partes  xx. 
Pulv.  Camphorae,  ....  part.  j. 

Acidi  Carbolici, . part.  j. 

M. — To  be  dissolved  in  water  and  either 
injected  or  sniffed  up  the  nose. 


R  .  Pulv.  Hydrastis  Canadensis,  partes  v. 

Pulv.  Indigo, . part.  y2. 

Pulv.  Camphorae, 

Acidi  Carbolici,  .  .  .  aa  partes  ij. 

Sodii  Chloridi, . partes  L. 

M.  (New  Remedies.') 


Sanford’s  Catarrh  Cure. 

According  to  an  analysis  made  by  Prof. 
A.  B.  Lyons  for  the  Neza  Idea ,  this  prepa¬ 
ration  is  composed  of  distilled  extract  of 
Witch-hazel,  containing  a  little  Alcohol  and 
Glycerin  and  some  Morphine.  The  pro¬ 
portions  of  the  constituents  were  not  de¬ 
termined.  (Nat.  Druggist.) 


St.  Jacob’s  Oil  — Contimied. 
Another,  perhaps  more  nearly  correct : — 


Gum  Camphor, . oz.  1. 

Chloral  Hydrate, . oz.  1. 

Chloroform, . oz.  1. 

Sulphuric  Ether, . oz.  1. 

Tinct.  of  Opium, . oz.  y2. 

Oil  of  Origanum, . oz.  y. 

Oil  of  Sassafras, . oz.  y. 

Alcohol, . gal.  y2 . 


Dissolve  the  Gum  Camphor  in  the  Oils 
and  Alcohol,  then  add  the  other  ingredients. 

Squibb  says  that  it  is  a  weak  Aconite 
Liniment,  also  containing  Ether,  Alcohol, 
Turpentines,  red  coloring  matter,  and  water. 

(Ephemeris,  p.  114.) 


Swift’s  Specific  “  S.  S.  S.” 

Fluid  Extr.  of  Smilax  Sarsaparilla,  16  parts. 
Fluid  Extr.  of  Stillingia  Sylvatica,  16  parts. 
Fluid  Extr.  of  Lappa  Minor,  .  .16  parts. 
Fluid  Extr.  of  Phytolacca  Decan- 

dra, . 16  parts. 

Tinct.  of  Xanthoxylum  Carolini- 

anum, . 8  parts. 

(Registered  Pharmacist.) 

Stearns’  New  Idea  gives  the  following  : 
Stillingia,  Pokeroot  and  Sarsaparilla,  with 
Nitrate  of  Potash  and  a  small  quantity  of 
Iron  and  enough  Alcohol  to  preserve  it. 


Tamar  Indien. 

According  to  the  Report  de  Pharmacie, 
the  formula  for  this  preparation  is  as  fol¬ 
lows  : — 

Tamarind  (pulp),  450;  powd.  Sugar, 
40;  powd.  Sugar-of-milk,  60 ;  pure  Gly¬ 
cerin,  50  (all  parts).  Mix  and  evaporate 
to  the  consistence  of  a  soft  extract,  then 
add  powd.  Anise,  10  ;  Ess.  Lemon,  3  ;  Tar¬ 
taric  Acid,  3  (all  parts).  Mix  and  divide 
into  100  boluses.  Roll  in  the  following 
mixture :  Cream  of  Tartar,  5  ;  White  Su¬ 
gar,  35  ;  Sugar-of  milk,  35  ;  Tragacanth,  2  ; 
Tartaric  Acid,  2;  powd.  Red  Sandal,  25 
(all  parts).  Dry  and  put  up  in  tin  foil. 

(American  Druggist.) 


St.  Jacob’s  Oil. 

Said  to  be  composed  as  follows  : —  R  . 

Sulphuric  Ether . oz.  3. 

Oil  of  Turpentine,  .  .  .  .  oz.  50. 

Oil  of  Origanum, . oz.  3. 

Oil  of  Lavender, . oz.  1. 

Alkanet  Root,  sufficient  to  color. 


Thompson’s  Eye-Water. 

Sulphate  of  Copper,  .  .  .  gr.  10. 
Sulphate  of  Zinc,  .  .  .  .  gr.  40. 

Rose-water, . pints  2. 

Tincture  of  Saffron,  ....  drchm.  4. 
Tincture  of  Camphor,  .  .  .  drchm.  4. 
Mix  and  filter. 


THE  TREATMENT  OF  POISONING. 


707 


Van  Buskirk’s  Sozodont. 


R.  Saponis  Albi, . g  ss. 

Alcoholis, . 

Aquae . 3  vj 

Glycerini, . spj. 


Olei  Gaultheriae, 

Olei  Caryophylli, 

Olei  Menthae  Piperitae, 

aa  q.  s.  ad  saporem  grat. 
Cocci  Cacti,  q.  s.  ad  coloret. 


R  .  Calcis  Praecipitat., 

Magnesia  Carbonatis, 

Indis  Florent.  Radicis, 

aa  p.  aeq. 

M.  et  trit.  ( Hoffmann .) 


Walker’s  Vegetable  Vinegar  Bitters. 

R.  Aloes  Socotrin., . 5  ij. 

Guaiaci  Resinae,  .  .  .  .  3  iv. 

Sassafras  Mucil.,  .  .  .  .  ^j. 

Aceti, . 3  ij. 

Aquae, . q.  s. 

Coque,  et  ft.  decoctum,  ad  5  xix, 
deinde  cola,  et  addantur — 


Walker’s  Bitters — Continued. 


Sodii  Sulphatis,  .  .  . 

Acaciae, . 

Spt.  Anisi,  10  p.  c.,  . 

Alcoholis, . 

M.  Dose  5  ij. 


5  J* 
.3U- 
7>  0* 

*7  • 

SJ-  . 


(. Eberbach .) 


Warner’s  Safe  Kidney  and  Liver  Cure . 

It  is  said  to  be  made  after  a  formula  of 
which  the  following  is  a  close  approxima¬ 
tion: — 

R.  Hepatica  (herb),  .  .  .  .  oz.  j. 

Boiling  Water, . pt.  j. 

Make  an  infusion;  strain  and 
dissolve  in  it :  — 

Extract  of  Taraxacum,  .  .  oz.  y2. 
Nitrate  of  Potassium,  .  .  gr.  320. 
Cool  and  add  [the  following 
mixture]  :  — 

Alcohol,  . fl.  oz.  2]/2. 

Glycerin,  . fl.oz. \]/2. 

Ess.  of  Gaultheria,  .  ,  .  drops  40. 

Water  enough  to  make  one  pint. 

This  formula  is  furnished  by  a  correspond¬ 
ent  of  the  Deutsche-A?nericanische  Apothe- 
ker  Zeitung  (in  No.  5  of  1884). 

[Am.  Druggist.) 


THE  TREATMENT  OF  POISONING. 

The  most  energetic  poisons  are  Hydrocyanic  Acid,  some  reptile  poisons,  Strychnine, 
and  Nicotine.  (See  pages  67,  288,  381.)  Those  usually  selected  for  criminal  purposes 
are  Arsenic,  Colchicum,  and  Tartarized  Antimony,  the  symptoms  of  which  resemble  those 
of  natural  disease. 

General  Principles  of  Treatment.  JeauneVs  General  Antidote. — R.  Liq.  Ferri 
Sulphaiis  (sp.  gr.  1.45)  3  ij  ss ;  Magnesite  Calcinat.  5  ij ;  Carbonis  Animalis  3  j ;  Aquae 

xx.  The  ingredients  should  be  kept  separate — the  solution  of  the  sulphate  in  one  ves¬ 
sel,  the  others  together.  When  needed,  the  former  should  be  added  to  the  latter  and 
violently  agitated.  Dose,  ^jss  to  3  iij.  This  is  a  perfect  antidote  to  Arsenic,  Zinc,  Digi- 
taline,  etc.  It  delays  the  action  of  salts  of  Copper,  Morphine  and  Strychnine,  and  slightly 
influences  compounds  of  Mercury.  It  is  valueless  for  Cyanide  of  Mercury,  Tartar  Emetic, 
Hydrocyanic  Acid,  Phosphorus,  or  the  caustic  Alkalies. 

Bellini,  of  Florence,  considers  the  Iodide  of  Starch  a  valuable  antidote  to  alkaline 
Sulphides,  earthy  Sulphides,  vegetable  and  caustic  Alkalies,  and  Ammonia.  In  the  first 
two  cases,  he  considers  it  superior  to  all  other  antidotes. 

A  fresh  mixture  of  the  Sulphide  of  Iron,  Magnesia,  and  the  Sulphide  of  Sodium,  is  a 
perfect  antidote  for  salts  of  Copper,  the  Bichloride  of  Mercury  (Corr.  Sub.),  and  the 
Cyanide  of  Mercury. 

If  the  nature  of  the  poison  is  unknown,  a  harmless  yet  in  most  cases  effectual  antidote 
is:  R.  Magnesiae,  Carbonis  Ligni,  Ferri  Oxidi  Hydrati,  aa  partes  sequales;  Aquae  q.  s. 
Give  ad  libitum. 

Castile  Soap,  dissolved  in  4  times  its  bulk  of  hot  water,  drunk  by  the  cupful,  is  one  of 
the  best  remedies  in  many  cases,  especially  poisoning  with  metals,  corrosive  acids  or  cor¬ 
rosive  vegetable  substances.  It  is  injurious  in  cases  of  alkali  poisoning. 

Albumen.  White  of  egg,  dissolved  in  water,  is  especially  useful  for  metallic  substances. 


yo8 


THE  TREATMENT  OF  POISONING. 


Vinegar ,  for  alkalies,  and  many  narcotics.  Coffee ,  made  strong  (black),  in  general  anti¬ 
doting  narcotic  poisons.  Camphor ,  the  principal  antidote  to  all  vegetable  poisons,  espe¬ 
cially  the  corrosive.  Afilk,  Oil ,  Mucilaginous  Substances ,  for  corrosive  acids,  and  alkalies. 
Charcoal ,  for  Arsenic,  Corrosive  Sublimate,  etc. 

E/nelics. — Zinc  Sulphate  is  the  best(R.);  gr.  v-^ss;  is  non-nauseating.  Apomor- 
phine ,  gr.  hypodermically,  when  narcosis  prevents  administration  by  stomach.  For 
children,  Antim.  Tart.  gr.  in  a  little  sweetened  water.  Use  but  little  water  in  mixing 
the  antidotes. 

Antidote  Bag,  designed  by  Martindaleof  London,  contains  the  following-named  articles, 
labeled  with  directions  for  use,  viz. — 


Iron. 


Dialysed 
Syrup  of  Chloral. 
Chloroform. 

Spt.  Chloroformi. 


Spt.  Ammonise  Aromat. 
Oil  of  Turpentine. 
Acetic  Acid. 

Tinct.  Digitalis. 


Amyl  Nitrite. 

Zinc  Sulphate. 
Ipecacuanha. 
Potassium  Bromide. 


Calcined  Magnesia. 


Tannic  Acid. 


Also  a  Hypodermic  Syringe  and  Solutions  therefor  of — 

Morphine  Acetate.  »  Pilocarpine  Nitrate. 

.  0  .  ,  .  Apomorphine.  ~  ,  K 

Atropine  Sulphate.  r  r  Strychnine  Nitrate. 


Acids.  Alkalies ,  for  those  least  irritating.  Magnesium  Oxide,  Slaked  Lime ,  chalk, 
or  magnesia;  plaster  from  wall,  with  water,  milk,  oil,  white  of  egg.  Bland  mucilaginous 
and  oily  fluids,  and  poultices  (R.).  Acetic. —  Magnesia,  or  its  carbonates.  Arsenious; 
see  Arsenic.  Carbolic. — Stomach-pump;  a  strong  solution  of  the  official  Syrup  of  Lime. 
Magnesium  or  Sodium  Sulphate,  up  to  2;  iij,  to  form  a  sulpho-carbolate,  is  a  very  efficient 
antidote.  Atropine  is  a  good  physiological  antagonist  (B.).  Characteristic  symptoms, 
very  dark,  black  urine.  When  used  locally  to  excess,  apply  a  strong  solution  of  Sodium 
Carbonate;  also  as  a  wash  for  the  mouth,  if  necessary.  Carbonic;  see  Gas.  Hydro¬ 
cyanic  (Dilute). — rt^xl  have  killed.  Ammonia,  in  any  form  ;  cold  douche  ;  Calcium  or 
Sodium  Chloride,  gtt.  xxx-xl,  in  water;  Aqua  Chlori  is  the  antidote.  Inhalations  of 
Chlorine  or  Ammonia;  artificial  respiration.  Muriatic,  Nitric,  or  Sulphuric. — Albu¬ 
men,  Carbonate  of  Magnesium,  Calcium,  Potassium,  or  Sodium,  Chalk,  Soap,  or  whiting, 
in  milk  ;  Oil.  No  water  in  Sulphuric  cases.  Oxalic. — Calcium  Carbonate  the  antidote 
(R.) ;  Magnesium  Oxide  (R.).  Prepared  Chalk,  plaster  from  ceiling,  or  common  whiting, 
made  into  a  creamy  paste  with  a  little  water.  Bland  mucilaginous  drinks,  and  pouliices 
to  the  abdomen.  Avoid  potash  or  soda,  and  all  alkaline  carbonates.  “  Salts  of  Lemon,” 
or  of  “  Sorrel,”  is  Potassium  Oxalate,  used  for  removing  ink  stains;  it  should  be  treated 
as  Oxalic  Acid. 

Aconite  (compare  Belladonna).  Stimulants,  emetics,  Castor-oil  or  other  purgatives; 
powdered  animal  Charcoal,  in  water;  coffee.  Bland  fluids,  and  poultices,  for  abdominal 
irritation.  Digitalis,  to  restore  heart’s  action  (Fothergill). 

Alcohol.  [Compare  Alcoholism  and  Delirium  Tremens  in  Part  III.]  Cold  water 
smartly  sprinkled  over  face,  or  cold  douche  from  a  height  on  the  head  (R.).  Stomach- 
pump;  warmth  to  cardiac  and  gastric  regions,  and  extremities.  Artificial  respiration. 

Alkaloids.  Tannic  Acid,  holds  a  high  place  (P.). 

Alkalies.  Dilute  Acids,  especially  Vegetable  Acids;  fixed  oils  (R.).  Vinegar  unites 
with  them,  producing  innocuous  acetates  (L.). 

Alum.  Ammonium,  or  Potassium  Carbonates,  etc. 

Ammonium.  ( Common  Sources  of  Danger,  Spt.  of  Hartshorn,  Smelling  Salts, 
Liquor  Ammonise  kept  for  cleaning  purposes  by  housekeepers.)  Vinegar,  Lemon-juice, 
Orange-juice,  followed  by  demulcents.  If  vapor  has  been  inspired,  inhale  Acetic  or 
Hydrochloric  Acid. 

Antimony.  Alkalies,  Tannin,  or  strong  tea  and  coffee  (R.).  Astringent  infusions; 
Magnesium  and  Sodium  Carbonates;  milk;  large  draughts  of  warm  water;  emesis  by 
tickling;  Magnesia  in  milk,  especially  for  Chloride  of  Antimony.  Tannic  Acid  especially 
valuable  (P  ) 

Arsenic  (Arsenious  Acid).  Gr.  ij  have  been  fatal.  Magnesium  Bicarbonate ,  or  other 
alkalies  (R.).  Charcoal  5  ss,  or  more  (R.).  Magnesium  Oxide  (R.).  Emesis  by  Zinc 
Sulphate  (avoid  tartar  emetic),  or  by  feather  tickling.  Albumen.  Oil  and  Lime-water 
mixed  (Ta) lor),  before  and  after  emesis.  Milk  or  other  bland  fluids  to  aid  emesis  in 


THE  TREATMENT  OF  POISONING. 


709 


washing  stomach.  Castor-oil  after  emesis.  Linseed  tea  and  Magnesia.  Dialysed  Iron 
is  a  good  antidote,  especially  for  chronic  poisoning.  After  free  emesis,  the  Ferri  Oxidum 
Hydratum  (add  Liq.  Ammon,  to  Tinct.  of  Iron)  ;  Ferri  Subcarbonaie  just  as  good;  5  ij 
followed  by  01.  Ricini  (Leale);  or  Hydrated  Magnesia;  or  Magnesia  and  sugar  (Carl), 
as  antidotes.  Poultices  and  fomentations  over  abdomen.  Common  sources  of  danger  are 
arsenical  wall-papers,  arsenic  mistaken  for  “  salts  ”  or  “  magnesia,”  or  adulterated  confec¬ 
tionery;  Paris  Green  (Aceto-Arsenite  of  Copper)  taken  with  suicidal  intent. 

Barium.  Fixed  oils;  Calcium,  Magnesium,  Potassium,  or  Sodium  Sulphates. 

Belladonna,  or  Atropine.  (Compare  Aconite).  Opium  a  direct  antidote,  gtt.  iij-v 
or  more.  Brandy,  astringent  infusions,  Coffee.  Cold  to  head,  electricity,  flagellation, 
pepper.  Alkalies,  especially  Magnesium  Bicarbonate,  in  p  nsoning  by  alkaloids  (R.). 
Ammonia ,  breathed  into  air-passages  (R.).  Charcoal,  3  ss  or  more  necessary  (R.).  Phy- 
sosligma  possibly  (R.). 

Bees  and  Insects.  Aq.  Ammonias,  solution  of  Sodium  Bicarb.,  or  Chloride,  or  Car¬ 
bolic  Acid,  applied  to  the  wound  ;  or  rr^xv  of  a  2  per  cent,  s  flution  hypodermically,  Liq. 
Ammon.  Acetatis  internally.  [Compare  Stings,  in  main  Index,  Part  III.] 

Cannabis  Indica.  Stimulation  by  Brandy,  evacuation  of  stomach,  Strychnine  and 
Faradic  Electricity  are  antagonistic,  also  Lemon-juice  freely. 

Camphor.  Stimulants,  as  wine,  and  Opium. 

Cantharis.  Emesis.  No  oils,  but  oleaginous  injections  into  bladder.  Warm  bath, 
Camphor,  Milk  copiously,  Broths,  Enemata  of  demulcents,  Opium. 

Chloral.  Strychnine,  the  antidote  (R.).  Hot  bath,  or  pack,  frictions,  stimulants,  arti¬ 
ficial  respiration.  Coffee,  fresh  air,  warmth  over  cardiac  region.  In  fact,  the  treatment 
of  narcoti-m. 

Chlorine.  After  emesis  with  warm  water,  give  milk,  white  of  egg,  flour  and  water, 
or  Lime-water;  Aqua  Ammonite. 

Chloroform,  or  Ether.  Fresh  air,  cold  effusions,  flagellation,  coffee,  electricity,  arti¬ 
ficial  respiration.  Amyl  ATitrite,  as  antidote  (Schuller).  Atropine ,  hypodermically  as 
antagonist  to  Ether  (Amidon  in  N.  Y.  Med.  Record,  May  2d,  1885);  is  equally  efficient 
in  chloroform  narcosis,  as  I  have  found  by  experience  (Potter).  Invert  patient,  draw  tongue 
well  forward  with  forceps,  then  compress  and  relax  chest ;  the  position  to  be  maintained 
until  breath  and  pulse  are  good  (Nelaton).  Ice  in  rectum.  Faradization  of  respiratory 
muscles.  If  swallowed,  use  stomach-pump,  then  Ammonia  and  warmth.  Liq.  Ammon. 
injected  (  rt^x-xl  aq.)  into  veins, — Bartholow  says  unsuccessfully. 

Colchicum.  Treatment  same  as  for  Aconite. 

Conium.  Alcohol,  etc. ;  external  warmth  after  evacuation  from  stomach. 

Copper.  Albumen,  gluten,  milk,  sugar,  Potassium  Ferrocyanide.  No  vinegar.  In 
absence  of  eggs,  give  a  thin  paste  of  flour  and  water. 

Creasote.  Mucilage,  Oil,  are  antidotes.  Ammonia  when  great  depression. 

Digitalis.  The  treatment  is  similar  to  that  for  Aconite.  Emetics,  brandy,  horizontal 
position;  galvanism,  in  bad  cases. 

Fish.  Capsicum,  Chloroform,  Potassium  Chlorate  freely;  Liq.  Ammon.  Acet.,  Opium. 

Gamboge.  Potassium  or  Sodium  Carbonate,  or  Magnesium  in  milk  ;  mucilaginous 
drinks,  Opium. 

Gases.  Carbonic  Acid. — Galvanism,  Oxygen  inhaled  ;  artificial  respiration  indis¬ 
pensable.  Ammonia  inhalations.  Sponge  with  brandy  or  alcohol  and  water.  Open  air, 
horizontal  position,  clothing  removed,  cold  douche,  hot  water  to  feet,  stimulants,  frictions. 
Subsequently,  warm  bed,  open  windows;  Condy’s  fluid  about  room  ;  stimulants  sparingly  ; 
cold  acid  drinks  ad  libitum.  Sulphuretted  Hydrogen. —  Chlorine  Gas,  well  diluted 
with  common  air. 

Gelsemium.  Galvanic  current,  stimulants,  Brandy  and  Cayenne  Pepper,  warm  baths, 
frictions,  hot  bricks  to  feet. 

Glass,  coarse  or  in  powder. — Much  bread  in  crumbs  to  envelope  it,  then  emetics. 

Gold.  Ferric  Sulphate,  Mucilage. 

Hyoscyamus.  See  Belladonna. 

Iodine.  Starch  or  flour  given  in  tepid  water;  white  of  egg  and  milk;  free  emesis,  so 
long  as  liquid  rejected  tinges  blue  a  solution  of  starch.  Sodium  Bicarbonate. 


7io 


THE  TREATMENT  OF  POISONING. 


Iron.  Carbonates  of  Ammonium  and  Sodium  ;  Magnesia  ;  Mucilaginous  drinks. 

Lead.  Albumen,  milk;  alkalies  especially  Magnesium  Bicarbonate  (R.).  Lukewarm 
drinks,  or  Sulphates  of  Sodium  or  Magnesium,  or  freshly  precipita’e  i  Ferric  Sulphate  (R.). 
Promote  vomiting;  stomach-pump  (R.).  Sulphicric  Acid  and  Magnesium  Sulphate ,  for 
the  constipation.  The  cachexia  is  much  relieved  by  a  combination  of  Sulphate  of  Quinine, 
Sulphate  of  Iron,  and  dilute  Sulphuric  Acid  (B.).  Potassium  Iodide ,  gr.  xv-xx  3  or  4 
times  each  day  (B.);  as  after  eliminative,  in  chronic  cases  (R.).  When  great  pain  at 
defecation  give  Extr.  Belladon.,  gr.  y%,  Rhei,  gr.  ij,  in  pill  twice  daily  ( Da  Costa).  Alum , 
the  most  effective  agent  for  the  colic.  [See  Colic  for  formula.]  Or  to  a  pint  of  boiling 
milk  add  90  grs.  of  alum,  powdered  ;  separate  the  curd,  and  sweeten  with  sugar.  Sig. — 
A  wineglassful  every  hour  or  two  (B.)  Electricity ,  in  the  paralysis  (dropped  wrist),  a 
slowly-interrupted  current  until  it  causes  reaction.  Cure  to  be  completed  by  the  faradic 
current  (B.).  Strychnine ,  in  paralysis,  gives  good  results  (B.).  Sulphides,  as  baths,  in 
chronic  form  (R.). 

Marked  Diagnostic  Signs. — Drop-wrist  (paralysis  of  extensor  muscles)  ;  dark-blue  line 
around  edges  of  gums. 

Lime.  Calcium  Chloride.  Albumen,  mucilaginous  drinks,  oils,  milk,  flour,  and 
water.  No  acids. 

Mercury.  Gr.  iij  of  Corrosive  Sublimate  have  proved  fatal.  Albumen,  Yolk-of  egg, 
vegetable  astringents,  gluten,  flour,  milk;  Potassium  Iodide ,  as  after-treatment.  The 
Hydrated  Protosulphide  of  Iron,  if  given  within  twenty  minutes,  is  said  to  be  a  chemical 
antidote.  Potassium  Iodide,  converts  the  metal  into  soluble  combinat'ons  (B.).  Bismuth, 
locally  in  salivation  (B.).  Sodium  Sulphite,  locally  3j-3J  aquae  (B.).  Tannic  Acid, 
locally,  as  gargle  in  salivation.  R .  Acidi  Tannici,  3  j,  Mel.  Rosae  3  ij,  Aquae  3  vj.  M. 
Gargle  (B.).  Belladonna,  to  diminish  secretion  in  ptyalism,  v-x  drops  of  tincture  every 
4  to  6  hours  (B.).  Hyoscyamine,  for  tremor,  gr.  3L  gradually  to  TC  (Oulmont).  Alkalies, 
Bicarb,  of  Magnesium  best  (R.).  Baths,  simple  or  sulphurous  (R.).  Charcoal,  3  ss  or 
more  necessary  in  poisoning  by  Corrosive  Sublimate  (R.).  Cod-liver  Oil,  in  chronic  cases 
(B.).  Nitric  Acid,  gtt.  ij  of  the  dilute  acid  in  water  ter  die;  also  gargles  of  lukewarm 
watef,  acidulated  with  same  (R.).  Sulphurous  Acid,  int.  and  as  gargle  (R-). 

Mezereum.  Albuminous  and  mucilaginous  drinks ;  milk,  oils,  and  fats;  albuminous 
enemata;  cool  poultices  to  abdomen;  Opium. 

Mushrooms.  Emetics,  if  soon  after  ;  Purgatives,  if  some  time  has  elapsed.  After 
general  treatment,  Stimulants,  unless  inflammatory  symptoms  present  themselves.  Poul¬ 
tices  to  abdomen.  Tannic  Acid  has  been  recommended. 

Opium  or  Morphine.  Common  Sources  of  Danger. — Soothing  Syrups  for  quieting 
of  children.  (The  American  Journal  of  Pharmacy  estimates  the  loss  from  this  cause  at 
150,000  every  year.)  Paregoric.  Overdosing  with  Cough-mixtures. 

Treatment. — Vegetable  astringents  ;  strongest,  hot  black  Coffee.  Cold  douche,  flagel¬ 
lation,  artificial  respiration,  persevered  in  for  hours.  Belladonna,  Hyoscyamus  or  Stramo¬ 
nium.  Faradism  of  phrenic  nerves ;  Stimulants.  Comp.  Tinct.  Iodine.  Emetics  by 
mouth  are  usually  useless,  may  be  given  as  enemata;  or  Apomorphine ,  gr.  ^  to  as 
emetic  (^hypoder.  TC),  must  be  administered  before  narcosis  has  set  in  (B.).  Stomach- 
pump  probably  best,  after  which  Vegetable  Acids,  to  contract  the  narcotism.  Cream  of 
Tartar  and  water,  Vinegar  and  water,  Leman-juice,  etc.,  every  ten  minutes  (R.).  Atropine, 
gr.  %-]/z  hypodermically  (R.) ;  gr.  TJ-0-  every  15  minutes  up  to  three  doses  (B.) ;  in  large 
amounts  till  pupil  dilates,  a  successful  antagonist  (R.).  No  one  is  warranted  in  omitting 
Belladonna  (P.).  -  Amyl  Nitrite,  inhaled,  has  proved  eminently  successful  in  a  case  in 
which  Belladonna  or  its  alkaloid  proved  useless  to  restore  the  patient.  Ammonia,  as 
intravenous  injection  for  failure  of  heart’s  action  from  Opium  and  Chloroform  narcosis,  etc. 
(B.)  ;  breathed  into  air-passages  (R.).  Potassizcm  Bromide,  controls  the  disagreeable 
cerebral  effects  and  vertigo  resulting  from  Opium  (R.,  B.).  IVa/er,  hot  water  and  ice 
alternately  to  nape  of  neck,  in  stupor  of  Opium-narcosis  (B.).  Copper  Sulphate,  as  emetic, 
prompt  and  effective  (B).  Zinc  Sulphate ,  gr.  vj  as  emetic,  well  diluted  with  water  (B.). 
Effervescent  Emetics,  effective  but  dangerous  (B. ).  Caffeine,  hypodermat.  (B.,  P.).  Heat, 
alternately  with  cold  (B.).  Charcoal,  3  ss  or  more  (R.). 

Phosphorus.  Emesis  by  Cupric  Sulphate ;  Magnesia  in  Linseed-tea  ;  Carbo  Animalis ; 
mucilaginous  drinks;  Liquor  Calcis.  Avoid  all  oleaginous  mixtures.  Poultices  to  epigas¬ 
trium.  Sulphate  of  Copper,  the  best  emetic,  combining  to  form  the  less  active  phosphide 
(B.).  Turpentine  emulsion  with  hydrated  Magnesia,  freely  (B.,  R.)  ;  TTLxxx  in  mucilage, 
every  hour,  excellent  (P.).  Transfusion,  has  been  employed  to  repair  blood  (B.). 


THE  TREATMENT  OF  POISONING. 


71  I 

Physostigma.  Minimum  fatal  dose,  grain  iy2^.  Chloral ,  the  antidote  (R.),  if  admin¬ 
istered  very  early.  Belladonna ,  gr.  to  Atropinse,  hypodermically  repeated  until 
effects  are  evident.  The  nine-thousandth  of  a  grain  of  Atropine,  injected  five  minutes 
before  giving  a  minimum  fatal  dose  of  physostigma,  prevents  its  fatal  effects  (R.). 

Picrotoxine,  or  Cocculus  Indicus.  Chloral ,  the  antidote  (B.). 

Potassium  Salts.  Potassium  Bromide.  Nervous  Stimulants — Brandy,  Opium. 
Potassium  Nitras  (Saltpetre), — No  chemical  antidote.  Emetics  and  stomach-pump, 
demulcent  drinks,  Opium,  milk,  aromatics,  emollient  enemata. 

Quinine.  Emetics  and  cathartics,  Opium,  Coffee,  Brandy,  or  wine,  diuretics  and  sudo- 
rifics  as  after-eliminatives. 

Reptiles.  (Compare  Stings.)  Ligate  limb  above  wound;  cleanse  thoroughly,  and 
cauterize  with  mineral  acids  or  strong  Carbolic.  The  w^ound  should  be  forcibly  sucked 
by  a  person  with  perfect  mucous  surface.  Internally,  Arsenic,  wrhen  rapid  prostration 
(R.)  ;  Ammonium,  diaphoretics,  Sodium  Bisulphate,  Whiskey,  largely.  Agave  Ameri¬ 
cana.  R.  Potass.  Iodidi  gr.  iv,  Hydrarg.  Chlor.  Corr.  gr.  ij,  Bromi  5  v,  Aquae  ;  gtt. 
x  in  £  %  °f  Brandy;  repeat  if  necessary  (Hammond).  Ammonia,  by  intra-  venous  injec¬ 
tion,  is  showm  to  be  unavailing  by  Brunton  and  Fayrer  (B.). 

Rhus  (Poison  Oak  or  Ivy), — Carbolic  Acid,  locally,  a  5  percent,  sol.  Sulphide  of 
Potassium ,  baths,  5  j  to  C  xx.  Lobelia ,  as  infusion,  ^  j  ad  Oj,  a  good  application  locally. 
Grindelia,  the  fluid  extract,  I  part  to  10  of  water,  as  lotion;  may  be  used  undiluted. 
Cocaine ,  a  10  per  cent,  oleate,  or  a  5  per  cent,  solution  in  water,  as  a  local  application, 
promptly  relieves  the  symptoms.  Acetate  of  Lead,  gij,  Ammonii  Chloridi  (crude)  2j  ss, 
Aquae  %  viij,  as  lotion  on  cloths  constantly  wetted  therewith,  used  with  uniform  success 
(Burns).  Soapsuds  and  w'ater,  hot,  frequent  wrashing  with  this  the  surest,  speediest,  and 
best  treatment  (Couch). 

Silver  Nitrate.  Alkalies,  especially  the  Magnesium  Bicarbonate  (R.).  Sodium  Chlo¬ 
ride,  largely  diluted,  effects  a  double  decomposition,  precipitating  the  silver  as  the  harmless 
insoluble  chloride  (R.).  The  resulting  irritation  may  be  allayed  by  milk,  which  should 
serve  as  food  until  the  stomach  is  restored. 

Silver,  Metallic.  Albumen,  Milk. 

Stramonium.  See  Belladonna. 

Strychnine  or  Nux  Vomica.  Fatal  dose  of  strychnine  gr.  yz  for  adult,  gr.  for 
child.  Chloral,  the  antagonist,  especially  when  given  soon.  Physostigma,  as  an  anti¬ 
dote  (R  ).  Chamomile  Oil,  remarkably  subdues  reflex  excitability  in  frogs  after  poison¬ 
ing  by  Strychnine  or  Brucine  (P.).  Tobacco,  a  good  antagonist.  The  Stomach-pump,  if 
available  before  tetanic  symptoms.  Animal  Charcoal,  largely  ;  Tannin  freely  ;  Solution 
of  Iodine.  Chloroform  Inhalations,  injections  of  Curare,  or  Urethan,  or  Methyl  and 
Ethyl  compounds  of  Strychnine,  Brucine,  or  Thebai'ne.  Artificial  respiration;  fats; 
Nitrite  of  Amyl,  inhaled  ;  Magnesia  (R.).  Tube  in  oesophagus,  and  flexible  catheter 
into  larynx  (R.).  Veratrum  Viride  has  cured  a  bad  case;  a  teasp.  was  given  at  once, 
then  gtt.  ij  every  10  minutes  (R.).  Ice  to  spine.  Tobacco  enemata.  Lobelia,  Potassium 
Bromide,  Monobromated  Camphor,  hot  bath.  Valerian  mitigates  the  spasms  (P.). 
Curare,  warmly  recommended,  but  its  claims  are  doubtful  (P.).  Nicotine,  many  cases 
prove  its  curative  powder  (P.). 

Tin.  Albumen,  Ammonium  and  Sodium  Carbonates,  Milk. 

Tobacco.  Strong  Coffee  and  Brandy;  warmth  and  friction;  artificial  respiration. 

Vegetable  Poisons.  Generally  albuminous  or  mucilaginous  drinks,  oils,  etc.  Stimu¬ 
lants,  Opium ,  ice  ;  cool  poultices  and  fomentations  to  abdomen. 

Veratrum  Viride.  Digitalis,  Opium,  Stimulants. 

Zinc.  Albumen,  mucilaginous  drinks,  milk,  Tannin.  Potassium  and  Sodium  Carbo¬ 
nates,  if  given  early.  Soapsuds  given  freely.  Warm  water  in  copious  draughts. 


712 


FORMS  OF  BRIGHT’S  DISEASE. 


DIFFERENTIAL  DIAGNOSIS. 


Forms  of  Bright’s  Disease. 


Compared  with  Acute  Nephritis  and  with  each  other. 


Clinical  Phenomena. 

Acute  Nephritis. 

(1)  Acute 
Bright’s 
Disease. 
*Acute 
Parenchy. 
Nephritis. 

Chronic  Bright’s  Disease. 

(2)  Chron. 
Parenchy. 
Nephritis 
{Large 
White 
Kidney ) . 

(3) 

Fatty 

Kidney. 

(4) 

Amyloid 
or  Waxy 
Kidney. 

(5)  Chron. 
Interstitial 
Nephritis 
( Cirrhotic 
Kidney ).  ; 

Quantity , . 

Normal 
or  — 

— 

—  or  + 

Normal 
or  — 

Normal 
or  + 

Normal 
or  + 

Reaction ,  . 

Acid. 

Acid. 

Acid. 

Acid. 

Acid. 

Acid. 

Color, . 

Wine 

yellow. 

Dark 

smoky. 

Brown 

yellow. 

Pale. 

Pale. 

Clear. 

Sp.  Gr., . 

Normal 
or  — 

High. 

1. 01 5-1.030 

— ,  above 
1. 010 

-  I. OIO 

Urea,  . 

W 

z 

Normal. 

— 

— 

Normal 
or  — 

Normal.  1 

Chlorides, . 

Normal. 

— 

— 

— 

Normal. 

Albumen  {per  cent  ),  .  .  . 

Iff  t0  B 

1  to  6 

Yz  to  2 

1  to  6 

Ttf  to 
of 

globulin. 

xV  to  ^ 

Casts, . 

Hyaline 

and 

Epithel. 

Blood 

Epithel. 

Hyaline. 

Granular 
Hyaline. 
No  blood. 

Fatty. 

Few  and 
hyaline. 

Very  few. 

Sediment  (macroscopical). 

Mucus. 

Blood. 

Brown 

cells. 

Urates. 

Kidney 

epithel’m. 

Blood 

Lymph. 

Free  oil. 

Seldom 

any. 

Seldom 

any. 

Dropsy, . 

Seldom. 

Great, 
especially 
of  face. 

Never 

absent. 

Great. 

Trifling. 

In  last 
stages. 

;  Uremia,  . 

Often 

great. 

Not 

marked. 

Rare. 

Rare. 

Great. 

Other  Symptoms, . 

Stiff 

joints. 

Sacral 

pain. 

Lassitude. 

Fever. 

Tempera¬ 
ture  low. 
No  fever. 
Inflam,  of 
serous 
membr’s. 
Cardiac 
hyper. 

Face  pale, 
puffy. 
Cardiac 
hyper. 

Emacia¬ 
tion,  sal¬ 
low  face, 
enlarged 
liver  and 
spleen, 
thirst, 
diarrhoea. 

Retinitis. 

Tense, 

quick 

pulse. 

Hyper,  of 
heart. 

Prognosis, . 

Favorable. 

Recovery 
or  No.  2. 

Recovery 
(?)or  No. 3. 

Always 

fatal. 

Depends 
on  con¬ 
stitutional 
disease 
present. 

Unfavor¬ 
able,  but 
course 
perhaps 
long. 

Note. — The  signs  -f  and  —  respectively  denote  a  specific  gravity  greater  than  1.024,  or  less  than  1.018, 
in  the  line  entitled  Sp.  Gr. 


DIFFERENTIAL  DIAGNOSIS. 


713 


Cancer. 


Cancerous  ( Malignant )  Tumors. 

Are  of  constitutional  origin. 

Have  no  cyst,  but  invade  and  convert  the 
surrounding  tissues. 

Cancer  material  is  short-lived  from  rapid 
deterioration,  but  is  rapidly  reproduced. 
Severe  increasing  pain. 

Extend  to  remote  parts,  reappearing  chiefly 
in  lymphatic  glands. 

Cancerous  cachexia  of  general  health. 
Recur  after  extirpation,  fatal  in  end. 

Scirrhus. 

Is  hard. 

Appears  mostly  on  female  breast. 

Hard  kernel,  movable  under  skin. 

Becomes  fixed  to  adjoining  structures,  which 
it  puckers. 

Single  and  grows  slowly. 

Course  slow — 2-4  years. 

Never  in  the  young. 


Non- malignant  Tumors. 

Origin,  some  local  error  of  growth. 

Limited  by  a  cyst;  may  compress,  but  do 
not  invade  adjacent  tissues. 

Have  uncertain  period  of  increase,  after 
which  may  remain  stationary. 

Usually  no  pain. 

Are  local,  have  no  disposition  to  spread. 

Impair  functions  of  parts  pressed  on. 

Do  not  recur. 

Encephaloma. 

Is  soft  and  brain-like. 

Most  frequently  on  the  limbs. 

At  first  deeply  seated,  hard  to  recognize. 
Spreads  through  loose  textures,  which  it 
pushes  aside  and  distends. 

Has  numerous  tumors,  grows  rapidly. 
Generally  fatal  in  1-2  years. 

Often  in  the  young,  even  at  birth. 


Carditis. 


Endocarditis. 

Blowing  sound.  Excited  heart  action. 
Slight  if  any  increase  of  percussion  dulness. 
Impulse  strong. 

Sounds  normal,  or  more  distinct,  except  at 
site  where  murmur  is  heard. 


Pericarditis. 

Friction  sound.  Excited  heart  action. 
Marked  increase  in  effusion  stage. 

Wavy  and  feeble. 

i  Feeble  and  muffled  ;  no  blowing  sounds. 


Cerebral. 


Concussion. 

Patient  can  be  roused ;  pupils  act. 
Breathing  seldom  stertorous. 

Urinary  action  normal. 

Symptoms  appear  closely  after  accident. 


Compression. 

Complete  insensibility;  motionless  pupils. 
Breathing  usually  stertorous. 

May  be  either  retention  or  incontinence. 
Frequently  do  not. 


Chancre  and  Chancroid. 


Chancre. 

Commences  about  3d  week  after  coitus. 
First  as  a  papule,  abrasion,  or  crack. 

Generally  indurated  (rarely  not). 

Develops  slowly. 

Discharge  slight,  unless  irritated. 

Is  soon  limited  and  seldom  phagedenic. 

Edges  sloping,  not  undermined. 

Scanty  serous  secretion. 

Sore  remains  solitary,  and  cannot  be  multi¬ 
plied. 

Followed  by  numerous  buboes,  rarely  sup¬ 
purating,  never  furnish  inoculable  pus. 


Chancroid. 

Tn  24  hours  to  3  days. 

First  as  a  red  spot,  then  a  pustule,  then  a 
suppurating  sore. 

Not  on  an  indurated  base. 

Develops  rapidly. 

Suppurates  profusely. 

Tends  to  invade  surrounding  tissues,  or  be¬ 
come  phagedenic. 

Edges  undermined. 

Discharge  is  pus  and  copious. 

May  be  transplanted  at  will,  and  is  seldom 
single. 

A  single  bubo  may  appear  and  suppurate. 


7H 


DIFFERENTIAL  DIAGNOSIS. 


Cholera. 


Asiatic. 

Preceded  by  painless  diarrhoea. 

Not  directly  from  error  in  diet. 

First  pain  shooting  down  thighs. 

Prostration  rapid  and  overwhelming,  and 
out  of  ratio  to  evacuations. 

Rapid  reduction  of  surface  temperature ; 

high  temperature  in  cavities. 

Evacuations  like  rice-water  from  first. 

Cramps  commence  in  extremities. 

Veins  congested  ;  tongue,  lips,  and  extremi¬ 
ties  livid  purple. 

Urine  albuminous. 


Simple. 

Seizure  sudden. 

Generally  is  from  error  in  diet. 

First  pain,  abdominal  colic. 

Prostration  gradual,  less  marked  than  the 
vomiting  and  purging. 

Gradual  reduction  of  surface  temperature ; 

internal  temperature  normal. 

Discharges  bilious,  causing  burning  and 
smarting  pain  ;  only  colorless  at  very  last. 
Cramps  commence  in  abdomen. 

Not  so. 

Not  so. 


Croup  and  Diphtheria. 


Croup. 

•  Premonitory  hoarse,  metallic  cough,  with¬ 
out  illness. 

A  child’s  disease. 

Tenacious  mucus,  covers  the  swollen  mem¬ 
brane. 

A  local  disease. 


Diphtheria. 

Premonitory  illness,  shivers,  fevers,  sore 
throat,  without  cough. 

Attacks  adults  as  well. 

Distinguished  by  a  false  membrane. 

A  blood  poison  ;  great  general  depression. 


Epilepsy  and  Hysteria. 


Epilepsy. 

Sudden,  complete  loss  of  consciousness. 

Livid  face,  frothy  saliva  escapes,  eyelids 
half  open,  eyeballs  rolling,  teeth  grind¬ 
ing,  tongue  biting  ;  more  or  less  insensi-  j 
bility  of  pupils  to  light. 

Countenance  is  distorted. 

Patient  shows  no  feeling. 

Aura  epileptica. 

Short  paroxysm,  followed  by  heavy  coma¬ 
tose  sleep  and  dull  intellect. 

Frequently  occurs  at  night. 

Not  necessarily  of  uterine  connection, 
though  a  paroxysm  often  occurs  at  the 
menstrual  period. 


Hysteria. 

Gradual  and  partial  or  apparent. 

Face  flushed,  or  complexion  unaltered,  no 
froth  on  lips,  eyelids  closed,  eyeballs 
fixed,  no  grinding  of  teeth,  or  biting  of 
tongue  ;  pupils  react  readily. 

Is  not. 

Sighs,  or  laughs,  or  sobs. 

Globus  hystericus. 

Longer  paroxysm,  not  sleepy,  but  usually 
wakeful  and  depressed  in  spirits. 

Rarely  occurs  at  night. 

Often  connected  with  uterine  or  menstrual 
disorders. 


Gout  and  Rheumatism. 


Gout. 

Chiefly  affects  small  joints,  especially  the 
metatarsal  joint  of  the  great  toe. 

From  35-50  years;  rarely  before  puberty. 

Most  frequent  in  men,  and  result  of  idle, 
intemperate  and  luxurious  life. 

Is  strongly  hereditary. 

Chalk  stones  (urate  of  soda)  in  ext.  ear,  on 
tops  of  fingers,  or  elsewhere. 

Uric  acid  in  the  blood,  absent  from  urine. 

A  fit  often  affords  temporary  relief. 

Is  confined  to  temperate  zone. 


Rheumatism. 

Large  joints  chiefly  implicated. 

Generally  in  young  adults. 

Affects  both  sexes  equally,  and  equally  the 
poor  and  the  rich. 

But  slightly  so. 

Not  so. 

Lactic  acid  in  the  blood. 

Quite  the  contrary. 

Is  ubiquitous — prevails  in  all  climates. 


DIFFERENTIAL  DIAGNOSIS. 


715 


Hematemesis  and  Hemoptysis. 


Hematemesis. 

If  from  the  stomach,  the  blood  is  of  a  dark 
color,  and  is  vomited. 

Often  mixed  with  food,  not  froth. 

Preceded  by  nausea  and  stomach  distress, 
and  blood  is  passed  with  the  stools. 


Hemoptysis. 

If  from  the  lungs,  it  is  bright  red,  and 
generally  coughed  up. 

Generally  frothy,  mixed  with  sputa. 
Preceded  by  pain  in  the  chest  and  dyspnoea. 
No  blood  in  the  stools. 


Pleurisy  and  Pneumonia. 


Pleurisy. 

Sharp  pain,  friction  sound,  dry  cough,  im¬ 
paired  chest  motion. 

In  stage  of  effusion,  obliteration  of  inter¬ 
costal  spaces,  enlargement  of  the  side, 
viscera  displaced. 

Dulness,  with  enfeebled  or  absent  respira¬ 
tion,  voice,  and  fremitus. 

Sputa  frothy,  rarely  any  rales. 

Febrile  symptoms  slight  usually. 

Temperature  irregular,  rarely  high. 


Pneumonia. 

Dull  pain,  crepitant  rale,  cough  followed 
by  expectoration. 

In  stage  of  hepatization  none  of  these 
signs  are  present. 

Dulness,  with  marked  bronchial  respira¬ 
tion,  distinct  thoracic  voice,  increased 
vocal  fremitus. 

Sputa  rusty  color,  rales  common. 

Febrile  symptoms  severe. 

Sudden  elevations  and  falls,  high  tempera¬ 
ture  not  uncommon. 


Phthisis. 


Tubercular. 

First  symptom,  a  dry,  short  cough. 

No  exciting  cause  apparent. 

Hereditary  cases  are  of  this  class. 
Frequently  preceded  by  enlarged  or  sup¬ 
purating  glands,  or  other  evidence  of 
scrofula. 

Voice  changes  from  tubercular  deposit. 


Non-  Tubercular. 

First  stage  follows  catarrh,  bronchitis,  or 
some  other  acute  disease. 

Is  referable  to  some  exciting  cause,  as  cold, 
inflammation,  or  inhaling  of  heavy  dust. 
Not  hereditary. 

No  evidence  of  scrofula. 

No  change  of  voice. 


Scarlet  Fever. 

Incubation  I  day  to  weeks. 

Fever,  great  heat  of  skin, 
and  frequent  pulse,  un¬ 
abated  during  eruption. 

Brilliant  stare. 

Eruption  on  second  day,  not 
rough,  first  on  neck  and 
chest,  spreads  rapidly, 
white  streak  on  pressure 
with  nail. 


Exanthemata. 

Measles. 

Incubation,  7-14  days. 

Same  fever  rather  increased 
by  eruption. 

Liquid  watery  eye. 

On  fourth  day,  on  face, 
rough,  spreads  gradually, 
streak  lasts  short  time. 


Small- pox. 

Incubation,  6-20  days, 
Average  10. 

Fever  often  violent,  bound¬ 
ing  pulse,  pain  in  loins, 
greatly  relieved  by  erup¬ 
tion. 

Usually  on  third  day,  at  first, 
on  lips  and  forehead, 
spreading  rapidly. 


DIFFERENTIAL  DIAGNOSIS. 


716 


Scarlet  Fever. 

Uniform,  or  large  patches, 
interspersed  raised  spots 
and  some  vesicles,  rash 
scarlet,  on  its  seventh  day 
very  complete  desquama¬ 
tion  in  large  patches. 

Sore  throat,  rarely  coryza 
or  bronchitis. 

“  Raspberry”  tongue,  red. 

Cerebral  symptoms  frequent 
and  grave. 

Temperature  may  be  1050- 
1220  to  10th  day,  subsides 
gradually,  falls  on  5th, 
10th,  and  15th  days. 

No  secondary  fever. 

Pneumonia  rare,  pleurisy 
more  frequent. 

Sequelae  :  Bright’s  disease, 
dropsy,  deafness,  conjunc¬ 
tivitis,  phthisis,  chronic 
diarrhoea  ;  glandular  en¬ 
largements. 


Measles. 

Crescentic  patches,  last 
about  5  days,  and  then 
partial  desquamation,  i 
scales  very  fine. 

Coryza  and  bronchitis  very 
constant,  rarely  sore  throat. 

Tongue  coated,  may  be  red 
at  edges. 

Not  so. 

io3°-io6  before  eruption, 
remains  high  for  1-2  days 
after,  then  falls  suddenly. 

None. 

Pneumonia  a  frequent  com¬ 
plication. 

Sequelae:  chronic  bronchitis, 
phthisis,  conjunctivitis. 


Small-pox. 

Papular,  then  vesicular, 
finally  pustular  ;  pustules 
maturate  on  8th  day  of 
eruption. 


Sore  throat  often  and  dry 
cough. 

Coated  and  swollen,  may  be 
red  at  edges. 

Cerebral  symptoms  are  fre¬ 
quent. 

Before  eruption  often  106°, 
then  rapidly  sinks  to  ioo° 
in  36  hours;  rises  during 
secondary  fever. 

Always  secondary  fever. 

Pneumonia  not  a  very  fre¬ 
quent  complication. 

Sequelae:  chronic  diarrhoea, 
glandular  enlargements, 
various  eye  diseases. 


Typhus  and  Typhoid. 


Typhus  Fever. 

Attacks  quickly,  incubation  9  days. 

Occurs  at  any  age. 

Rare  among  the  higher  classes,  except 
those  exposed. 

Mulberry  eruption  on  4th  or  5th  day,  on 
extremities,  lasts  till  close. 

Brain  chiefly  affected  ;  bowels  are  often  but 
little  so ;  abdomen  natural,  evacuations 
dark,  but  never  bloody  (these  are  occa¬ 
sionally  reversed). 

Contracted  pupils,  dusky  face. 

Pulse  and  temperature  rise  to  120  and  105° 
till  3d  day,  high  for  6  days,  then  fall. 

Lasts  2-3  wee*ks. 

Relapses  rare. 

Death  from  coma,  or  congestion  of  the 
lungs,  in  1st  or  2d  week. 

Arises  from  destitution,  over-crowding,  bad 
ventilation,  is  contagious,  and  generally 
epidemic. 

Post-mortem  :  not  constant,  most  frequent 
are  dark  blood  and  enlarged  spleen,  soft 
heart. 


Typhoid  ( Enteric )  Fever. 

Commences  slowly,  incubation  about  13 
days. 

Most  common  in  youth  and  childhood, 
rarely  after  40. 

As  common  among  the  rich  as  the  poor. 

Rose  eruption,  few,  on  abdomen,  and  in 
successive  crops,  which  fade  and  disap¬ 
pear. 

Bowels  chiefly  affected,  evacuations  ochre- 
color  and  watery,  sometimes  hemorrhage, 
or  even  ulceration,  abdomen  tumid. 

Dilated  pupils,  cheeks  flushed. 

Pulse  and  temperature  rise  and  fall  inde¬ 
pendently,  and  without  uniformity,  but 
both  are  usually  high  to  15th  day. 

Lasts  4-6  or  more  weeks. 

Relapses  frequent. 

Death  from  asthenia,  pneumonia,  hemor¬ 
rhage,  or  perforation  of  intestine,  in  or 
after  3d  week. 

Bad  drainage,  poisoned  drinking  water, 
putrid  animal  matter,  want  of  ozone, 
certain  electrical  conditions;  is  not  con¬ 
tagious,  often  sporadic. 

Post-mortem  :  morbid  Peyer’s  patches,  en¬ 
larged  mesenteric  glands,  ulcerated 
mucous  coat  of  intestines;  enlarged  and 
soft  spleen,  ulcerated  pharynx. 


TEMPERATURE  IN  DISEASE. 


717 


Yellow  and  Bilious  Fevers. 


Yellow  Fever. 

Short  duration;  ends  in  3-7  days. 

Incubation  5-9  days. 

A  disease  of  one  paroxysm,  terminating  in 
recovery  or  collapse. 

Very  severe  nausea  and  vomiting,  early 
epigastric  tenderness. 

Black  vomit. 

Hemorrhages  from  various  parts. 

Tongue  clean,  or  slightly  coated. 

Pulse  variable,  slow  at  end. 

Injected  and  humid  eye. 

Supra-orbital  pain,  pain  in  back  and  in 
calves  of  legs. 

Rarely  delirious,  mind  clear  generally. 

Urine  albuminous,  usually  suppressed. 

Rapid  convalescence,  no  sequelae. 

Little  muscular  prostration. 

High  mortality,  epidemic. 

Treatment  unsatisfactory. 

Autopsy:  inflamed  or  congested  stomach, 
enlarged  yellow  liver,  filled  with  oil 
globules,  muscular  fibres  of  heart  are 
often  disintegrated. 


•  Bilious  Remittent. 

Lasts  9  days  or  more. 

Incubation  may  extend  to  months. 

A  disease  of  several  paroxysms,  with  in¬ 
tervening  remissions. 

These  symptoms  are  not  so  severe  nor  so 
early. 

Bilious  vomiting. 

No  hemorrhagic  tendency. 

Tongue  heaviiy  coated. 

Pulse  quick  to  convalescence. 

Eye  natural. 

Headache,  sense  of  fullness  in  head,  often 
no  loin  or  leg  pains. 

Delirium  frequent,  mind  dull. 

Not  so. 

Slow  convalescence,  tedious  sequelae. 

Greater  muscular  prostration. 

Slight  mortality,  endemic.- 

Very  amenable  to  treatment. 

Autopsy  :  stomach  congested,  rarely  in¬ 
flamed,  liver  olive  or  bronze  hue,  not 
fatty. 


Vomiting. 


Cerebral. 

Little  or  no  nausea,  vomiting  continues  after 
stomach  is  emptied. 

No  tenderness  or  pressure  over  the  liver  or 
stomach. 

Pulse  infrequent  and  hard. 

Tongue  clean,  breath  sweet,  conjunctivas 
normal  or  injected,  and  headache  primary. 

Generally  obstinate  constipation. 

No  salivation. 


Gastric  or  Hepatic. 

Nausea  relieved  by  discharge,  returns  when 
food  is  taken. 

Liver  and  stomach  are  tender,  pressure  pro¬ 
duces  inclination  to  vomit. 

Pulse  frequent  and  weak. 

Tongue  furred,  breath  offensive,  conjunc- 
tivae  often  yellowish,  and  headache  sec¬ 
ondary  as  to  time. 

Griping  abdominal  pain,  diarrhoea  and 
clay-colored  stools. 

Increased  salivation. 


NOTES  ON  TEMPERATURE  IN  DISEASE. 

Temperature,  average  normal,  of  adults,  98.6°  F. ;  of  children,  990  ;  of  the  aged 
98.8°.  Diurnal  variation  1°  to  1.50  F.,  highest  from  9  A.  M.  to  2  P.  M.  Above  1080  F.  is 
a  fatal  sign,  which  issue  may  be  averted  by  cold  baths,  reduced  by  ice  from  96°  to  about 
6o°  F.  (A).  The  clinical  thermometer  placed  in  the  mouth,  axilla  or  rectum,  and  retained 
in  situ  for  five  minutes,  should  go  hand  in  hand  with  Aconite  in  the  treatment  of  inflam¬ 
mations  (R).  [For  antipyretics  see  the  articles  Fever,  Inflammation,  in  part  1 1 1,  also 
the  list  of  these  agents  on  page  42.] 

Clinical  Thermometry  is  one  of  the  principal  means  of  positive  diagnosis.  The  ther¬ 
mometer  should  be  self-registering,  certified,  and  accurately  marked  according  to  the 
Fahrenheit  scale.  The  most  reliable  temperature  is  that  in  recto ,  or  in  the  vagina;  less 
so  in  the  axilla  and  folds  of  skin,  and  still  less  reliable  in  the  mouth.  A  correct  reading 
of  the  thermometer  cannot  be  obtained  in  less  time  than  five  to  seven  minutes.  (Da  Costa.) 

The  Average  Normal  Temperature  of  the  body  is  98.6°  ;  which,  like  the  pulse,  will 


718 


TEMPERATURE  IN  DISEASE. 


vary  somewhat  in  individual  cases  ;  as  a  general  practical  result,  it  is  agreed  that  in  tem¬ 
perate  regions  the  normal  temperature  at  completely  sheltered  patts  of  the  suiface  of  the 
human  body  amounts  to  98.4°  Fahr.,  or  a  few  tenths  more  or  less;  and  a  rising  above 
99. 50,  or  a  depression  below  97. 30  F.,  are  sure  indications  of  some  kind  of  disease,  if  the 
increase  or  depression  is  persistent.  The  temperature  is  increased  at  the  prime  of  life,  is 
raised  and  depressed  temporarily  by  the  influence  of  diet,  stimulants,  exercise,  etc.  The 
minimum  diurnal  temp,  is  observed  at  2  A.  M.,  the  maximum  at  4  to  6  p.  m.  Any  rise 
above  99. 50,  or  fall  below  97.30,  if  persistent,  indicates  disease;  on  the  other  hand,  a 
normal  temperature  does  not  always  indicate  good  health.  The  greatest  recorded  range 
of  temperature  in  disease  is  50. 40  ;  the  minimum  is  71. 6°  in  a  case  of  sclerema  neonatorum 
(Quain’s  Diet.),  the  maximum  1220.  In  severe  and  fatal  cases  it  rarely  exceeds  107°, 
and  rarely  falls  below  920,  even  in  fatal  collapse.  It  may  rise  3°-4°  after  d^  ath,  as  ob¬ 
served  in  a  case  of  typhoid  fever  in  which  death  occurred  with  a  temperature  of  107°, 
which  increased  shortly  afterwards  to  110.50.  A  temperature  of  107°  indicates  malig¬ 
nancy,  and  where  met  with  for  two  consecutive  days  in  typhus,  scarlatina,  measles,  pneu¬ 
monia,  pyaemia,  meningitis  or  rheumatism,  death  may  be  expected  shortly.  In  relapsing, 
remittent  and  intermittent  fevers,  and  in  the  initial  chill  of  an  abortion,  the  temperature 
may  reach  107°  without  indicating  great  danger.  During  the  last  hours  of  life,  in  many 
diseases,  the  temperature  rises  to  io90-i  n°;  for  example,' in  tetanus,  sun  s’roke,  typhus,, 
etc.  With  a  temperature  of  96°,  collapse  is  imminent. 

Abnormally  High  Temperatures  reported  in  the  British  Med.  Jour.,  by  Dr.  Donkin. 
In  these  eight  cases  all  but  one  were  in’ females,  and  none  proved  fatal.  Pain  was  a 
prominent  symptom  in  all.  No.  i,m.6°;  convalescing  from  enteric  fever.  No.  2,  1080; 
no  organic  lesions  :  ovarian  pain.  No  3,  1 15. 8°  ;  great  abdominal  pain  and  excitement. 
No.  4,  hi0;  convalescing  from  enteric  fever.  No.  5,  1 1 30  ;  enteric  fever  and  double 
pneumonia.  No.  6,  1120;  synovitis.  This  was  the  only  male.  No.  7,  1120;  painful 
stump,  with  necrosis.  No.  8,  1170  ;  pyonephrosis. 

A  High  Average  Te?nperature  (above  104°),  is  found  in  severe  pneumonia,  scarlatina, 
remittent,  typhus,  typhoid  and  relapsing  fevers,  pyaemia,  etc.  A  Moderate  High  Tem¬ 
perature  ( 1020  and  above),  is  seen  in  peritonitis,  acute  rheumatism,  pericarditis,  pleurisy, 
dysentery,  cerebro-spinal  meningitis,  catarrhs,  etc.  A  temperature  of  ioo°  and  above  is 
found  in  chronic  affections,  incipient  inflammations,  and  mild  fevers.  When,  in  efferves¬ 
cence,  the  heat  increases  rapidly,  it  will,  in  defervescence,  decline  proportionately  fast, 
and  vice  versa.  Beware  of  a  grave  affection  when  the  temperature  is  of  acominuous  type. 
A  distinct  interval  between  morning  and  evening  temperature  is  a  favorable  sign.  A  slow 
and  gradual  increase  indicates  typhoid  fever  ;  in  rheumatism  and  anomalous  fevers  the 
increase  is  more  rapid,  and  still  more  so  in  acute  inflammatory  disease,  pneumonia,  angina, 
pleurisy,  typhus,  scarlatina,  rubeola,  etc.  It  is  usually  very  rap;d  in  intermittent  fever, 
febricula,  and  ephemeral  fevers.  A  rapid  effervescence  and  slow  defervescence  indicates 
some  complication  of  disease  ;  the  reverse  order  indicates  great  danger.  When  the  tem¬ 
perature  begins  to  fall  from  the  evening  to  the  morning,  it  is  an  indication  of  improvement ; 
while  a  rise  of  temperature  from  the  evening  to  the  morning  is  a  sure  indication  that  the 
patient  is  worse.  Stability  of  temperature  from  morning  to  evening  is  a  good  sign,  but 
from  evening  to  the  morning,  unfavorable. 

A  Decrease  of  Temperature  below  the  normal  heat  is  rare.  It  occurs  sometimes 
transitorily,  announcing  thereby  a  favorable  crisis,  by  preceding  the  return  to  a  normal 
temperature.  It  is  also  met  with  occasionally  during  the  morning  remission  of  remittent 
fever;  also  during  the  apyrexia  of  intermittents ;  in  acute  collapse,  preceded  or  not  by 
fever  ;  in  chronic  wasting  diseases  ;  and  sometimes,  also,  on  the  approach  of  death, 
especially  in  typhus  fever. 

In  Phthisis,  the  temperature  is  higher  in  the  evening  than  in  the  morning  ;  later,  higher 
at  early  bedtime  than  at  noon,  and  high  again  at  dusk.  This  is  a  valuable  and  delicate 
test  of  the  progress  of  tuberculization. 

In  Typhoid  Fever,  the  accession  is  by  a  rise  of  one  degree  each  day,  with  the  diur¬ 
nal  variation.  If  the  evening  temperature  does  not  exceed  103. 50,  the  disease  will 
probably  be  mild;  but  a  temperature  of  105°  in  the  evening  indicates  a  severe  type  and 
much  danger.  A  sudden  reduction  to  950  in  the  third  week  denotes  intestinal  hemor¬ 
rhage  ;  a  lingering  temperature  of  ioi°-io2°  in  the  fourth  and  filth  weeks  indicates  non¬ 
cicatrization  of  the  intestinal  ulceration. 

In  Scarlatina,  the  rise  of  temperature  is  rapid,  104.70  may  be  reached  in  a  few  hours. 
It  seldom  rises  above  105°  and  never  above  1060  ;  is  continuous  until  the  eruption  begins 
to  fade,  when  remissions  take  place,  unless  complications  arise. 

In  Measles,  103°  is  the  usual  temperature,  with  daily  variations,  increasing  with  the 


OBSTETRICAL  MEMORANDA.  719 

eruption  and  catarrhal  symptoms.  A  high  temperature  lasting  beyond  the  tenth  day 
denotes  complications. 

In  Diphtheria,  the  temperature  by  the  end  of  the  third  day  will,  in  uncomplicated  cases, 
not  exceed  I03°-I04°.  It  falls  temporarily  with  the  exudation.  Defervescence  in  the 
severe,  favorable  cases,  is  from  the  twelfth  to  the  fourteenth  day;  in  the  milder  cases  not 
before  the  sixth.  In  some  fatal  cases  it  occurs  early,  from  the  third  to  the  fourth  day.  In 
asthenic  cases,  the  temperature  of  ihe  suiface  falls,  while  that  of  the  interior  remains  high 
—  ioo°  in  the  axilla,  and  103°  in  the  rectum.  During  convalescence,  the  temperature  is 
low,  and  readily  depressed,  but  may  be  raised  by  intercurrent  maladies.  Any  increase 
after  the  first  five  days,  or  a  continuous  high  temperature  after  the  first  ten  days,  is 
unfavorable.  A  sudden  rise  may  indicate  complications. 

Co-Relation  of  Pulse  and  Temperature. — As  a  general  rule  the  co  relation  of  pulse 
*and  temperature  may  be  stated  as  follows,  namely  :  an  increase  of  temperature  of  one 
degree  above  98°  F.  corresponds  with  an  increase  of  ten  beats  of  the  pulse  per  minute,  as 
in  the  following  table  : — 

Temperature  of  98°  corresponds  with  a  pulse  of  60. 


u 

99° 

C  6 

66 

70. 

u 

IOO° 

66 

66 

80. 

a 

IOI° 

66 

(4 

90. 

<< 

102° 

66 

66 

100. 

u 

l-« 

O 

O 

66 

66 

1 10. 

t  6 

IO40 

tc 

66 

120. 

u 

105° 

66 

6  . 

130. 

a 

1060 

66 

66 

140. 

OBSTETRICAL  MEMORANDA. 

Pregnancy. — Duration  about  275  days;  usually  reckoned  as  about  280  days  from 
the  first  day  of  the  last  menstruation.  The  extremes  of  405  cases  at  the  Hotel  Dieu  were 
6  months,  and  1 1  months  8  days.  Many  rules-  for  the  calculation  of  the  date  when  labor 
may  be  expected  are  given;  as  good  a  one  as  any  is  to  count  backward  three  calendar 
months  from  the  last  day  of  the  last  menstruation,  then  add  7  days  to  obtain  the  date  of 
expected  confinement  (Naegele).  The  French  law  makes  a  child  illegitimate  if  born 
within  200  days  after  marriage,  or  over  300  days  after  the  husband’s  death. 

Evidences  of  pregnancy  may  include  :  suppression  of  the  menses ;  nausea  and  vomit¬ 
ing,  morning  sickness  ;  salivation  ;  changes  in  the  appearance  of  the  breasts  and  nipples  ; 
changes  in  the  position  of  the  uterus,  which  descends  during  the  first  two  months,  rising 
from  the  third  m  nth,  until,  at  the  fifth,  its  fundus  is  level  with  the  umbilicus,  at  the  eighth 
nearly  to  the  sternum,  settling  down  at  the  ninth  month;  oedema  of  limbs;  neck  of 
uterus  becomes  shortened,  the  os  patulous.  The  most  positive  signs  are  quickening ,  if 
the  statements  of  the  women  are  credible;  ballottemenl ;  and  above  all,  the  pulsations  of 
the  foetal  heart. 

Labor.  Preliminary  Signs. — Abdominal  tumor  sinks  lower,  occasional  uterine  pains 
and  contractions,  freer  respiration,  dFcharge  of  glairy  fluid  from  vagina,  frequent  desire 
to  urinate,  hemorrhoids,  oedema  of  legs. 

Essential  Signs. — Paroxysmal  pains,  at  regular  intervals  ;  os  uteri  generally  low,  neck 
effaced,  os  aff  cted  by  each  pam  (easily  ascertained  by  keeping  finger  on  it).  Dilatation 
of  os  uteri,  requiring  longer  to  acquit e  the  size  of  a  half-dollar,  than  from  thence  to 
completion.  Shiverings  and  vomiting,  tremblings  and  fainting,  especially  at  complete 
dilatation. 

Dead  Positions  (4). — Right  ( 1st),  or  left  (5)  occipito-anterior,  forehead  backwards; 
right  (3d),  or  left  (4th)  occipito-posterior,  forehead  forwards.  Order  of  their  comparative 
frequency  ;  1st,  3d,  2d,  4th.  The  3d  rotates  into  the  2d,  the  4th  into  the  1st. 

Facial  Positions  (4) — Right  ( 1st),  or  left  (2d)  mento- posterior,  forehead  forwards; 
right  (3d),  or  left  (4th)  mento-antenor,  forehead  backwards.  The  2d  rotates  into  the  3d, 
and  the  1st  into  the  4th. 

Pelvic,  or  Breech  Positions  (4). — Left  dorso-anterior  (ist),  left  trochanter  forwards; 
right  dorso-anterior  (2),  right  trochanter  forwards;  left  dorso- posterior  (3),  right  tro¬ 
chanter  forwards;  right  dorso  posterior  (4),  left  trochanter  forwards.  Order  of  their 
comparative  frequency,  1st,  2d,  4th,  3d. 


720 


OBSTETRICAL  MEMORANDA. 


Shoulder  Positions. — Varieties  (2) ;  dorso-anterior,  and  dorso-posterior,  the  former 
occurring  twice  as  often  as  the  latter.  In  each  variety  the  head  may  lie  in  either  iliac 
fossa ;  the  presenting  shoulder  being,  in  dorso-anterior  position,  the  left  if  the  head  is  in 
the  right  fossa ;  in  dorso-posterior  position,  the  left  if  the  head  is  in  the  left  fossa,  and 

vice  versa. 

AVERAGE  PELVIC  DIAMETERS. 


• 

As  usually  given. 

Prof. 

E.  Wallace  gives — 

Antero- 

Posterior. 

Oblique. 

Transverse. 

1 

Antero- 

Posterior. 

Oblique. 

Transverse 

Brim, . 

4 Y\  in. 

4.8  in. 

5.2  in. 

4  O  in. 

—5.0  in. 

+5-°  in- 

Cavity,  .... 

4.7  “ 

5.2  “ 

4  A  “ 

*A  “ 

4A  “ 

4A  “ 

Outlet,  .... 

5.0  “ 

•  • 

4.2  “ 

4.2  tC 

4.0  “ 

4.0  “ 

Circumferential  measurement  of  the  brim — about  17  inches. 


DEVELOPMENT  OF  THE  FCETUS. 

[Entries  in  the  column  headed  “  Month”  refer  to  the  end  of  each  month,] 


Month. 

Name. 

Length  in 
inches. 

Weight. 

Appearance. 

1st 

Ovum 

one-twelfth 

.  . 

Appears  as  a  gray  gelatinous  mass. 

2d 

Embryo 

1.2 

60  grains. 

Extremities  apparent;  points  of  ossifica¬ 
tion  appear. 

3d 

ii 

2^  to  y/z 

310  “ 

Neck,  eyes,  fingers,  nails  begin  to  form  ; 
sexes  distinct. 

4th 

Foetus 

ON 

nN 

r-*- 

O 

^4 

9  oz. 

Hair,  fat ;  muscles  capable  of  contrac¬ 
tion. 

5th 

U 

8  to  10 

IO  to  12  OZ. 

Eyebrows,  skin,  scrotum;  nails  nearly 
solid. 

6th 

t ; 

11  to  12 

i  lb. 

Pupillary  membrane  formed,  lips  closed. 

7  th 

4. 

1 2yz  to  14 

2  %  lbs. 

Eyelids  open,  testes  begin  to  descend, 
foetus  is  viable. 

8th 

4  . 

15  to  17 

4  to  5  lbs. 

Skin  red,  smooth,  covered  with  down. 

9th 

&4 

19  to  24 

7  to  7^  libs 

Testes  near  scrotum,  left  often  therein. 

DIAMETERS  OF  THE  FOETAL  SKULL  AT  TERM. 


Diameter. 

Where  measured. 

Inches. 

Fronto-mental,  ...... 

Occipito-mental, . 

Occipito-frontal, . 

Sub-occipito-bregmatic,  .  . 

Cervico-bregmatic,  .... 

Bi-parietal, . 

Bi-temporal, . 

Apex  of  forehead  to  chin,  .  . 

Occipital  protuberance  to  point  of  chin,  .  . 
Occiput  to  centre  of  forehead,  . 

Midway  between  occiput  and  foramen  mag¬ 
num  to  centre  of  ant.  fontanelle,  .... 
Ant.  margin  of  foram.  mag.  to  centre  of  an¬ 
terior  fontanelle, . 

Between  the  parietal  protuberances,  .... 
Between  the  ears, . 

3>t 

s'AsA 

4'A-S 

3  A 

lA 

zA-4 

l'/z 

[Compare  the  articles  in  Part  III,  entitled — Abortion,  After-pains,  False-pains, 
Hemorrhage  Post-Partum,  Labor,  Lactation,  Pregnancy,  Puerperal  Disorders, 
Vomiting  of  Pregnancy,  etc.] 


ASPHYXIA  AND  APNCEA. 


72  I 


ASPHYXIA  AND  APNCEA. 

From  Drowning. — Remove  the  person  from  the  water  as  rapidly  and  gently  as 
possible,  turn  the  face  downwards  for  a  moment,  and  depress  the  tongue,  in  order  that 
water,  mucus,  etc.,  may  be  removed  from  immediately  over  the  entrance  of  the  windpipe. 
Give  the  patient  plenty  of  fresh  air,  fully  exposing  neck  and  chest  to  the  breeze,  unless 
inclement.  Turn  gently  on  the  face,  one  forearm  being  under  the  forehead,  and  raise  the 
body  up  that  the  water  may  have  free  discharge  from  the  mouth.  Place  the  patient  upon 
the  side  and  apply  stimulants  (ammonia,  etc.)  near  the  nostrils  ;  or  the  cold  douche,  in 
order  to  excite  respiration. 

The  above  measures  being  ineffectual,  convey  the  body  to  the  nearest  convenient  spot, 
strip  it  carefully  and  dry  it,  and  place  it  on  a  warm  bed,  with  head  and  shoulders  slightly 
raised,  and  at  once  employ  one  of  the  following  methods,  known  as  Silvester’s  and 
Marshall  Hall’s. 

Silvester's  Method. — Pull  the  tongue  forward,  to  prevent  obstruction  to  entrance  of  air 
into  the  windpipe;  produce  expansion  of  the  chest  by  drawing  the  arms  from  the  sides  of 
the  body  and  upwards  until  they  almost  meet  over  the  head.  Then  bring  the  arms  down 
to  the  sides  again,  causing  the  elbows  almost  to  meet  over  the  pit  of  the  stomach,  and 
thus  producing  contraction  of  the  chest.  This  imitation  of  the  act  of  respiration  should 
be  continued  at  the  rate  of  fifteen  or  sixteen  times  a  minute,  as  in  health. 

Marshall  Hall's  Method. — The  person  should  be  placed  flat  on  the  face,  gentle  inter¬ 
mittent  pressure  being  made  with  the  hands  on  the  back,  the. body  turned  on  the  side,  or 
a  little  beyond,  then  on  the  face,  and  the  same  pressure,  etc.,  continued  as  at  first.  The 
whole  body  must  be  worked  simultaneously.  The  same  number  and  frequency  of  these 
artificial  processes  of  respiration  should  be  employed  as  in  the  other  method. 

The  Michigan  Method. — Lay  the  body  face  down,  the  head  upon  the  arm,  and  stand 
astride  it ;  grasp  it  then  about  the  shoulders  and  armpits,  and  raise  the  chest  as  high  as 
you  can  without  lifting  the  head  quite  off  the  arm,  and  hold  it  about  three  seconds;  then 
replace  the  body  upon  the  ground,  and  press  the  lower  limbs  downwards  and  upwards, 
with  slowly-increasing  force,  for  ten  seconds;  then  suddenly  let  go,  to  perform  the  lifting 
process  again. 

Whichever  process  be  employed,  the  effort  to  restore  the  temperature  of  the  body  must 
be  maintained,  the  body  being  well  rubbed  in  an  upward  direction  with  the  hands,  with 
warm  flannels,  etc.;  bottles  of  hot  water,  hot  bricks,  etc  ,  being  applied  to  the  stomach, 
the  axillae,  the  soles  of  the  feet,  etc.,  stimulants  and  beef  tea  being  judiciously  adminis¬ 
tered  when  restoration  is  about  taking  place.  The  attempts  at  resuscitation  must  be  per¬ 
severed  in  for  several  hours,  if  necessary. 

Laryngotomy  or  tracheotomy,  with  or  without  catheterization,  or  forced  insufflations  of 
air  or  oxygen,  have  proved  successful,  as  also  electro-puncture  (Garratt). 

In  artificial  inflation,  always  press  the  larnyx  and  trachea  against  the  vertebral  column, 
so  as  to  close  the  oesophagus  and  thus  prevent  the  air  entering  the  stomach. 

After  Long  Submersion  is  Recovery  Possible  ? — According  to  Harley  (p.  881),  dogs 
kept  under  water  I  minutes  always  died,  if  water  had  entered  the  lungs.  If  it  had  not, 
the  trachea  being  plugged,  they  survived  a  submersion  of  4  minutes.  When  persons  rise 
after  sinking  they  usually  get  some  air,  and  less  speedily  come  into  a  state  from  which 
recovery  is  impossible.  The  greatest  period  between  the  last  inspiration  and  the  stoppage 
of  the  heart  is  4  minutes.  Some  think  that  no  recovery  has  been  made  after  complete 
cessation  of  the  heart’s  action.  We  infer  that  after  complete  submersion  for  5  minutes 
recovery  is  improbable,  unless  the  person  had  been  previously  choked,  or  in  a  fainting 
state,  so  that  no  water  entered  the  lungs.  But  in  Anderson’s  case,  the  patient  had  been 
under  water  at  least  15  minutes,  and  in  Garratt’s  the  time  was  variously  estimated  at  from 
15  to  60  minutes. 

When  is  a  Case  Hopeless  ? — Harley  says  (p.  892)  :  “  If  the  eyes  are  open,  the  pupils 
dilated,  the  conjunctiva  insensible,  the  countenance  placid,  the  skin  cold,  frothy  mucus 
round  the  nostrils  and  mouth,  no  attempt  at  respiration,  and  the  heart’s  action  inaudible 
(when  the  ear  is  applied  to  the  chest),  the  case  is  hopeless.” 

Signs  of  Death. — The  following  have  been  suggested  as  methods  of  deciding  whether 
death  has  occurred  : — 

(a)  Tie  a  string  firmly  about  the  finger.  If  the  end  of  the  finger  becomes  swollen 
and  red,  life  is  not  extinct 

( b )  Insert  a  bright  steel  needle  into  the  flesh.  If  it  tarnishes  by  oxidation  in  the  course 
of  half  an  hour,  life  may  be  considered  not  extinct. 

46 


722 


CLINICAL  EXAMINATION  OF  THE  URINE. 


(c)  Inject  a  few  drops  of  Liquor  Ammoniae  under  the  skin.  During  life  a  deep  red 
or  purple  spot  is  formed. 

(d)  Moisten  the  eye  with  Atropine.  During  life  the  pupil  will  dilate. 

(<?)  Look  at  a  bright  light  or  at  the  sun,  through  the  fingers  held  closely  side  by  side. 
During  life  the  color  is  pink  ;  after  death  a  dead  white. 

(/)  After  death  a  dark  spot  is  said  to  form  gradually  on  the  outer  side  of  the  white  of 
the  eye,  from  drying  of  the  sclerotic,  so  that  the  dark  choroid  shows  through. 

( g)  Putrefaction  is  an  absolute  sign  of  death.  Better  delay  for  it  than  run  any  risk  of 
burying  alive. 

From  Foreign  Bodies  in  Air  Passages. — If  round  and  smooth,  invert  the  patient 
and  strike  on  the  back  :  laryngotomy  :  tracheotomy. 

Of  the  New-Born. — Clean  the  mucus  out  of  nostrils  and  throat;  catheterize  the 
trachea,  and  suck  up  the  mucus.  “  Marshall  Hall’s  Method:”  by  placing  child  on  abdo¬ 
men,  then  bringing  into  lateral  posture,  repeating  slowly  and  deliberately.  “  Schultze’s 
method  :  ”  by  placing  the  thumbs  upon  the  anterior  surface  of  thorax,  the  indices  in  the 
axillae,  and  the  other  fingers  along  the  back,  the  face  of  the  child  being  from  you  ;  rotate 
the  child,  by  swinging  upwards,  so  that  the  inferior  extremities  turn  over  towards  you, 
In  a  moment  re-rotate  to  the  original  position.  Do  not  support  head  or  legs  in  the  for¬ 
ward  rotation ;  their  bending  upon  or  towards  the  abdomen  gives  a  forced  expiration. 


CLINICAL  EXAMINATION  OF  THE  URINE. 


Note. — Use  morning  urine,  or  a  sample  of  all  passed  during  the  24  hours. 


r 


Color  -{ 


Smell 


Pale  (and  copious),  1.030  -f-  .  . 
Pale  (and  copious),  below  1.018 
Of  urine  and  froth,  very  yellow 

or  greenish, . 

Bright  yellow  to  crimson,  .  .  . 

Dark,  odor  of  violets, . 

High  (scanty),  sp.  gr.  +  .  .  . 

High  (scanty),  sp.  gr.  —  .  .  . 

Dark,  muddy,  smoky, . 

Black,  . 

Fragrant, . 

Fetid, . 

Of  violets,  . 


indicates  Sugar. 

“  Hysteria  and  convulsions, 

nervous  disease. 

Bile,  Rhubarb. 

“  Santonin, 

“  Turpentine. 

“  Fever,  Uric  Acid  Dia¬ 

thesis. 

“  A  grave  symptom  of 

Bright’s  Disease. 

“  Blood,  strong  Coffee. 

“  Putridity,  disintegrated 

Blood,  Tar,  Creasote. 

“  Cystine,  Sugar,  etc. 

“  Alkalinity. 

“  Turpentine. 


Quantity  (in  24  hours).  Normal  about  50  fl.  oz.,  from  which  there  may  be  consider¬ 
able  variation  either  way,  according  to  the  quantity  of  sweat,  the  fluidity  of  food  used,  etc. 

Specific  Gravity.  If  possible,  take  the  mixed  urine.  Normal  is  about  1.018,  i.  e., 
18  grains  of  solids  in  each  fl.  oz.  If  sp.  gr.  is  high,  suspect  sugar;  if  low,  suspect 
albumen. 

Reaction,  in  health  is  always  acid  in  24-hours’  urine.  It  may  be  alkaline  from  medi¬ 
cine,  or  disease,  or  shortly  after  a  meal.  If  excessively  acid,  examine  for  crystal  of  uric 
acid.  If  alkaline,  let  the  test-paper  dry,  so  as  to  ascertain  whether  the  alkali  be  fixed  or 
volatile. 

Albumen  by  Heat  and  Nitric  Acid.  With  Acetic  Acid,  or  dilute  Ammonia,  make 
the  urine  slightly  acid.  If  a  precipitate  appear  on  boiling,  it  may  be  Albumen  or  Phos¬ 
phates \  Add  a  drop  or  two  of  Nitric  Acid.  If  the  precipitate  dissolve,  it  is  Phosphates ; 
if  not,  it  is  Albumen.  If  a  deposit  or  turbidity  disappears  on  heating,  it  consists  of 
Urates ;  if  not,  add  a  drop  of  Nitric  Acid.  If  now  dissolved,  we  have  Phosphates  ;  if 
not,  Cystine.  Other  Tests  are  the  Potassio- Mercuric  Iodide ,  the  Sodium  Tungstate , 
Potassium  Ferro-cyanide ,  and  Picric  Acid  Tests;  but  the  above  described  one,  if  care¬ 
fully  done,  will  give  as  good  results  as  any. 

Bile  Pigment  and  Acids,  if  necessary.  Vogel's  color-table.  Marechal's  Test m as 
follows:  Put  of  urine  in  a  test-tube,  and  pour  one  or  two  drops  of  Tinct.  Iodi.  to 


CLINICAL  EXAMINATION  OF  THE  URINE. 


723 


trickle  down  along  the  side  of  the  tube,  held  horizontally  nearly,  so  that  the  two  fluids 
may  touch,  but  not  mix.  If  bile  pigment  be  present,  a  fine  green  color  will  at  once  be 
developed  below  the  red  Iodine  layer.  Noel's  Test ,  Pettenkofer' s  Test ,  Nitric  Acid  Test , 
Oxide  of  Silver  Test. 

Sugar,  if  necessary.  Urine  containing  sugar  is  usually  light-colored,  froths  readily 
when  poured  from  one  vessel  to  another,  and  has  a  high  specific  gravity.  Fehling's  Test , 
as  follows :  Add  to  the  boiling  urine  a  few  drops  of  freshly-prepared  solution  of  Potassio- 
Cupric  Tartrate  (Fehling' s  Solution).  If  sugar  be  present,  a  yellow,  orange,  or  red  pre¬ 
cipitate  of  Cuprous  Oxide  will  form,  10  cubic  centimeters  of  the  solution  being  reduced 
by  0.05  gram,  of  diabetic  sugar.  To  prepare  Fehling's  Solution,  dissolve  34.639  grams 
of  pure,  crystallized  Copper  Sulphate  in  about  200  grams  of  Distilled  Water;  also  173 
grams  of  chemically  pure,  crystallized,  neutral  Tartrate  of  Sodium  in  500  or  600  grams  of 
a  solution  of  Caustic  Soda,  of  specific  gravity  1.12,  pouring  the  first  solution  into  the 
latter,  slowly  and  a  little  at  the  time.  The  clear,  mixed  fluid  is  then  diluted  with  distilled 
water  up  to  a  litre.  *  This  solution  soon  spoils,  and  must  be  kept  in  a  dark,  cool  place. 
Much  more  convenient  are  Dr.  Pififard’s  Cupro-Potassic  Paste,  and  Dr.  Pavy’s  Cupric 
Test  Pellets  (see  Tyson  on  Urine,  page  57) ;  and  still  more  handy  are  Wyeth’s  Compressed 
Tablets  for  preparing  Fehling’s  Solution  of  Potassio-Cupric  Tartrate,  U.  S.  P.,  18S0,  a  box 
of  which  costs  50  cents,  and  may  be  obtained  from  any  good  drug-store.  The  writer  has 
used  these  Tablets  for  some  two  or  three  years,  with  extreme  satisfaction. 

Pavy's  Solution  is  a  modification  of  Fehling’s;  is  equally  good  for  qualitative  and 
volumetric  testing,  and  is  intended  for  those  who  prefer  the  apothecaries’  weights  and 
measures  to  the  metric  system.  It  is  made  in  the  same  manner  as  Fehling’s,  100  minims 
corresponding  to  yz  grain  of  diabetic  sugar,  and  consists  of — Copper  sulphate,  gr.  320  ; 
Potassium  Tartrate  (neutral),  gr.  640;  Caustic  Potash,  gr.  1280;  and  Distilled  Water, 

f  5  2°. 

Other  Tests  for  Sugar  are  Bottcher's  Bismuth  Test,  the  Fermentation  Test,  Moore's, 
Trommer' s,  the  Picric  Acid  and  the  Indigo -Carmine.  They  are  all  useful,  but  will  not 
be  detailed  here,  as  one  good  method  is  all  that  the  average  practitioner  wants. 

Chlorides.  Add  a  drop  of  Nitric  Acid,  and  then  Silver  Nitrate  until  a  precipitate 
ceases  to  form.  Thus  estimate  the  amount  of  Chlorides. 

Urea.  Place  a  drop  of  urine  on  platinum-foil,  and  to  it  add  a  drop  of  Nitric  Acid, 
and  leave  undisturbed  in  a  cool  place  for  a  minute  or  two.  If  the  urea  is  in  excess, 
crystals  of  Uric  Nitrate  form  immediately. 

To  ascertain  the  percentage  of  urea  present,  use  Parke,  Davis  &  Co.’s  Ureometer,  em¬ 
ploying  the  Solution  of  Hypobromite  of  Sodium,  instead  of  the  solution  of  Chlorinated 
Soda,  the  former  giving  much  the  best  results.  This  apparatus  is  simple,  reliable,  and 
quite  accurate  enough  for  clinical  purposes. 

Mucus  and  Pus  resemble  each  other  so  closely  under  the  microscope,  that  it  is  almost 
impossible  for  any  one,  except  an  expert,  to  distinguish  between  them  thereby.  Mucus 
is  more  cloudy  and  flocculent  to  the  naked  eye  than  Pus,  which  latter  is  generally  of  a 
stringy  consistence  and  thickish  yellow  appearance  at  the  bottom  of  the  vessel.  The 
supernatant  liquid  being  poured  off,  and  an  equal  bulk  of  Liquor  Potassse  added,  the 
deposit,  if  containing  much  pus,  becomes  gelatinized,  and  so  tough  that  it  cannot  be  poured 
out.  If  Mucus,  Acetic  Acid  added  coagulates  it,  forming  delicate  molecular  fibres. 

Other  Deposits  are  best  examined  with  the  microscope,  and  compared  with  good 
plates,  rather  than  with  printed  descriptions.  The  plates  in  Hoffmann  and  Ultzmann  on 
Analysis  of  the  Urine,  will  answer  the  wants  of  most  general  practitioners,  but  the  text 
follows  the  metric  system.  The  urinary  deposits  may  be  classified  thus : — 


In  Alkaline  Urine 
only. 

In  Alkaline  or  Acid 
Urine. 

Organized  Deposits. 

Calcium  Phosphates 
Ammonium  Urates 
Ammoniaco- 

magnesian,  or  the 
Triple  Phosphates. 

Uric  Acid 

Urates 

Phospb  ates 
Oxalates 

Cystine 

Mucus  Toruloe 

Pus  Sarcinse 

Blood  Vibriones 

Tube-casts  Bacteria 

Spermatozoids,  etc. 

;24 


ETHICS. 


Necessary  Apparatus.  A  dozen  test  tubes.  Alcohol  lamp.  A  small  porcelain 
dish.  2  watch-glasses.  A  sheet  of  platinum  foil,  ^  inch  square.  3  pipettes  of  different 
sizes,  to  be  used  only  for  urine.  A  2-oz  graduate.  Urinometer.  Blue  and  red  litmus- 
paper.  The  reagents  mentioned  above.  A  little  Grape-sugar,  for  use  in  testing  the 
Fehling’s  solution.  Ureometer  (Parke,  Davis  &  Co’s). 

The  foregoing  directions  comprise  all  that  the  average  practitioner  will  usually  perform 
in  the  matter  of  urinary  analysis.  For  fuller  directions,  the  reader  is  referred  to  one  of 
the  numerous  manuals  on  the  subject,  among  which  may  be  mentioned  Da  Costa  on 
Medical  Diagnosis,  Chapter  vii. — Tyson  on  the  Practical  Examination  of  Urine, — and 
Sir  Henry  Thompson’s  Clinical  Lectures  on  Diseases  of  the  Urinary  Organs,  Lecture 
XXIV. 

A  “  Physician' s  Pocket  Reagent  Case,"  intended  for  urinalysis  at  the  bedside,  is  put  up 
by  Parke,  Davis  &  Co.,  and  sold  at  the  low  price  of  $1.50.  It  contains  a  set  of  Dr. 
Oliver’s  Test  Papers  or  Pellets  (the  latter  preferable),  a  color  scale,  specific  gravity  beads, 
two  test-tubes,  a  pipette,  and  full  directions  for  the  use  of  the  reagents,  which  are  to  be 
absorbed  by  the  test-papers. 


ETHICS. 

The  Hippocratic  Oath, — I  swear  by  Apollo,  the  physician,  and  Hisculapius,  and 
Health,  and  All-heal,  and  all  the  Gods  and  Goddesses,  that  according  to  my  ability  and 
judgment,  I  will  keep  this  oath  and  this  stipulation  : — to  reckon  him  who  taught  me  this 
Art  equally  dear  to  me  as  my  parents,  to  share  my  substance  with  him  and  relieve  his 
necessities  if  required;  to  look  upon  his  offspring  in  the  same  footing  as  my  own  brothers, 
and  to  teach  them  this  Art,  should  they  wish  to  learn  it,  without  fee  or  stipulation  ;  and 
that  by  precept,  lecture,  and  every  other  mode  of  instruction,  I  will  impart  a  knowledge 
of  the  Art  to  my  own  sons,  and  those  of  my  teachers,  and  to  disciples  bound  by  a  stipu¬ 
lation  and  oath,  according  to  the  law  of  medicine,  but  to  none  others.  I  will  follow  that 
system  of  regimen  which  according  to  my  ability  and  judgment  I  consider  for  the  benefit  of 
my  patients,  and  abstain  from  what  is  deleterious  and  mischievous.  I  will  give  no  deadly 
medicine  to  any  one,  if  asked,  nor  suggest  any  such  counsel;  and  in  like  manner  I  will 
not  give  to  a  woman  a  pessary  to  produce  abortion.  With  purity  and  holiness  I  will  pass 
my  life,  and  practice  my  art.  I  will  not  cut  persons  laboring  under  the  stone,  but  will 
leave  this  to  be  done  by  men  who  are  practitioners  of  this  work.  In  whatever  houses  I 
enter,  I  will  go  into  them  for  the  benefit  of  the  sick,  and  will  abstain  from  every  voluntary 
act  of  mischief  and  corruption;  and  further  from  the  seduction  of  females  or  males,  of 
freemen  and  slaves.  Whatever,  in  connection  with  my  professional  practice,  or  not  in 
connection  with  it,  I  see  or  hear  in  the  life  of  men,  which  ought  not  to  be  spoken  of 
abroad,  I  will  not  divulge,  as  reckoning  that  all  such  should  be  kept  secret.  While  I 
continue  to  keep  this  oath  unviolated,  may  it  be  granted  me  to  enjoy  life  and  the  practice 
of  the  Art,  respected  by  all  men,  in  all  times.  But  should  I  trespass  and  violate  this  oath, 
may  the  reverse  be  my  lot!  [Adam’s  Genuine  Works  of  Hippocrates,  Sydenham 
Society,  London,  1849.]  # 

Extracts  from  the  Code. 

Consultations  should  be  promoted  in  difficult  cases.  During  them  no  jealousy  or  rival- 
ship  should  be  indulged.  Candor,  probity,  and  all  due  respect  should  be  exercised 
toward  the  physician  in  charge.  The  attending  physician  should  first  question  the  patient, 
the  consulting  one  afterwards  putting  such  other  questions  as  may  seem  fit  to  further  eluci¬ 
date  the  case.  The  discussion  should  take  place  in  a  private  place,  and  no  opinions  de¬ 
livered  which  are  not  the  result  of  concurrence.  In  discussion,  the  attendant  delivers  his 
opinion  first,  the  others  in  the  order  in  which  they  have  been  called. 

A  Regular  Medical  Education  furnishes  the  only  presumptive  evidence  of  professional 
abilities  and  acquirements,  and  ought  to  be  the  only  acknowledged  right  of  an  individual 
to  the  exercise  and  honors  of  his  profession.  No  one  can  be  considered  a  fit  associate  in 
consultation,  whose  practice  is  based  on  an  exclusive  dogma,  to  the  rejection  of  the  accu¬ 
mulated  experience  of  the  profession. 

Punctuality  should  especially  mark  the  keeping  of  these  engagements;  if  one  of  the 
parties  be  delayed,  the  other  should  wait  a  reasonable  time,  and  then,  if  the  attendant, 
prescribe ;  if  the  consulting,  he  should  retire,  unless  the  case  is  urgent  or  he  be  called 
from  a  distance,  when  he  should  prescribe  for  the  emergency  or  leave  a  written  opinion 
under  seal.  All  theoretical  discussion  should  be  avoided.  Should  diversity  of  opinion 


SPECIFIC  GRAVITIES  AND  SPECIFIC  VOLUMES. 


725 


prevail,  the  majority  should  rule ;  should  the  numbers  be  equal  on  each  side,  the  decision 
should  rest  with  the  attending  physician.  The  consulting  physician  should  always  justify, 
as  far  as  may  be  consistent  with  truth,  the  course  pursued  by  the  attending  one,  and 
no  hint  impairing  confidence  in  him,  or  his  reputation,  should  be  thrown  out.  A  double 
fee  should  be  expected  in  all  consultations. 

Interference. — A  physician  should  not  visit  or  prescribe  for  a  patient  who  has  been 
under  the  care  of  another  for  the  same  malady,  unless  in,  1st,  a  case  of  emergency;  2d, 
of  consultation;  3d,  of  relinquishment,  by  the  physician,  of  the  case;  4th,  or  a  regular 
notification  to  him  that  his  services  are  no  longer  desired.  When  the  case  is  assumed  by 
another,  he  should  indulge  in  no  insinuations  against  the  former  attendant.  If  called 
because  the  family  physician  is  not  at  hand,  or  is  sick,  he  should  resign  the  case  to  him 
on  his  arrival.  In  case  several  physicians  are  simultaneously  called,  as  in  accidents,  the 
first  arriving  should  take  full  charge  of  the  case,  unless  the  family  attendant  be  present, 
when  he  should  assume  the  charge;  if  not  present,  he  should  be  sent  for,  and  the  further 
treatment  resigned  to  his  hands. 

Miscellaneous. — A  case  should  never  be  abandoned  because  it  is  supposed  to  be  a 
hopeless  one. 

Contumelious  and  sarcastic  remarks  relative  to  the  Faculty,  as  a  body,  should  always 
be  avoided.  “  It’s  a  foul  bird  that  fouls  its  own  nest.” 

It  is  held  unprofessional  to  resort  to  “public  ”  advertising,  to  hold  a  patent  upon  an 
instrument,  or  to  dispense  or  prescribe  a  secret  nostrum. 

Gratuitous  services  should  be  given  to  an  afflicted  brother  practitioner.  If  compelled 
to  temporarily  suspend  his  practice,  on  account  of  sickness,  the  physician  who  has  been 
invited  to  take  charge  of  his  cases  should  turn  the  accruing  fees  over  to  the  sick  one,  save 
in  surgical  or  obstetrical  cases. 


TABLE  OF  SPECIFIC  GRAVITIES  AND  SPECIFIC 

VOLUMES. 

(Temperature  at  590  F.,  except  when  otherwise  stated.) 


Liquid. 

Specific 

Gravity. 

Specific 

Volume. 

Liquid. 

Specific 

Gravity. 

Specific 

Volume. 

Acid,  Acetic, . 

I.O48 

•954 

Liq.  Ferri  Tersulph.,  . 

9 

1.329 

•757 

Ac.  Acet.  dil., . 

Ac.  Hydrobromic 

1.008 

.992 

Liq.  Potassae, . 

Liq.  Sodae,  .... 

I.O36 

I.O59 

•965 

•944 

(34  per  cent  ),  .... 

r-303 

.767 

Mel  (Honey), . 

1-333 

•7sO 

Ac.  Hydrobrom.  Dil.,  . 

1-077 

.928 

01.  Adipis, . 

.900 

l.III 

Ac.  Hydrochloric,  .  .  . 

1. 1 60 

.862 

01.  Amyg  Expres.,  .  . 

.917 

I  .091 

Ac.  Hydrochlor.  Dil.,  . 

1.049 

•953 

Ol.  Aurant.  Cort.,  .  .  . 

.860 

1.163 

Ac.  Lactic . 

1. 212 

•833 

Ol.  Bergamii . 

•  875 

1. 143 

Ac.  Nitric, . 

1  420 

•  7°4 

Ol.  Caryophilli,  .... 

1.050 

.952 

Ac  Nitric.  Dil  ,  .  .  .  . 

1  059 

•944 

Ol.  Copaibae, . 

.890 

1.123 

Ac.  Oleic., . 

Ac.  Phosphoric,  .... 

0.800 

1.250 

Ol.  Cubebae, . 

.920 

1.087 

1  347 

.742 

01.  Eucalypti,  .  . 

.900 

l.III 

Ac.  Phosphor.  Dil.,  .  . 

1057 

•945 

Ol.  Gaultheriae,  .... 

I-I73 

.852 

Ac.  Sulphuric,  .... 

1.840 

•543 

Ol.  Gossyp.  Sem  ,  .  .  . 

•925 

1.081 

Ac.  Sulphuric.  Dil.,  .  . 

1.094 

.914 

Ol.  Lavandulae,  .... 

.890 

1. 123 

Aether, . 

•  750 

T-333 

01.  Limonis, . 

.850 

1.176 

A£ther  Fortior,  .... 

•725 

1-379 

Ol.  Lini, . 

01.  Menthae  Pip.,  .  .  . 

.956 

1.068 

Alcohol,  at  6o°  F.,  .  .  . 

.820 

1. 219 

.900 

l.III 

Alcohol,  at  770  F.,  .  .  . 

.812 

1. 231 

Ol.  Morrhuae, . 

.920 

1.087 

Alcohol,  Dil.,  at  6o°  F., 

.928 

1.077 

Ol.  Olivae . 

.916 

I.O92 

Alcohol,  Dil.,  at  770  F., 

.920 

r.087 

j  01.  Ricini, . 

.960 

I  .042 

Aqua  Destill.,  at  390  F., 

I. OOO 

I. OOO 

Ol.  Rosmarini,  .... 

.900 

I.  OOO 

Aqua  Ammoniae,  .  .  . 

•959 

1-043 

01.  Sassafras, . 

I. O9  I 

■9J7 

Aq.  Ammon.,  Fort.,  .  . 

.900 

I. I  I  I 

Ol.  Sesami, . 

.918 

1 .089 

Benzin, . 

Carbon  Bisulphide,  .  . 

.670 

1-493 

Ol.  Terebinthinae,  .  .  . 

.862 

1. 160 

1.272 

.786 

Spt.  yEtheris  Nitrosi,  . 

.824 

1 .214 

Chloroform.  Purif.,  .  . 

1.488 

.672 

Spt.  Frumenti . 

.920 

1.087 

Chloroform.  Venale, 

1.470 

.680 

Spt.  Vini  Gallici,  .  .  . 

•93° 

1-075 

Glycerin . 

1.250 

.800 

Syrupus  Simplex,  .  .  . 

1 -310 

•763 

Liq.  Ferri  Acet.,  .... 

1. 160 

.862 

Vinum  Album,  .... 

I. OOO 

I.OCO 

Liq.,  Ferri  Chlor.,  .  .  . 

i-4°5 

•7" 

Vinum  Rubrum,  .  .  . 

I. OOO 

I.  OOO 

726 


DROPS  IN  A  FLUI DRACHM. 


TABLE  SHOWING  THE  NUMBER  OF  DROPS  IN  A 
FLUIDRACHM  OF  VARIOUS  LIQUIDS,  ALSO  THE 
WEIGHT  OF  ONE  FLUIDRACHM  IN  GRAINS. 

(Compare  page  438.) 


Liquid. 

Drops 
in  f5j. 

onix.) 

Weight 
of  f5j  in 
grains. 

Liquid. 

Drops 
in  f5j. 

(mix.) 

Weight 
of  f5j  in 
grains. 

Acetum  Opii, . 

90 

6l 

Liq.  Iodi  Compos.,  .... 

63 

59 

Acetum  Scillse, . 

68 

57 

Liq.  Potassae, . 

62 

58 

Acid.  Acetic, . 

108 

58 

Liq.  Zinci  Chloridi,  .... 

89 

88 

Ac.  Acetic.  Dil.,  .... 

68 

55 

Oleores.  Aspidii, . 

I3° 

52 

1  Acid.  Carbolic, . 

III 

59 

Oleores  Capsici,  .... 

120 

51 

1  Ac.  Hydrochloric,  .  .  . 

70 

65 

Oleores.  Cubebae, . 

123 

52 

Ac.  Hydrocyanic,  .  .  . 

60 

54 

Oleum  Anisi, . 

119 

54 

Acid,  Lactic, . 

III 

66 

Oleum  Bergamii, . 

130 

46 

Acid,  Nitric, . 

102 

77 

Oleum  Cari,  . 

132 

50 

Ac.  Nitro  hydrochlor., 

76 

66 

Oleum  Juniperi, . 

148 

49 

j  Ac.  Phosphor.  Dil.,  .  .  . 

59 

57 

Oleum  Liinonis, . 

129 

47 

Ac.  Sulphuric, . 

128 

IOI 

Oleum  Ricini, . 

77 

5154 

|  Ac.  Sulph.  Aromat.,  .  . 

146 

53 

Oleum  Rosae, . 

132 

47 

Ac.  Sulph.  Dil.,  .... 

60 

58}4 

Oleum  Terebinth, . 

136 

4554 

Ac.  Sulphurosum,  .... 

59 

55 

Oleum  Tiglii, . 

I04 

50 

1  iFther  Fortior, . 

176 

39 

Spt.  ^Etheris  Comp.,  .  .  . 

148 

45 

1  Alcohol, . 

146 

44 

Spt.  ./Etheris  Nitrosi,  .  .  . 

146 

47 

Aqua, . 

60 

55 

Spt.  Camphorae, . 

143 

47 

Aqua  Destillata,  .... 

60 

5354 

Syrupus  Simplex, . 

65 

72 

Bals.  Peruvian, . 

IOI 

60 

Syrupus  Acaciae, . 

44 

73 

Bromine, . 

250 

165 

Syrupus  Ferri  Iod.,  .... 

65 

77 

Chloroform,  Pur.,  .... 

250 

80 

Syrupus  Scillae, . 

75 

74 

Copaiba . 

no 

5i 

Syr.  Scillae  Comp.,  .... 

102 

70 

Creasote, . 

122 

5654 

Syrupus  Senegae, . 

106 

70 

Ext.  Belladon.  FI.,  .  .  . 

156 

57 

Tinctura  Aconiti, . 

146 

46 

Ext.  Buchu  FI . 

150 

4754 

Tinctura  Belladonnae,  .  .  . 

*37 

53 

Ext.  Digitalis  FI.,  .  .  . 

134 

62 

Tinct.  Benzoini  Comp.,  .  . 

148 

48 

Ext.  Ergotae  FI.,  .... 

133 

60 

Tinct.  Cantharidis,  .... 

I3I 

51 

Ext.  Ipecac.  FI.,  .... 

120 

60  . 

Tinct.  Digitalis, . 

128 

53 

Ext.  Rhei  FI., . 

158 

6l 

Tinct.  Ferri  Chlor.,  .... 

150 

53 

Ext.  Senegae  FI . 

137 

62 

Tinct.  Iodi, . 

148 

47 

Ext.  Valerianae  FI.,  .  . 

150 

49 

Tinct.  Opii, . 

130 

53 

Ext.  Zingib.  FI.,  .... 

142 

48 

Tinct.  Opii  Camph.,  .... 

130 

52 

Glycerin . 

67 

68 

Tinct,  Opii  Deodor.,  .  . 

no 

54 

Hydrargyrum, . 

i  =;o 

760 

Vin  Colchici  Rad.,  .... 

107 

55 

Liq.  Acidi  Arseniosi,  .  . 

67 

55 

Vin.  Colchici  Sem.,  .... 

in 

54 

Liq.  Ferri  Chloridi,  .  .  . 

71 

72 

Vinum  Opii, . 

100 

55 

WEIGHTS  AND  MEASURES. 


APOTHECARIES  OR  TROY  WEIGHT. 


Pound. 

Ounces.  Drachms . 

Scruples. 

Grains. 

Gallon. 

Pints. 

Pi’  ounces. 

FI’  dr'  ms. 

Minim 

Ib. 

0  5 

9 

gr- 

C. 

O. 

ft 

f5 

m- 

1 

=  12  =  96  = 

288  = 

5760 

1  •  = 

8 

=  128  == 

1024  = 

61440 

1=8  = 

24  = 

480 

1 

=  16  = 

128  = 

7680 

=  1  = 

3  = 

60 

1  = 

8  - 

480 

1  = 

20 

1  = 

60 

APOTHECARIES  OR  WINE  MEASURE. 


i  Milligram, 
1  Centigram, 
1  Decigram, 

1  Gram,  .  . 
1  Kilogram, 


METRIC  WEIGHTS. 

.  O.OOI 

.  0.01 

.  0.1 


=  Sr-  jh 

=  gr.  h 
=  gr.  4 
=  gr.  iS-432 
=  lb  2.7 


APPROXIMATE  EQUIVALENTS. 


i  ll|  or  i  gr., . =  .06  grams. 

1  f5  or  1  5,  ...  ......=  4. 

i  fS, . .  .  .  =  30.  “ 

1  S, . =31.  “ 

1  fS  Glycerin, . =  37. 

i  fS  Syrups, . =40.  “ 


1. 

1000. 


METRIC  CONVERSIONS. 

TABLE  FOR  CONVERTING  APOTHECARIES’  WEIGHTS 
AND  MEASURES  INTO  GRAMS. 

Adapted  from  Maisch. 

[Multiply  all  grains,  or  fractions  of  a  grain,  by  6479  (or  648)  for  the  metric  equivalent 

in  millegrams. — Potter.] 


Troy  Weight. 

Metric. 

Grams  for  Liquids 

Apothecaries’ 

Grains. 

Grams. 

Measure. 

Lighter  *  than 
Water. 

Specific 
Gravity  f  of 
Water. 

Heavier  J 
than  Water. 

Millegram. 

"1  1 

•055 

.06 

.08 

A 

.001 

2 

.IO 

.12 

•"5 

To 

.0015 

3 

.16 

.18 

.24 

l 

3  0 

.002 

4 

.22 

.24 

•32 

l 

1 0 

.003 

5 

.28 

•30 

.40 

l 

l¥ 

.004 

6 

•32 

•36 

.48 

1 

1  2 

.005 

7 

■38 

.42 

•55 

1 

TO' 

.006 

8 

•45 

•5° 

•65  | 

8 

.008 

9 

•50 

•  -55 

•73 

Centigram. 

10 

•55 

.65 

.80 

1 

6 

.010 

15 

.80 

•72 

.96 

1 

¥ 

.016 

16 

.90 

1. 00 

1.32 

1 

3 

.02 

20 

1. 12 

125 

1.60 

1 

2 

•03 

25 

1.40 

i-55 

2.00 

1 

.065 

3° 

1.70 

1.90 

2.50 

Decigram. 

35 

2.00 

2.20 

2.90 

2 

•13 

40 

2.25 

2.50 

3-30 

3 

.20 

48 

2.70 

3.00 

4.00 

4 

.26 

50 

2.80 

3. 12 

4.i5 

5 

•32 

60  fgj 

3-40 

3-75 

5.00 

6 

•39 

72 

4.00 

4-5o 

6.00 

8 

.52 

80 

4-5° 

5-oo 

6.65 

10 

•65 

90 

5.10 

5.60 

7.50 

Gram. 

96 

5-40 

6.00 

8.00 

15 

1 .00 

100 

5.60 

6.48 

8.30 

20  9j 

1.30 

120  f  3  ij 

6-75 

7-50 

10.00 

24 

1  50 

160 

9.00 

10.00 

13-3° 

26 

1.62 

180  f%  iij 

10. 10 

11.25 

15-00 

30  3  ss 

i-95 

240  f  ^  ss 

i3-5o 

15.00 

20.00 

40 

2.60 

f3  v 

16.90 

18.75 

25.00 

50 

3.20 

f3vJ 

20.25 

#  22.50 

30.00 

6°  3j 

3-90 

f  A  vij 

23.60 

26.25 

35-0° 

100 

6.48 

f.tj 

27.00 

30.00 

40.00 

120  sy 

7.80 

Cll 

54.00 

60.00 

80.00 

180 

11.65 

1000 

59.00 

64.79 

85.00 

250  gss 

i5-5o 

Cl  i'J 

81.00 

90.00 

120.00 

300 

19.40 

f  3 lv 

108.00 

120.00 

160,00 

360 

23-5o 

.  Cl v 

i35-oo 

150.00 

200.00 

420 

27.20 

fSvj 

162.00 

180.00 

240.00 

480  5j 

31.10 

f^viij 

216.00 

240.00 

320.00 

960  ^  ij 

62.20 

1000 

64.79 

qiv 

124.40 

3  vi 

186.60 

3  V,,J 

248.80 

*  Lighter  than  water  are  tinctures,  spirits,  compound  spirit  of  ether,  sweet  spirits  of  nitre,  fixed  and 
volatile  oils.  Hither  Fortior,  f3j  =  grams  2.80. 

f  Same  as  water  are  waters,  liquids,  decoctions,  infusions,  most  fluid  extracts,  and  tinctures  made 
with  dilute  alcohol. 

X  Heavier  than  water  are  syrups,  glycerin,  a  few  fluid  extracts,  and  chloroform.  Of  the  latter 
f3j  =  grams  5.50. 


INDEX. 


Note. — This  Index  has  been  arranged  with  the  object  of  enabling  instant  reference  to 
be  made  to  the  mention  of  every  article  of  the  Materia  Medica,  every  drug,  official  or 
unofficial,  and  each  preparation,  derivative  or  constituent  thereof,  which  is  treated  of  in 
the  first  part  of  the  book,  every  article,  preparation  or  operation  discussed  in  the  pharma¬ 
ceutical  portion,  and  every  disease  or  other  title  contained  in  the  therapeutical  section. 
Many  of  the  entries  are  only  made  once,  but  double  and  even  treble  entries  are  made  for 
every  item  which  seemed  of  sufficient  importance  to  warrant  such  repetition. 

Salts  are  each  placed  but  once  in  the  Index,  under  their  English  names  and  the  titles 
of  their  acid  factors,  thus,  Acetate  of  Potassium.  A  basic  view  of  the  salts  under  their 
basis  titles  is  seen  in  the  section  on  Materia  Medica,  but  as  no  such  view  of  the  Allyl, 
Ethyl,  Methyl,  Propyl  and  similar  compounds  exists  in  the  book,  these  are  each  indexed 
twice,  under  both  the  acid  and  basic  portions  of  their  names,  as  Cetyl  Palmitate  and 
Pabnitate  of  Cetyl. 

Plants  are  indexed  under  both  English  and  Latin  names,  except  where  the  technical 
name  of  the  plant  corresponds  in  part  with  the  official  drug-title,  in  which  case  the  one 
entry  serves  for  both.  Thus  the  entry  Conium  answers  for  the  plant  Conium  maculatum , 
as  well  as  for  the  official  drug ;  but  the  drug  ATux  Vomica  and  the  plant  Strychnos  Arux- 
vomica  receive  separate  index  entries. 

Alkaloids  are  each  entered  once  only  and  under  their  chemical  termination,  ine ;  their 
salts  following  the  same  rule  as  other  salts. 

Glucosides  and  similar  principles  (except  such  as  are  acids)  are  indexed  under  their 
chemical  termination,  in. 

Preparations  are  indexed  under  their  Latin  names  where  the  reference  is  to  the  class, 
as  Infusa,  422  ;  but  the  several  individual  preparations  are  placed  under  their  English 
titles,  thus,  Infusion  of  Digitalis ,  1 99  ;  the  reference  being  to  the  Infusum  Digitalis,, 
page  199. 


Abbreviations,  their  use,  443 
Table  of,  443,  691 
Abdominal  Plethora,  480 
Abies,  315 
Abies  balsamea,  384 
canadensis,  315 
excelsa,  315 
Abietic  Anhydride,  385 
Abortion,  48,  480 
Abrus,  55 
Abscess,  481 

of  the  Liver,  590 
Absinthe,  56 
Absinthium,  56 
Abstract  of  Aconite,  76 
of  Belladonna,  126 
of  Conium,  186 
of  Digitalis,  199 


Abstract  of  Hyoseyamus,  248 
of  Ignatia,  250 
of  Jalap,  258 
of  Nux  Vomica,  288 
of  Podophyllum,  320 
of  Senega,  363 
of  Valerian,  394 
Abstracta,  429 
Acacia,  56 

Catechu,  159 

Aceta  (see  also  Vinegars),  428 
Acetanilide,  56 
Acetate  of  Copper,  194 
of  Ethyl,  79 
of  Iron,  215 

of  Iron  and  Ammonium,  217 
of  Lead,  317 
of  Morphine,  293 


INDEX. 


730 


Acetate  of  Potassium,  322 
of  Sodium,  369 
of  Zinc,  403 
Acetic  Ether,  79 
Acetous  Preparations,  428 
Acetum,  58 
Acid  Abietic,  334 
Abric,  55 
Acetic,  58 
Aconitic,  76 
Agaric,  83 
Aloetic,  90 
Anemonic,  328 
Angelic,  380,  390 
Arabic,  56 
Arsenious,  1 1 6 
Artanihic,  277 
Benzoic,  129,  179 
Boracic,  59 
Boric,  59 
Brassic,  367 
Calumbic,  145 
Camphoric,  147 
Camphretic,  147 
Capronic,  114 
Caprylic,  1 14 
Carbazotic,  72 
Carbolic,  60,  179 
Solutions  of,  60 
Gauze,  60 
Carminic,  183 
Caryophyllic,  156 
Caryophyllinic,  156 
Catechuic,  159 
Catechu-tannic,  159 
Cathartic,  364 
Cathartogenic,  364 
Cerotic,  160 
Cetraric,  161 
Cevadic,  396 
Chelidonic,  162,  353 
Chromic,  62 
Chrysammic,  90 
Chrysophanic,  1 74,  344 
Cinnamic,  124,  129,  376 
Citric,  266 
Coca-tannic,  208 
Copaibic,  189 
Cresylic,  60 
Cubebic,  193 
Ergotic,  204 
Ergotinic,  204 
Erucic,  367 
Eugenic,  284 
Euonic,  213 
Euphrastic,  214 
Filicic,  121 
Fluoric,  63 
Gallic,  63,  223 
Gallo-tannic,  74 
Gambogic,  146 
Gelsemic,  224 


Acid  Gentesic,  226 
Gentianic,  226 
Glvcyrrhizic,  228 
Guaiac,  232 
Guaiaconic,  232 
Guaiarec,  232 
Gurjunic,  234 
Gynocardic,  161 
Hydriodic,  252 
Hydrobromic,  65 
Hydrochloric,  65 
Hydrocyanic,  67 
Hypopicrotoxic,  310 
Igasuric,  288 
Ipecacuanhic,  256 
Juglandic,  259 
Kinic,  177 
Kinotannic,  177,  261 
Kinovic,  177 
Kinovo-tannic,  177 
Lactic,  69,  292 
Lactucic,  263 
Linoleic,  268 
Lobelic,  269 
Lupulinic,  238 
Maizenic,  402 
Malic,  126 
Mastichic,  277 
Meconic,  292 
Melassic,  347 
Methyl-salicylic,  224 
Mezereinic,  281 
Muriatic,  65 
Myristic,  285 
Nitric,  70 

Nitro-hydrochloric,  65,  70 
Nitro-muriatic,  65,  70 
Oleic,  7 1,  290 
Ophelic,  164 
Oxalic,  48,  487 
Palmaric,  334 
Palmitic,  290 
Phenic,  60 
Phosphoric,  71 
Phytolaccic,  309 
Picric,  72 
Picrotoxic,  310 
Pinic,  334 
Piperonylic,  19 1 
Podophyllinic,  320 
Polygonic,  321 
Protocatechuic,  320 
Prussic,  67 
Punico-tannic,  230 
Pyrogallic,  63,  179 
P>  roligneous,  31 5 
Quercitannic,  74,  332 
Rhatania-tannic,  74,  262 
Rhtotannic,  336 
Rheumic,  336 
Ricinoleic,  340 
Sabadillic,  396 


INDEX. 


731 


Acid,  Salicylic,  179,  349 
Salicylous,  349 
Salicyluric,  350 
Sanguinarinic,  353 
Scheele’s,  67 
Sclerotinic,  204 
Silvic,  334 
Sphacelinic,  205 
Strychnic,  288 
Sulphuric,  72 
Sulphuric,  Aromatic,  72 
Sulphurous,  73 
Succinic,  91 
Tannic,  74,  223 
Tannic  and  Iron,  453 
Tartaric,  75 
Thebolactic,  292 
Tiglinic,  390 
Toxicodendric,  339 
Tropic,  126,  247 
Valerianic,  380,  393 
Vanillic,  395 
Veratric,  396 
Viburnic,  399 
Xylic,  60 

Acids,  their  action,  36,  65 
Acidity,  481 
Acipenser  Huso,  249 
Acne,  482 
Aconine,  76 
Aconite,  75 
Aconitine,  76 
Aconitum,  75 

Cammarum,  76 
Chinense,  76 
ferox,  76 
Japonicum,  76 
Napellus,  76 
Acorin,  143 
Acorus  Calamus,  143 
Acrinyl,  Sulpho-cyanate,  367 
Acrolein,  227 
Addison’s  Disease,  483 
Administration  of  Medicines,  20 
Adynamia,  483 
Adeps,  78 

Benzoinatus,  78 
Hither,  78 
Hither,  Acetic,  79 
After-pains,  484 
Agalactia,  484 
Agaricin,  83 
Agaricus  albus,  83 
chirurgorum,  83 
muscarius,  84 
Agave  Americana,  90 
Ague,  see  Intermittent  Fever,  598 
Ailanthus  glandulosa,  85 
Albau,  234 
Albumin,  400 
Albuminate  of  Iron,  217 
of  Mercury,  244 


Albuminuria,  484 
Alcohol,  85 

Caustic,  369 
Phenylic,  60,  87 
Alcoholic  Preparations,  423 
strength  of  Bitters,  704 
Alcoholism,  87,  485 
Aldehyde,  87 

Proto-catechuic,  395 
Alder  bark,  64,  89 
Alder,  Black,  327 
Alder,  Buckthorn,  221 
Ale,  86 

Alkalies,  their  action,  36 
Alkaline  Mineral  Waters,  109 
Alkaloids,  409 
Allium  cepa,  89 
porrum,  89 
sativum,  89 
Allspice,  313 
Allyl  Sulphide,  119 

Sulpho-cyanide,  367 
Almond,  67,  97 
Alnus,  64,  89 
Aloe  socotrina,  89 
Aloes,  89 
Alopecia,  486,  673 
Alstonia  scholaris,  202 
Alteratives,  41 
Uterine,  48 
Althaea  officinalis,  91 
Alum,  91 

Alum,  Ammonio-ferric,  217 
Alum  root,  64 
Alumen,  91 

Alumen  Exsiccatum,  91 
Aluminium,  92 
Amanita  Muscaria,  84 
Amaurosis,  486 
Amber,  377,  385 
Amblyopia,  30,  486 
Amenorrhoea,  486 
Amido-benzene,  179 
Ammonia,  93 
Ammonia-alum,  91 
Ammoniated  Mercury,  240 
Ammoniacum,  93 
Ammonium,  93 
Amorphous  Bodies,  415 
Amygdala,  97 

Amara,  67,  97 
Dulcis,  97 
Amygdalin,  67,  9 7 
Amyl  Chloride,  81 
Hydrate,  87 
Hydride,  81 
Nitrite,  98 
Amylene,  81 

Hydrate,  164 
Amylic  Alcohol,  87 
Amylum,  100,  348 

Iodatum,  100,  252 


INDEX. 


732 


Anaemia,  488 

cerebral,  512 
Anaesthesia,  80,  17 1,  489 
Local,  209 

Anaesthetics,  25,  27,  80,  81,  1 71 
Local,  25 
Mixtures,  79 
Modes  of  using,  17 1 
Anacyclus  Pyrethrum,  330 
Analgesics,  27 
Anamirta  paniculata,  310 
Anaphrodisiacs,  47 
Anaphrodisiac  Pills,  468 
Anasarca,  see  Dropsy,  540 
Andira  Araroba,  174 
Anemone,  Meadow,  328 
patens,  328 
pratensis,  328 
Pulsatilla,  328 
Anemonin,  328 
Aneurism,  489 
Angelate  of  Butyl,  101 
Angina. — See  Croup,  Laryngitis,  Pharyn¬ 
gitis,  Throat,  Tonsillitis,  etc. 

Angina  Pectoris,  489 
Anhidrotics,  46 
Anilin,  179 
Anilin  Red,  222 
Anise,  100 
Star,  100 
Anodynes,  25,  27 
Local,  25 
Ant-acids,  36 
Antagonists,  52 

List  of,  53,  451 
Anthelmintics,  40 
Anthem  is,  101 

Anthrax. — See  Carbuncle,  507 
Antibilious  Pills,  469 
Antidote,  Jeaunel’s,  707 
Antidote- bag,  708 
Antidotes,  52,  707 
Anti-emetics,  37 
Anti-fat,  222 
Antifebrin,  56 
Antilithics,  45 
Antimonial  Powder,  102 
Antimony,  102 

Sulphurated,  102 
Antiperiodics,  43 
Antiphlogistics,  43 
Antipyretics,  42 
Antipyrine,  104 
Antiseptic  Fluid,  389 
Antiseptics,  51,  389 
Antisialics,  35 
Antispasmodics,  28 
Antizymotics,  51 
Anus,  Fissured,  490 
Prolapse  of,  647 
Aperients,  38,  468 
Aphonia,  490 


Aphrodisiacs,  47 
Aphthae,  491 
Apiin,  106  • 

Apiol,  106 

Apis  mellifica,  160,  278 
Apnoea,  72 1 
Apocynin,  107 
Apocynum,  107 
Apomorphine,  107,  292 
Apoplexy,  491 
Apotheme,  429 
Appetite,  491 

Approximate  Measures,  438 
Aqua,  108 

Bulliens,  108 
Carbonata,  108 
Communis,  108 
Destillata,  108 
Fervens,  108 
Fluvialis,  108 
Fontana,  108 
Marina,  108 
Pluvialis,  108 

Aquae  (see  also  Water  of),  419 
Aqueous  Preparations,  419 
Arabin,  56,  391 
Arbor  Vitae,  385,  388 
Arbutin,  162,  180,  223,  393 
Arctostaphylos  glauca,  393 
Uva-ursi,  392 
Argentum,  112 
Argol,  322 
Argyria,  113 

Aristolochia  reticulata,  365 
Serpentaria,  365 
Aristolochine,  365 
Arnica,  1 14 
Arnicin,  1 14 

Aromatic  Fluid  Extract,  183 
Aromatic  Powder,  183 
Aromatic  Sulphuric  Acid,  72 
Arseniate  of  Iron,  217 
of  Sodium,  1 16 
Arsenic,  1 16 

Arsemte  of  Bromine,  117 
of  Copper,  1 17,  709 
of  Potassium,  1 1 6 
Arsenium,  1 16 
Artemisia  Absinthium,  55 
maritima,  355 
Arterial  Transfusion,  21 
Artanthe  elongata,  277 
Asafcetida,  1 19 
Asagraea  officinalis,  396 
Ascarides. — See  Worms,  688 
Ascites,  492 
Asclepias,  120 
Ash,  Flowering,  276 
Prickly,  401 

Asparagin,  91,  213,  228 
Asphyxia,  721 
Aspidium,  121 


INDEX. 


733 


Aspidosperma  Quebracho,  331 
Aspidospermine,  331 

Asthenia. — See  Adynamia,  Convalescence, 
Atrophy. 

Asthenopia,  492 
Asthma,  492 
Astigmatism,  494 
Astragalus  gummifer,  39 1 
Astringents,  42,  50,  64,  468 
Intestinal,  39 
Powder,  472 
Urinary,  45 
Atheroma,  494 
Atrophy,  494 
Atropine,  126 

and  Morphine,  299,  702 
Atrosin,  126 
Aurantiin,  121 
Aurantium,  12 1 
Aurum,  122 
Ava  kava,  261 
Avena  Sativa,  123 
Ayer’s  Ague  Cure,  704 
Cherry  Pectoral,  704 
Pills,  704 

Recamier  Balm,  704 
Cream,  704 
Sarsaparilla,  704 
Vita  Nuova,  704 
Azedarach,  123 

Azoturia. — See  Urinary  Disorders,  680 
Azulen,  278 


Balanitis,  494 

Baldness. — See  Alopecia,  486,  673 
Balm,  279 

of  Gilead,  384 
Balnea,  462 
Balneum  Maris,  108 
Vaporis,  108 
Balsam  of  Copaiba,  189 
of  Fir,  384 
P'riar’s,  129,  376 
of  Peru,  124 
of  Tolu,  124 

Balsamodendron  Myrrha,  285 
Balsamum  Dipterocarpi,  233 
Peruvianum,  124 
Tolutanum,  124 
Bandoline,  1 97 
Baptisia,  1 25 
Baptisin,  1 25 
Barberry,  129 
Bark,  Cuprea,  176 
Peruvian,  176 
Tincture  of,  177 
Barley,  273 
Barosma,  137 
Barosmin,  137 
Basham’s  Mixture,  217 


Basilicon  Ointment,  334 
Bassorin,  391 
Baths,  Formulae,  462 
Bay- berry,  284 
Bay  Rum,  284 
Bear-berry,  392 
Bed-sores,  49 5 
Beer,  86 
Belladonna,  125 
Belladonnine,  1 25 
Benne  Oii,  366 
Benzene,  128,  179 
Benzin,  128 

Benzoate  of  Ammonium,  94,  129 
of  Lithium,  129,  268 
of  Sodium,  129 
Benzoin,  1 29 
Benzoinated  Lard,  129 
Benzol,  128,  179 
Benzyl  Cinnamate,  124 
Berberine,  129,  145,  246,  320,  401 
Muriate  of,  129,  246 
Berberis,  129 
Bergamium,  1 30 
Bergamot,  Oil  of,  13 1 
Bergaptene,  130 
Beta-naphthol,  286 
Beta  vulgaris,  347 
Bhang,  150 

Bibliography  and  References,  479 
Bicarbonate  of  Potassium,  322 
of  Sodium,  369 

commercial,  369 
Bichloride  of  Ethene,  81 
of  Ethylene,  169 
of  Mercury,  239 
of  Methylene,  170 

Bichlorinated  Chloride  of  Methyl,  168 

Bichromate  of  Potassium,  62 

Bile,  Agents  affecting  the,  40 

Biliary  Solvents,  45 

Biliousness,  495 

Bilious  Remittent  Fever,  71 7 

Bind-weed,  237 

Biniodide  of  Mercury,  240 

Bird-lime,  400 

Bismuth,  131 

Bismuth  Mixture  for  Children,  457 
Bisulphate  of  Quinine,  177 
Bisulphide  of  Carbon,  81,  154 
Bisulphite  of  Sodium,  73 
Bitartrate  of  Potassium,  323 
Bites  and  Stings,  667 
Bitters,  Action  of  the  Simple,  146 
Alcoholic  Strength  of,  704 
Bittersweet,  203 
Black-berry,  64,  343 
Bark,  343 

Black  Draught,  364 
Drop,  293 
Paste,  571 

Bladder,  Inflammation  of,  529 


734 


INDEX. 


Bladder,  Irritable,  496 
Paralysis  of,  496 
-wrack,  222 
Blende,  403 
Blepharitis,  496 
Blistering  Cerate,  151 
Blisters,  49 
Blood-root,  352 
Blood-stains,  666 
Blue  Flag,  257 
Mass,  239 
Ointment,  239 
Pill,  239 
Boiling,  41 1 
Boils,  496 
Boldine,  132 
Boldo,  132 
Boldus,  132 
Bolus,  463 
Bone  Diseases,  497 
Boneset,  213 
Borate  of  Quinine,  178 
of  Sodium,  59 
Borax,  59 

Boro-citrate  of  Magnesium,  59 
Boro-glyceride,  59 
Bos-taurus,  214 
Bots,  124 

Bougies,  Formulae  for,  475 
Boxwood,  301 

Brain  Disorders. — See  Cerebral  Anaemia, 
Cerebral  Concussion,  etc. 

Fever. — See  Meningitis, Cerebro-spinal 
Meningitis,  Typhoid  Fever,  Typhus 
Fever. 

Brandreth’s  Pills,  704 
Brandy,  86 
Brayera,  132 

Breasts. — See  Abscess,  Lactation,  Mastitis, 
Nipples. 

Breath,  Fetid,  497 
Bright’s  Disease,  Acute,  497 
Chronic,  498 
Diagnosis,  712 

Bromide  of  Ammonium,  94,  133 
of  Arsenic,  1 1 7 
of  Calcium,  133 
of  Ethyl,  79 
of  Iron, 133,  215 
of  Lithium,  133,  268 
of  Methyl,  81 
of  Potassium,  133 
of  Sodium,  133 
of  Zinc,  133 
Bromidrosis,  559 
Bromine  and  Bromides,  133 
Bromism,  134 
Bronchiectasis,  499 
Bronchitis,  Acute,  499 
Capillary,  500 
Chronic,  501 

Bronchocele. — See  Goitre,  569 


Bronchorrhoea,  502 
Broom,  360 
Brown  Mixture,  228 
Brucine,  237,  250,  288 
Bruises,  503 
Bryonia,  135 
Bryonin,  136 
Bubo,  503 
Buchu,  137 

Helmbold’s,  705 
Buckthorn,  158,  221 
Bulimia,  491 
Bunion,  504 
Burdock,  264 

Burnett’s  Disinfectant,  51,  403 
Burns,  504 
Bursitis,  504 
Butternut,  259 
Butyl  Angelate,  101 
Butyl  chloral  Hydrate,  168 
Chloride,  81 
Plydride,  81 
Valerianate,  101 
Buxine,  301 

Buxus  sempervirens,  301 


Cacao-butter,  387 
Cachets,  471 
Cachexiae,  504 
Cadmium,  137 
Caffea,  138 
Caffeine,  138 
Cajuput  Oil,  142 
Cajuputene  Bihydrate,  142 
Cajuputol,  142 
Calabar  Bean,  307 
Calabarine,  307 
Calamine,  403 

Ointment,  405 
Calamus,  143 
Calcination,  412 
Calcium,  143 
Calculi,  Biliary,  505 
Renal,  505 
Solvents  of,  45 
Vesical,  505 
Calendula,  145 
Calomel,  240 
Calumba,  145 
Calx,  143 

Chlorata,  172 
Sulphurata,  378 
Cambogia,  146 
Camellia  Thea,  138,  139 
Camp  Fever. — See  Typhus,  677 
Camphor,  147 

Baldrian,  393 
Bergamot,  131 
Carbolated,  148 
-Chloral,  148 


INDEX. 


735 


Camphor-Cymol,  147 
Monobromated,  147 
Peppermint,  280 
Salicylated,  148 
Canadian  Hemp,  107 
Cancer,  506 

Diagnosis  of,  713 
of  Uterus,  681 
Cancrum  Oris,  507 
Cane  Sugar,  347 
Cannabene,  149 
Cannabin,  149,  165 
Cannabis,  149 

Americana,  149 
Indica,  149 
sativa,  149 

Cantharides,  1 5 1,  229 
Cantharidin,  15 1 
Cantharis,  1 5 1 
Capsicin,  153 
Capsicum,  153 
Cap>ules,  469 
Caraway,  156 
Carbo,  154 

Animalis,  154 
Purified,  154 
Ligni,  154 

Carbolate  of  Iodine,  251 
Carbon,  154 

Bisulphide,  154 
Dioxide,  81,  348 
Monoxide,  81 
Tetrachloride,  170 
Carbolate  of  Iodine,  252 
Carbonei  Bisulphidum,  154 
Carbonate  of  Ammonium,  94 
of  Calcium,  Precipitated,  143 
of  Iron,  215 

Saccharated,  215 
of  Iron  and  Manganese,  275 
of  Lead,  317 
of  Lithium,  268 
of  Magnesium,  271 
of  Potassium,  322 
of  Sodium,  369 
Dried,  369 

of  Zinc,  Precipitated,  403 
Carbonated  Mineral  Waters,  108 
Carbonization,  412 
Carbuncle,  507 

Carcinoma. — See  Cancer,  506 
Cardamom,  155 

Cardiac  Disorders. — See  Heart. 
Sedatives,  33 
Stimulants,  33 
Tonics,  33 

Cardialgia. — See  Pyrosis,  653 
Carduus,  155 
Carica  Papaya,  300 
Caries,  508 
Carminatives,  37 
Dewees’,  272 


Carmine,  183 
Caroval,  196 
Carron  Oil,  144,  268 
Carthamus  tinctorius,  193 
Caruen,  156 
Carum,  156 
Caruol,  156 
Caryophyllin,  156 
Caryophyllus,  156 
Casca  Bark,  157 
Cascara  Amarga,  157 
Sagrada,  158 
Cascarilla,  158 
Cascarillin,  158 
Cassia  acutifolia,  364 
elongata,  364 
Fistula,  158 
Castanea,  64,  159 
vesca,  159 
Castor  Oil,  340 

Emulsion;  Formula,  524 
Castoria,  704 
Catalepsy,  508 
Cataplasmata,  477 
Cataract,  508 

Catarrh,  Acute  Nasal,  509 

Broncho  pulmonary. — See  Bronchitis,. 

Bronchorrhoea. 

Chronic  Nasal,  510 
Duodenal,  541 

Epidemic. — See  Influenza,  597 
Gastric. — See  Gastritis,  Chronic,  566 
Genito-urinary. — See  Bladder,  Catarrh 
of,  Cystitis,  Endometritis,  Gonor¬ 
rhoea,  Leucorrhoea,  etc. 

Intestinal. — See  Dysentery,  Jaundice, 
etc. 

Summer. — See  Hay  Fever,  573 
Catechol,  180 
Catechu,  64,  159 
Cathartics,  38 
Catharto-mannite,  364 
Caulophyllin,  159 
Caulophyllum,  159 
Caustic,  Lunar,  112 
Potash,  322 
Soda,  368 
Caustics,  49 
Cedar,  Oil  of,  354 
Red,  346 
Celandine,  162 
Cellulose,  229,  348 
Centaurea  benedicta,  156 
Cephaelis  Ipecacuanha,  256 
Cephalalgia,  575 
Cera,  160 
Cera  Alba,  160 
Flava,  160 
Cerata,  433,  475 
Cerate  of  Camphor,  147 
of  Cantharides,  1 5 1 
of  Cantharides  Extract,  1 5 1 


INDEX. 


736 

Cerate  of  Cetaeeum,  161 

of  Lead  Subacetate,  318 
of  Resin,  334 
of  Sabine,  346 
Cerates,  433,  475 

Compounding  of,  475 
Ceratum,  160,  433 
Cerebellum,  Agents  affecting,  28 
Cerebral  Anaemia,  512 

Compression,  Diagnosis,  713 
Concussion,  5 1 2 
Diagnosis,  713 
Congestion,  5 1 2 
Depressants,  26 
Excitants,  26 
Softening,  512 
Vomiting — Diagnosis,  717 
Cerebro-spinal  Fever,  615 
Cerium  Oxalate,  160 
Cerolein,  160 
Cetaeeum,  161 
Cetin,  1 61 
Cetraria,  1 6 1 
Cetyl  Palmitate,  161 
Cevadilla,  396 
Cevadilline,  396 
Cevadine,  396 
Chalk,  Prepared,  143 
Chalybeate  Waters,  109 
Chamomile,  101 
German,  278 
Chamomilla,  278 
Chancre,  513 

Diagnosis  of,  7 1 3 
Chancroid,  513 

Diagnosis  of,  713 

Change  of  Life — See  Climacteric,  518 
Chapped  Hands  and  Lips,  513 
Charcoal,  154 

Chartoe  (see  also  Papers),  434 

Chartulae,  471 

Chaulmoogra  Oil,  1 6 1 

Chelerythrine,  162 

Chelidonine,  162 

Chelidonium,  162 

Chelidoxanthin,  162 

Chelsea  Pensioner,  470,  659 

Chemical  Incompatibility,  448 

Chenopodium,  162 

Cherry-laurel,  67,  68 

Cherry,  Wild,  327 

Chestnut,  159 

Chestnut-leaves,  64 

Chest-pains,  513 

Chian  Turpentine,  384 

Chicken-pox,  514,  684 

Chilblains,  514 

Chidreti,  Dosage  for,  22 

Chimaphila,  162 

Chimaphilin,  162 

China,  Pride  of,  123 

Chininum  Amorphum  Boricum,  178 


Chinoidin,  178 
Chinoline,  163,  179 
Chiratin,  164 
Chiretta,  164 
Chittem  Bark,  158 
Chloral,  164 

Analogues  of,  164 
Butylic,  168 
Hydrate,  164 
Chloralamid,  165 
Chloral-habit,  167 
Chlorate  of  Potassium,  322 
of  Sodium,  369 
Chloride  of  Ammonium,  94 
of  Amyl,  81 
of  Arsenic,  85 
of  Butyl,  81 
of  Calcium,  143 
of  Cocaine,  208 
of  Ethene,  81 
of  Ethyl,  81 
of  Ethylidene,  170 
of  Gold,  122 
of  Gold  and  Sodium,  122 
Double,  704 
of  Iron,  215 
of  Lime,  172 
Mercur-ammonium,  240 
of  Mercury,  Corrosive,  2^9 
Mild,  240 

of  Methane,  81,  170 
of  Methyl,  81,  170 
of  Sodium,  369 
of  Zinc,  403 
Chlorinated  Waters,  108 
Chlorine,  172 
Chlorine-water,  172 
Chlorodyne,  169 

Formulae  for,  compared,  703 
Chloroform,  80,  168 
Commercial,  169 
Methylic,  169 
Purified,  169 
Chlorosis,  514 
Chlorum,  172 
Chocolate,  387 
Choking,  515 
Cholagogues,  39 
Pills,  468 
Purgatives,  38 
Cholera  Asiatica,  515 
Infantum,  515 
Simplex,  516 
Diagnosis  of,  714 

Cholera  Mixture  (Squibb),  293,  515 
Cholesterin,  400 

Chondodendron  tomentosum,  301 

Chondrus,  174 

Chordee,  517 

Chorea,  517 

Choroiditis,  518 

Chrysarobin,  174 


INDEX. 


737 


Chrysophan,  336 
Churrus,  1 50 

Cigarettes,  Formulae  for,  493 
Ciliary  Excitants,  33 
Cimicifuga,  174 
Cimicifugin,  175 
Cinchona,  176 
Flava,  176 
Rubra,  176 
Cinchonidine,  177 
Cinchonine,  177 
Cinchonism,  181 
Cinnabar,  240 
Cinnamein,  124 
Cinnamomum,  182 
Camphora,  147 
Cinnamon,  182 
Cinquefoil,  636 

Circulation,  Agents  affecting,  33 
Circumcision,  639 
Cissampeline,  301 
Cissampelos  Pareira,  301 
Citrate  of  Bismuth,  13 1 

of  Bismuth  and  Ammonium,  13 1 
of  Caffeine,  138 
of  Cocaine,  208 
of  Iron,  215 

of  Iron  and  Ammonium,  21 7 
of  Iron  and  Quinine,  217 
of  Iron  and  Strychnine,  217 
of  Lithium,  268 
of  Magnesium,  Granulated,  272 
of  Potassium,  322 
Citrates,  266 
Citrine  Ointment,  240 
Brown,  240 

Citron,  266 

Citrullus  Colocynthis,  185 
Citrus  acris,  266 
Aurantium,  121 
Bergamia,  131 
Limonum,  266 
medica,  266 
vulgaris,  121 
Clarification,  415 
Classification  of  Medicines,  23 
Claviceps  purpurea,  204 
Clavus. — See  Headache,  575 
Clemen’s  Solution,  117 
Climacteric  Disorders,  518 
Cloves,  156 
Club-moss,  270 
Clysters,  461 
Cnicin,  156 
Cnicus  benedictus,  156 
Coca,  130,  208 
Cocaine,  208 
Cocaine-habit,  209 
Cocculus  Indicus,  310 
Coccus,  183 
Coccyodynia,  518 
Cochineal,  183 

47 


Cocoa,  140 
Codamine,  292 
Codfish,  282 
Codeine,  292,  294 
Cod-liver  Oil,  282 

Emulsion,  282 

Coffee,  138 
Cohosh,  Black,  173 
Blue,  159 
Colation,  414 
Colchiceine,  184 
Colchicine,  184 
Colchicum,  184 
Coldness,  518 
Colic,  Hepatic,  520 
Intestinal,  518 
Lead,  519 
Renal,  520 
Colic-root,  201 
Collodia,  427 
Collodion,  229 

with  Cantharides,  15 1,  229 
Flexible,  229,  427 
Styptic,  74,  229,  427 
Colloids,  416 
Collunarium,  461 
Collyrium,  460 

Formulae  for,  460 
of  Four  Sulphates,  460 
Colocynth,  185 
Colocynthein,  185 
Colocynthin,  185 
Colocynthis,  185 
Colocynthitin,  185 
Cologne-water,  86 
Colophony,  334,  385 
Columbo,  145 
Coma,  520 

Combination,  Principles  of,  441 
Comminution,  412 
Compounding  Medicines,  434 
a  Mixture,  456 
Condylomata,  520 
Condy’s  Fluid,  51 
Confectio  Damocratis,  470 
Confection  of  Rose,  342 
of  Senna,  364 
Confectiones,  431, 470 
Formulae  for,  470 
Conhydrine,  186 
Coniine,  186 
Conium,  186 

Conjunctivitis,  Catarrhal,  520 
Diphtheritic,  521 
Gonorrhoeal,  521 
Granular,  521 
Phlyctenular,  522 
Purulent,  522 
Conspergative,  463,  464 
Constipation,  523 
Constituents  of  Drugs,  408 
Convalescence,  524 


INDEX. 


738 


Convallamarin,  188 
Convallaria  Majalis,  187 
Convallarin,  1 88 
Convolvulin,  258,  359 
Convolvulus  Scammonia,  359 
Convulsions,  524 
Infantile,  525 
Puerperal,  650 
Copaiba,  189 

Emulsion,  459 
Copaifera  Langsdorffii,  189 
Copper,  194 
Cordial,  Cascara,  158 
Coriander,  190 
Coriandrum,  190 
Corneal  Opacities,  525 
Corneitis. — See  Keratitis,  603 
Corn,  Indian,  402 
Silk,  402 
Smut,  402 
Cornin,  190 
Corns,  525 
Cornus,  190 
Cornutin,  205 

Corpulence. — See  Obesity,  626 

Corrosive  Sublimate,  239 

Coryza — See  Catarrh,  Acute,  509 

Coto  Bark,  190 

Cotoin,  190 

Cosmoline,  304 

Cotton,  229 

Iodized,  Formula  for,  581 
Cotton-seed  Oil,  229 
Couch  grass,  392 
Cough,  526 

Mixtures,  Formulae  for,  527,  597,  638 
Counter  irritants,  49 
Court  Plaster,  249 
Coxalgia,  527 

Coxe’s  Hive  Mixture,  102,  360 
Crab  Lice. — See  Pediculi,  635 
Cramp  Bark,  399 

Cramps. — See  Trismus,  Spasmodic  Affec¬ 
tions. 

Cranberry  Tree,  399 
Cranesbill,  64,  226 
Cream,  Cold,  342 
of  Tartar,  323 
Creasol,  19 1 
Creasote,  61,  1 9 1 
Creolin,  192 
Creta  Praeparata,  143 
Crocus,  192 

Croton-chloral,  165,  168 
Croton  Eluteria,  158 
Oil,  390 
Tiglium,  390 
Croup,  Catarrhal,  528 
Membranous,  528 
Diagnosis,  714 
Cryptopine,  292 
Crystallization,  415 


Cubeba,  193 
Cubeben,  193 
Cubebene,  193 
Cubebin,  193 
Cuca,  208 

Cucumber,  Squirting,  203 
Cucumber  Tree,  273 
Cucurbita  Pepo,  302 
Cucurbitine,  302 
Culver’s  Root,  265 
Cuprea  Bark,  176 
Cuprum,  194 

Ammoniatum,  194 
Curare,  196 
Curarine,  196 
Cutaneous  Irritants,  49 
Cyanide  of  Mercury,  240 
of  Potassium,  67 
of  Silver,  1 13 
Cyanosis,  529 
Cydonin,  197 
Cydonium,  197 
Cymene,  389 

Cynips  Gallae  tinctorise,  223 
Cypripedin,  197 
Cypripedium,  197 
Cystitis,  Acute,  529 
Chronic,  529 
Cysts,  531 


Damiana,  197 
Dandelion,  383 
Dandruff. — See  Pityriasis,  642 
Daphne  Mezereum,  281 
Daphnin,  281 
Datura  Stramonium,  374 
Tatula,  198 
Daturine,  198,  374 
Deafness,  531 

Death,  Signs  of. — See  Asphyxia,  721 
Debility. — See  Adynamia,  Anaemia,  Con 
valescence. 

Decantation,  414 
Decocta,  422 

Decoction  of  Cetraria,  161 
of  Chimaphila,  163 
of  Dulcamara,  203 
of  Granatum,  230 
of  Haematoxylon,  235 
of  Hydrangea,  239 
of  Inula,  25 1 
of  Prinos,  327 
of  Quercus,  332 
of  Quillaia,  333 
of  Rumex,  344 

of  Sarsaparilla,  Cofnpound,  357 
of  Stillingia,  373 
of  Viola  Tricolor,  400 
of  Viscum,  400 
of  Xanthoxylum,  401 
Decoloration,  415 


INDEX. 


739 


Deer,  Musk,  283 
Deflagration,  412 
Deliquescence,  416 
Deliquescent  Salts,  List  of,  466 
Deliriants,  26 
Delirium,  5 3 1 

Tremens,  531 
Delphinine,  372 
Delphinium  Staphisagria,  372 
Dementia,  532 

Paralytica,  533 
Demulcents,  51 
Dengue,  533 
Dentition,  533 
Dentifrices,  34 
Deodorants,  52 
Depressants,  Cerebral,  26 
Hepatic,  40 
Renal,  44 
Respiratory,  30 
Uterine,  48 
Desiccation,  41 1 
Destructive  Metamorphosis,  42 
Dew  berry,  343 
Dewees’  Carminative,  119,272 
Dextrin,  348 
Dextrose,  347 
Diabetes  Insipidus,  S44 
Mellitus,  534 
Diachylon  Ointment,  318 
Plaster,  318 

Diagnosis,  Differential,  712 
Dialysis,  416 
Dialysed  Iron,  217,  417 
Diaphoretics,  46 
Diarrhoea,  535 
Diastase,  273 

Pancreatic,  300 
Dichloro-methane,  170 
Diffusate,  416 

Digestive  System,  Agents  affecting,  34 

Digitalein,  199 

Digitalin,  199 

Digitalis,  198 

Digitonin,  199 

Digitoxin,  199 

Diluents,  46,  455 

Dioscorea,  201,  399 

Dioscorein,  201 

Diospyros,  64 

Dioxide  of  Carbon,  81,  348 
Diphtheria,  537 

Diagnosis  of,  714 

Dipsomania. — See  Alcoholism,  Delirium 
Tremens. 

Discutients,  42 
Disinfectants,  51 

Burnett’s,  52,  403 
Condy’s,  52 
Labarraque’s,  51,  172 
Dislocations,  563 
Dispensatories,  407 


Dispensing,  434 

by  Physicians,  434,  445 
Displacement,  417 
Distillation,  41 1 
Dry,  41 1 
Fractional,  41 1 
Disulphide  of  Iodine,  378 
Dita  Bark,  202 
Ditaine,  202 
Ditamine,  202 
Diuretics,  43 

Formulae  for,  541,  680 
Dizziness. — See  Vertigo,  685 
Dobell’s  Nasal  Wash,  462,  51 1 
Dock,  Yellow,  344 
Dog-wood,  190 
Jamaica,  314 
Domestic  Measures,  438 
Donovan’s  Solution,  117 
Dorema  Ammoniacum,  93 
Dosage  of  Medicines,  54 
of  Opium,  294,  297 
Dover’s  Powder,  256 
Fluid,  256 

Drastic  Purgatives,  38 
Draught,  459 

Black,  364,  459 
Effervescing,  459 
Drink,  459 

Imperial,  Formula,  460 
Drops,  438 

Table  of  Drops  to  a  Drachm,  438,  726 
Dropsy,  540 
Drosera,  202 

Drowning. — See  Asphyxia,  721 
Drugs,  Their  Constituents,  408 
Drug-experimentation,  19 
Duboisia,  202 
Duboisine,  202 
Dulcamara,  203 
Dulcamarin,  203 
Duodenal  Catarrh,  541 
Dutch  Liquid,  169 
Dyscrasiae. — See  Cachexke,  504 
Dysentery,  541 
Dyspepsia,  544 
Dysphagia,  546 
Dysmenorrhoea,  543 
Dyspnoea,  546 
Dysuria,  547 


Ear,  Agents  affecting  it,  30 
Earache,  630 
Eau  Sedative,  94,  147 
Ebullition,  41 1  , 

Ecballium  Elaterium,  203 
Ecbolics,  47,  48 
Ecboline,  204 
Ecchymosis,  547 
Ecgonine,  208 


740 

Eclampsia,  650 
Ecthyma,  547 
Ectropium,  547 
Eczema,  547 
Efflorescence,  416 
Efflorescent  Salts,  List  of,  466 
Egg,  Yolk  of,  400 
Eights,  The  Three,  670 
Elaterin,  203 
Elaterium,  203 
Elder,  352 
Elecampane,  251 
Electuaria,  431,  470 
Electuary  for  Piles,  470 
Elixir  of  Orange,  122 
of  Opium,  293 
of  Vitriol,  72 
Elixiria,  426,  459 
Elm,  Slippery,  392 
Elutriation,  413 
Ely’s  Cream  Balm,  704 
Emaciation,  549 
Embrocation,  461 
Emetics,  36 

General  or  Systematic,  37 
Local,  37 
Emetine,  256 
Emissions,  550 
Emmenagogues,  47 
Formulae  for,  487 
Pills,  468 
Emollients,  50 
Emphysema  of  Lungs,  550 
Emplastra,  433,  476 
Empyema,  550 
Emulsification,  457 
Emulsin,  67 

Emulsion  of  Cod-liver  Oil,  282,  459 
of  Copaiba,  459 
Pancreatic,  300 
Emulsions,  457 
Natural,  457 

Encephaloma. — See  Cancer,  506 
Diagnosis  of,  713 
Endarteritis. —  See  Atheroma,  494 
Endocarditis,  551 

Diagnosis  of,  713 
Endometritis,  551 
Enema  of  Tobacco,  381 
Enemas,  Formulae  for,  462,  552 
Enemata,  461,  552 
Enteralgia. — See  Colic,  Intes.,  518 
Enteric  Fever. — See  Typhoid,  676 
Enteritis,  552 
Entropium,  547 
Enuresis,  552 
Epididymitis,  553 
Epilation. — See  Tinea  Circin.,  673 
Epilepsy,  553 

Diagnosis  of,  714 
Epispastics,  49 
Epistaxis,  555 


INDEX. 

Epsom  Salt,  271 
Epulis. — See  Teeth,  671 
Equinia. — See  Glanders,  568 
Erections,  550 
Ergot  of  Rye,  204 

of  Corn. — See  Ustilago,  402 
Ergota,  204 
Ergotine,  204 
Ergotinine,  204 
Ergotism,  205 
Ericolin,  223,  393 
Erigeron,  207 
Eriodyction,  207 
Errhines,  32 
Eructations,  544,  562 
Eruptions  caused  by  Drugs,  555 
Erysipelas,  555 
Erythema,  557 
Erythrophleine,  157 
Erythrophloeum  Guinense,  1 5 7 
Erythroretin,  336 
Erythroxylon,  140 
Escharotics,  49 
Eserine,  307 
Essence  of  Lemon,  266 
of  Nutmeg,  285 
of  Peppermint,  280 
of  Spearmint,  281 
Ethene,  81 

Chloride,  81 
Dichloride,  8 1 
Ether,  78 

Acetic,  79 
Chloric,  169 

Chlorinated  Muriatic,  170 
Hydrobromic,  79 
Hydriodic,  79 
Methylic,  81 
Petroleum,  128 
Ethereal  Oil,  79 

Preparations,  427 
Ethics,  724 
Ethyl  Acetate,  79 
Alcohol,  85,  87 
Bromide,  79,  81 
Carbamate,  166 
Chloride,  81 
Hydrate,  87 
Hydride,  81 
Iodide,  79,  253 
Nitrite,  79 
Oxide,  78 

Ethylate  of  Sodium,  369 
Ethylene  Bichloride,  169 
Ethylidene  Chloride,  170 
Eucalyptene,  212 
Eucalyptol,  212 
Eucalyptolen,  212 
Eucalyptus,  212 
Eugenia  caryophyllata,  156 
Pimenta,  313 
Eugenin,  156 


INDEX. 


741 


Eugenol,  156 
Euonymin,  213 
Euonymus,  213 
Eupatorin,  213 
Eupatorium,  213 

perfoliatum,  213 
purpureum,  2 14 
Euphrasia,  214 
Evaporation,  410 

Spontaneous,  41 1 
Exanthemata,  Diagnosis  of,  715 
Excipients,  430,  455 
for  Emulsions,  458 
for  Pills,  464 
Excitants,  Cerebral,  26 
Ciliary,  33 

Excoriation. — See  Intertrigo,  600 
Excretion. — Agents  affecting,  43 
Exhaustion,  557 
Exogonium  purga,  258 
Exophthalmos,  558 
Exostosis,  558 
Expectorants,  32 
Explosive  Compounds,  449 
Expression,  417 
Exsiccation,  412,  416 
Extemporaneous  Pharmacy,  434 
Preparations,  453 
Prescriptions,  439 
Extract  of  Aconite,  76 
of  Aloes,  Watery,  90 
of  Arnica-root,  1 1 5 
of  Baptisia,  125 
of  Belladonna,  Alcoholic,  126 
of  Cannabis  Indica,  149 
of  Cinchona,  1 7 7 
of  Colocynth,  185 
of  Colocynth,  Compound,  185 
of  Colchicum-root,  184 
of  Conium,  Alcoholic,  186 
of  Convallaria,  188 
of  Damiana,  198 
of  Digitalis,  199 
of  Duboisia,  202 
of  Ergot,  205 
of  Eriodyction,  207 
of  Euonymus,  213 
of  Gentian,  226 
of  Glycyrrhiza,  228 
Pure,  228 

of  Hsematoxylon,  235 

of  Hellebore,  236 

of  Hyoscyamus,  Alcoholic,  248 

of  Iris,  257 

of  Juglans,  259 

of  Krameria,  262 

of  Leptandra,  265 

of  Malt,  273 

of  Mezereum,  281 

of  Nux  Vomica,  288 

of  Opium,  292 

of  Physostigma,  308 


Extract  of  Pichi,  310 

of  Pinus  Canad.,  316 
of  Podophyllum,  320 
of  Polygonum,  32 1 
of  Quassia,  331 
of  Quebracho,  332 
of  Rheum,  336 
of  Rhus  Toxicodendron,  339 
of  Stramonium,  374 
of  Taraxacum,  384 
Extracta,  428 

Extracta  Fluida. — See  Fluid  Extracts,  423 
Extractive,  429 
Eye-bright,  214 
Eye  Diseases,  558 

Ointments. — Formulae  for,  521 
Sensibility,  Agents  affecting  it,  29 
Water,  Formulae  for,  521 
Eyelids,  559 


Fabiana  imbricata,  310 
Face,  559 

Face-ache. — See  Neuralgia,  Tic  Doulou¬ 
reux,  622,  672 

Fainting. — See  Syncope,  668 
False  Pains,  559 
Farcy,  568 

Fat. — See  Obesity,  626 
Fatigue. — See  Exhaustion,  557 
Favus. — See  Tinea  Favosa,  673 
Febricula. — See  Fever,  Simple,  561 
Febrifuge,  178 
Feet,  559 

Fehling’s  Solution,  194 
Fel  Bovis,  214 

Inspissatum,  214 
Purificatum,  214 
Felon. — See  Onychia,  627 
Fennel,  221 

Fermentation,  Lactic,  348 
Fern,  Male,  121 
Ferrier’s  Snuff,  Formula,  510 
Ferro-cyanide  of  Potass.,  67 
Ferrum,  215 

Dialysatum,  217,  417 
Reductum,  215 
Ferula  galbaniflua,  222 
Narthex,  119 
Scorodosma,  1 1 9 
Sumbul,  380 
Fever,  560 

Bilious  Remittent,  Diagnosis,  717 

Cerebro-spinal,  613 

Hay,  573 

Hectic,  580 

Intermittent,  598 

Miliary,  618 

Milk. — See  Lactation,  604 
Pernicious. — See  Intermittent  Fever, 
Remittent  Fever. 


INDEX. 


742 

Fever,  Puerperal,  651 
Relapsing,  654 
Remittent,  655 

Diagnosis  oQ  717 
Rheumatic,  656 
Scarlet,  660 

Diagnosis  of,  715 
Simple,  561 
Spotted. — See  Typhus  Fever,  also 
Meningitis,  Cerebro-spinal. 
Surgical,  668 

Traumatic. — See  Surgical  Fever,  668 
Typhoid,  676 

Diagnosis  of,  716 

Typho-malarial. — See  Typhoid,  676 
Typhus,  677 

Diagnosis  of,  71 6 
Yellow,  689 

Diagnosis  of,  71 7 
Ficus  (Fig),  221 
Filix  Mas,  121 
Filtering-paper,  414 
Filtration,  414 
Fir,  Balsam  of,  384 
Scotch,  316 
Silver,  384 
Firs,  315 
Fish-berries,  310 
Fistula,  562 

Fits. — See  Apoplexy,  Convulsions,  Epi¬ 
lepsy,  Hysteria,  Syncope. 

Flatulence,  562 
Flavoring  Agents,  456 
Flax-seed,  267 
Flea-bane,  207 

Fleming’s  Tincture  of  Aconite,  76 
Flooding. — See  Hemorrhage  Post-partum, 
Menorrhagia  and  Metrorrhagia. 
Fluavil,  234 

Fluid  Extract  of  Aconite,  76 
of  Ailanthus,  85 
of  Arnica-root,  1 15 
Aromatic,  183 
of  Aurantium  Amarum,  122 
of  Baptisia,  125 
of  Belladonna,  126 
of  Berberis,  130 
of  Brayera,  1 32 
of  Buchu,  137 
of  Calamus,  143 
of  Calumba,  145 
of  Cannabis  Indica,  149 
of  Capsicum,  153 
of  Cascara  Amarga,  157 
of  Cascara  Sagrada,  158 
of  Castanea,  159 
of  Chimaphila,  163 
of  Chirata,  164 
of  Cimicifuga,  175 
of  Cinchona,  177 
of  Cocculus,  310 
of  Coffee,  Green,  138 


Fluid  Extract  of  Colchicum-root,  184 
of  Colchicum-seed,  184 
of  Conium,  186 
of  Convallaria,  188 
of  Corn-silk,  402 
of  Cornus,  190 
pf  Coto,  191 
of  Cotton-root,  229 
of  Cubeb,  193 
of  Cypripedium,  197 
of  Damiana,  198 
of  Digitalis,  199 
of  Drosera,  202 
of  Dulcamara,  203 
of  Ergot,  205 
of  Eriodyction,  207 
of  Erythroxylon,  208 
of  Eucalyptus,  213 
of  Eupatorium,  214 
of  Frangula,  221 
of  Gelsemium,  224 
of  Gentian,  226 
of  Geranium,  226 
of  Ginger,  406 
of  Glycyrrhiza,  228 
of  Gossypium,  229 
of  Granatum,  230 
of  Grindelia,  230 
of  Guarana,  233 
of  Hamamelis,  235 
of  Hellebore,  Black,  236 
of  Hydrangea,  239 
of  Hydrastis,  246 
of  Hyoscyamus,  248 
of  Ipecacuanha,  256 
of  Iris,  257 
of  Jaborandi,  312 
of  Krameria,  262 
of  Lactucarium,  263 
of  Leptandra,  265 
of  Liquorice,  228 
of  Lobelia,  269 
of  Lupulin,  238 
of  Manaca,  274 
of  Matico,  277 
of  Mezereon,  281 
of  Nux  Vomica,  288 
of  Orange,  Bitter,  122 
of  Pareira,  301 
of  Phytolacca,  309 
of  Pichi,  310 
of  Pilocarpus,  312 
of  Pink-root,  372 
of  Piscidia,  314 
of  Plantago,  317 
of  Podophyllum,  320 
of  Poke-root,  309 
of  Polygonum,  321 
of  Prunus  Virginiana,  328 
of  Quassia,  33 1 
of  Quebracho,  332 
of  Rhatany,  262 


INDEX. 


743 


Fluid  Extract  of  Rheum,  336 
of  Rhubarb,  336 
of  Rhus  Aromatica,  338 
of  Rhus  Glabra,  338 
of  Rose,  342 
of  Rubus,  344 
of  Rumex,  344 
of  Sabina,  346 
of  Sanguinaria,  353 
of  Santalum,  354 
of  Sarsaparilla,  357 
Compound,  357 
of  Savine,  346 
of  Scilla,  359 
of  Scutellaria,  362 
of  Senega,  363 
of  Senna,  364 
of  Serpentaria,  365 
of  Spigelia,  372 
of  Stigmata  Maydis,  402 
of  Stillingia,  373 
of  Stramonium,  374 
of  Sumach,  Smooth,  338 
Sweet,  338 
of  Taraxacum,  384 
of  Tonga,  391 
of  Triticum,  392 
of  Ustilago,  402 
of  Uva-ursi,  393 
of  Valerian,  394 
of  Veratrum  Viride,  396 
of  Viburnum,  399 
of  Wild  Cherry,  328 
of  Witch-hazel,  235 
of  Xanthoxylum,  40 1 
of  Zingiber,  406 
Fluid  Extracts,  423 
Flushing-heats,  563 
Fly-agaric,  84 
Foeniculum,  21 1 
Foetal  Development,  720 

Skull,  its  Diameters,  720 
Fomentation,  460 
Food,  Horlick’s,  273 
Mellin’s,  273 
Foods,  41 

Foreign  Bodies,  563 
Formulae,  Hypodermic,  701 
Formyl  Iodide,  252 
Fotus,  460 

Fowler’s  Solution,  116 
Fox-glove,  198 
Fractures,  563 
Franciscea  uniflora,  274 
Frangula,  221 
Frangulin,  22 1 
Frankincense,  385 
Franklinite,  403 
Fraxin,  276 
Fraxinus  Ornus,  276 
Freckles,  563 
Friar’s  Balsam,  129,  376 


Fuchsin,  222 
Fucus  Vesiculosus,  222 
Furuncle. — See  Boils,  496 
Fusel  Oil,  87 
Fusion,  412 


Gaduin,  282 
Gadus  Morrhua,  282 
Galactagogues,  49 
Galbanum,  222 
Galla,  64,  223 
Galena,  3 1 7 
Gallipots,  476 

Gall-stones. — See  Calculi,  Biliary,  505 
Gallus  Bankiva,  400 
Gamboge,  146 
Gangrene,  564 

of  Lungs,  610 
Garcinia  Hanburii,  146 
mangostana,  276 
Gargarysma,  460 

Gargles,  Formulae  for,  460,  539,  639,  672 
Garlic,  89 

Gaseous  Preparations,  477 
Gastralgia,  564 
Gastric  Dilatation,  565 
Gastric  Fever. — See  Fever,  Simple, — Ty¬ 
phoid  Fever,  Gastritis. 

Gastric  Pain,  37 
Sedatives,  37 
Tonics,  35 
Ulcer,  567 

Vomiting,  Diagnosis,  717 
Gastritis,  Acute,  565 
Chronic,  566 
Gastrodynia,  564 
Gaultheria,  223 
Gaultherilene,  224 
Gauze  of  Thymol,  389 
Gelatin,  249 

Capsules,  469 
Gelsemine,  224 
Gelsemium,  224 

Generative  System,  Agents  affecting,  47 

Genitive  Case-endings,  700 

Gentian,  225 

Gentianin,  225 

Gentopicrin,  225 

Geranium,  64,  226 

Gin,  86,  259 

Ginger,  405 

Glanders,  568 

Glandular  Enlargements,  568 

Glass,  Soluble,  366 

Glauber’s  Salt,  369 

Glaucoma,  568 

Gleet,  568 

Glonoin,  98 

Glossitis,  569 

Glottis,  CEdema  of,  569 

Gluco-pepsin,  303 


INDEX. 


744 


Glucose,  347 
Glucosides,  407 
Glycerin,  227 

Preparations,  428 
Glycerita,  428 

Glycerite  of  Carbolic  Acid,  60 
of  Tannin,  74 
of  Starch,  100 
of  Yolk  of  egg,  400 
Glyceryl,  290 

Trinitrate,  98 

Glycocholate  of  Sodium,  214 
Glycogen,  348 

Agents  affecting  production,  40 
Glyconin,  400 

Emulsion  of,  282 
Glycyrrhetin,  228 
Glycyrrhiza,  228 
Glycyrrhizin,  228 

Glycyrrhizinum  Ammoniatum,  228 

Gnoscopine,  292 

Goa-powder,  174 

Goitre,  569 

Gold,  122 

Double  Chloride  of,  704 
Golden  Seal,  246 
Gonorrhoea,  570 
Gossypii  Radicis  Cortex,  229 
Gossypium,  229 
Goulard’s  Cerate,  318 
Extract,  318 
Gout,  572 

Diagnosis  of,  714 
Granatum,  64,  230 

Granular  Lids. — See  Conjunctivitis,  Oph¬ 
thalmia. 

Granulation,  416 
Granule,  463 
Grass,  Ribbed,  317 
Gravel-root,  214 

Graves’  Disease. — See  Exophthalmos,  558 
Gray  Powder,  239 
Griffith  Mixture,  215 
Pills,  215 
Grindelia,  231 
Guarana,  140,  233 
Guaranine,  140,  233 
Guaiac,  232 

Lignum,  232 
Resina,  232 
Guaiacol,  191 
Gum  Arabic,  56 
Gumboil. — See  Gums,  573 
Gum-tree,  Blue,  212 
Gums,  573 
Gun-cotton,  229 
Gunjah,  150 
Gurjun  Balsam,  233 
Gutta,  234 
Gutta-percha,  234 
Guttae  (Drops),  438 
Gynocardia  odorata,  161 


Hair,  573 
Hair-tonic,  573 
Hair  Washes,  Formulae,  573 
Haller’s  Dictum,  19 
Hamamelin,  234 
Hamamelis,  64,  234 
Hamburg  Tea,  705 
Hamlin’s  Wizard  Oil,  705 
Hands. — See  Chapped  Hands,  5 
Hashish,  150 
Haustus,  459 
Haw,  Black,  399 
Hayah,  157 
Hay-fever,  573 
Haematics,  41 
Haematoxylin,  235 
Haematoxylon,  64,  234 
Head-ache,  Bilious  Sick,  575 
Congestive,  575 
Nervous,  576 
Heart,  Fatty,  578 
Dilated,  578 
Diseases,  577 
Hypertrophied,  578 
Palpitation,  578 
Valvular  Disease,  579 
Heartburn. — See  Pyrosis,  653 
Heart’s-ease,  399 
Hectic  Fever,  580 
Hedeoma,  236 
Helenin,  251 
Hellebore,  236 
American,  395 
Swamp,  395 
White,  396 
Helleborein,  236 
Helleborin,  236 
Helleborus,  236 
Hematemesis,  580 
Diagnosis  of,  7 15 
Hematocele,  Pelvic,  580 
Hematuria,  581 
Helmbold’s  Buchu,  705 
Hemeralopia,  581 
Hemicrania,  582 
Hemiopia,  583 
Hemiplegia,  583 
Hemlock,  186 
Hemlock  Spruce,  315 
Hemoptysis,  583 

Diagnosis  of,  715 
Hemorrhage,  584 
Intestinal,  585 
Post-partum,  585 
Hemorrhagic  Diathesis,  584 
Hemorrhoids,  586 
Hemostatics,  50 
Hemp,  149 

American,  149 
Canadian,  107 
Indian,  149 
Henbane,  247 


INDEX. 


745 


Hepar  Sulphuris,  378 
Hepatalgia,  587 
Hepatic  Abscess,  590 
Congestion,  588 
Cirrhosis,  587 
Depressants,  40 
Diseases,  589 
Stimulants,  39 
Vomiting,  Diagnosis,  717 
Hepatitis,  590 
Hernia,  590 
Herpes,  590 
Zoster,  591 
Hesperidin,  121,  266 
Heuchera,  64 
Hiccough,  591 
Hip-joint  Disease,  527 
Hippocratic  Oath,  724 
Hive  Mixture,  102,  360 
Syrup,  102 

Hives. — See  Urticaria,  681 
Hoang  Nan,  237 
Hoarseness. — See  Aphonia,  490 
Hoffman’s  Anodyne,  79,  83 
Hoff’s  Malt  Extract,  273 
Holloway's  Pills,  705 
Homatropine,  126 
Honduras  Bark,  157 
Honey,  278 

Clarified,  278 
of  Rose,  278,  343 
Honeys  (Mellita),  421 
Hong-Pang-Chong,  337 
Hooper’s  Female  Pills,  468 
Hope’s  Mixture,  537 
Hop  tree,  339 
Hops,  238 

Hordeolum. — See  Eyelids,  559 

Hordeum  distichum,  273 

Plorehound,  277 

Horlick’s  Food,  273 

Hostetter’s  Bitters,  705 

Housemaid’s  Knee. — See  Bursitis,  504 

Humulus,  238 

Hunger. — See  Appetite,  491 

Hunyadi  Water,  524 

Pluxham’s  Tincture  of  Bark,  177 

Hydragogue  Purgatives,  38 

Hydrangea,  239 

Hydrargyrism,  242 

Hydrargyrum,  239 

Ammoniatum,  240 
cum  Creta,  239 
Hvdrastin,  246 
Hydrastine,  246 
Hydrastis,  246 
Hydrate  of  Aluminium,  92 
of  Amyl,  87 
of  Amylene,  164 
of  Butyl-chloral.  168 
of  Chloral,  165 
of  Ethyl,  87 


Hydrate  of  Magnesium,  271 
of  Methyl,  87 
of  Potassium,  322 
of  Sodium,  368 
of  Terpine,  385 
Hydrated  Oxide  of  Iron,  216 
with  Magnesia,  216 
Hydrated  Silicate  of  Magnesium,  36S 
Hydride  of  Amyl,  81 
of  Butyl,  81 
of  Ethyl,  81 
Plydriodic  Ether,  79,  83 
Hydrobromate  of  Coniine,  186 
of  Hyoscine,  165,  248 
of  Quinine,  177 
Hydrobromic  Ether,  79,  82 
Hydrocele,  592 
Hydrocephalus,  592 
Hydrochlorate  of  Apomorphine,  107 
of  Cocaine,  208 
of  Quinine,  177 

Carbamide,  178 
of  Morphine,  293 
of  Narcotine,  294 

of  Oxy-ethyl-chinoline-hydride,  179 
of  Pilocarpine,  312 
of  Rosanilin,  222 
Hydrocotarnine,  292 
Hydrocotyle,  247 
Hydrogen,  Sulphuretted,  378 
Peroxide,  385 
Hydro-naphthol,  286 
Hydrophobia,  592 
Hydroquinone,  179,  180,  393 
Hydrothorax,  593 
Hygrine,  208 
Hygroscopic  Bodies,  416 
Hyoscine,  165,  247 
Hyoscyamus,  247 
Hyoscyamine,  247 
Hyperidrosis,  636 
Hypnone,  165 
Hypnotics,  27,  165 
Hypochondriasis,  593 
Hypodermic  Formulce,  701 
Hypodermic  Injections,  22,  702 
Hypophosphite  of  Calcium,  305 
of  Iron,  216,  305 
of  Potassium,  305 
of  Sodium,  305 
Hypophosphites,  305 

with  Iron,  Syrup  of,  305 
Hyposulphite  of  Sodium,  73 
Hysteria,  593 

Diagnosis  of,  714 


Ice,  no 

Iceland  Moss,  161 
Ichthyocolla,  249 
Ichthyol,  378 
Ichthyosis,  594 


746 


INDEX. 


Icterus. — See  Jaundice,  601 
Igasurine,  288 
Ignatia,  250 
Ignition,  41 2 

Ileus. — See  Intestinal  Obstruction,  600 
Ilex  Paraguayensis,  140 
Illicium,  250 

Anisatum,  100 
Impetigo,  594 
Impotence,  595 
Incineration,  412 
Incompatibility,  448 
Chemical,  448 
Pharmaceutical,  448,  450 
Rules  for  avoiding,  452 
Therapeutical,  451 
Indian  Tobacco,  269 
Indigestion. — See  Dyspepsia,  544 
Indigo,  Wild,  125 
Inflammation,  595 
Influenza,  597 
Infusa,  422 

Infusion  of  Arnica,  1 1 5 
of  Brayera,  1 32 
of  Buchu,  137 
of  Cardamom,  155 
of  Caraway,  156 
of  Cascarilla,  158 
of  Cinchona,  1 7  7 
of  Cloves,  156 
of  Convallaria,  1 88 
of  Digitalis,  199 
of  Gentian,  Compound,  226 
of  Hops,  238 
of  Jequirity,  55 
of  Juniper,  259 
of  Linseed,  268 
of  Lobelia,  269 
of  Pareira,  301 
of  Quassia,  331 
of  Sassafras,  358 
of  Senna,  Compound,  364 
of  Spigelia,  Compound,  372 
of  Tansy,  383 
of  Tar,  316 
of  Wild  Cherry,  328 
of  Uva-ursi,  393 
Infusions,  422 
Ingluvin,  303 

Inhalation  of  Thymol,  389 
Inhalations,  Formulae  for,  477 
Injection  Brou,  462 

of  Morphine,  Hypodermic,  294 
Injections,  461 

Formulae,  22,  462,  702 
Injuries. — See  Bruises,  Burns,  Ecchymosis, 
Fractures,  Sprains,  Wounds. 
Inoculation,  22 
Inosit,  347 
Insanity,  532 

Insolation. — See  sunstroke,  668 
Insoluble  Salts,  449 


Insomnia,  598 

Intemperance. — See  Alcoholism,  Delirium 
Tremens. 

Intermittent  Fever,  598 
Intertrigo,  600 
Intestinal  Astringents,  39 
Intestinal  Diseases. — See  Colic,  Constipa¬ 
tion,  Diarrhoea,  Duodenitis,  Dysentery, 
Enteritis,  Hemorrhoids,  Hernia,  In¬ 
testinal  Obstruction,  Intussusception, 
Typhlitis,  Tabes  Mesenterica,  Worms. 
Intestinal  Obstruction,  600 

Parasites. — See  Worms,  688 
Intussusception,  600 
Inula,  251 
Inulin,  1 14,  251 
Iodide  of  Ammonium,  94,  252 
of  Arsenic,  1 16 
of  Cadmium,  137 
of  Ethyl,  79 
of  Formyl,  252 
of  Iron,  216 

Saccharated,  216 
and  Manganese,  218 
of  Lead,  317 
of  Manganese,  274 
of  Mercury,  240 
Green,  240 
Red,  240 
of  Potassium,  252 
of  Silver,  113 
of  Sodium,  252 
of  Sulphur,  378 
of  Zinc,  403 
Iodides,  252 
Iodine,  251 
Iodism,  253 
Iodized  Cotton,  581 
Phenol,  252 
Starch,  252 
Iodol,  252 
Iodoform,  252 
Iodum,  251 
Ipecacuanha,  256 
Iridin,  257 
Iris,  257 
Irish  Moss,  174 
Irisin,  257 
Iritis,  601 
Iron,  215 

Dialysed,  217,  417 
Pills,  468 

and  Tannic  Acid,  453 
Irritability,  601 
Irritants,  Cutaneous,  49 
Ischuria. — See  Urinary  Disorders. 
Isonandra  Gutta,  234 
Iso-naphthol,  286 
Itch. — See  Scabies,  659 
Itching. — See  Lichen,  Prurigo,  Pruritus, 
Pediculi,  Scabies,  Urticaria,  etc. 

Ivy,  Poison,  338 


INDEX. 


747 


Jaborandi,  31 1 
Jaborine,  31 1 
Jalap,  258 
Jalapin,  258,  359 
James’  Powder,  102 
Jamestown  Weed,  374 
Japaconitine,  76 
Jasmine,  Yellow,  224 
Jateorrhiza  Calumba,  145 
Jaundice,  601 
Jequirity,  55 
Jervine,  396 
Joint  Affections,  602 
Juglans,  259 
Juniperin,  259 
Juniper,  259 

Juniperus  communis,  259 
Sabina,  346 
Virginiana,  346 


Kairine,  179 
Kairoline,  179 
Kalium,  322 
Kalmia  latifolia,  279 
Kamala,  260 
Kavahin,  261 
Kava-kava,  261 
Kawin,  261 
Kefir,  263 
Keratitis,  603 

Kidneys,  Diseases  of. — See  Albuminuria, 
Bright’s  Disease,  Calculi,  Diabetes, 
Dropsy,  Hematuria,  Lithaemia,  Ne¬ 
phritis. 

Kino,  64,  261 

Kinoin,  261 

Kino-red,  261 

Kinovate  of  Calcium,  177 

Kinovin,  177 

Komb&  arrow-poison,  375 

Koussin,  132 

Kousso,  132 

Krameria,  64,  261 

Kumyss,  86,  262 

Kurung  Oil,  321 


Labarraque’s  Solution,  51,  172 
Labor,  603,  719 

Positions  in,  719 
Signs  of,  719 
Lac  Sulphuris,  378 
Lactate  of  Iron,  216 
Lactation,  604 
Lactopeptine,  303 
Lactophosphate  of  Calcium,  305 
Lactose,  348 
Lactuca  virosa,  263 
Lactucerin,  263 


Lactucin,  263 
Lactucarium,  263 
Ladies’  Slipper,  197 
La  Fayette’s  Mixture,  189 
Lallemand’s  Specific,  572 
Lanolin,  263 
Lanthopine,  292 
Lapathin,  344 
Lappa,  264 
Larch,  83 

European,  83,  385 
Lard,  78 

Benzoinated,  78 
Oil,  78 

Larix  Europaea,  385 
Laryngismus  Stridulus,  604 
Laryngitis,  605 
Laryngotomy,  606 
Latin  Phrases  and  Terms,  691,  700 
Laudanine,  292 
Laudanosine,  292 
Laudanum,  292 
Laurel,  Mountain,  279 
Laurocerasus,  67 
Lavandula,  264 
Lavender,  264 
Water,  265 

Laville’s  Anti-gout  Remedy,  185,  656,  705 
Laxatives,  38 

Powder,  472 
Lead,  317 

Colic,  519 
Plaster,  318 
Sugar  of,  317 
Water,  318 

and  Laudanum,  460 
White,  317 
Leek,  89 

Legal’s  Disease,  624 
Lemon,  266 
Juice,  266 
Peel,  266 

Lentigo. — See  Freckles,  563 
Leopard’s  Bane,  1 14 
Leprosy,  606 
Leptandra,  265 
Leptandrin,  265 
Lettuce,  263 
Leucocytheemia,  606 
Leucoline,  163 

Leucoma. — See  Corneal  Opacities,  525 

Leucorrhoea,  607 

Levigation,  413 

Levulose,  347 

Lice. — See  Pediculi,  635 

Lichen,  607 

Lichenin,  161 

Licoperdon  giganteum,  265 
Lignum  Vitae,  232 
Lily-of-the  Valley,  187 
Lily,  Water,  290 
Lime,  143,  144,  266 


748  INDEX. 


Lime,  Chlorinated,  172 
Sulphurated,  378 
Water,  144 
Limon,  266 
Limonis  Cortex,  266 
Succus,  266 
Linimenta,  427,  460 
Liniment,  Aconite,  76 
Ammonia,  93 
Anodyne,  461 
Army,  561 
Belladonna,  126 
Camphor,  147 
Cantharides,  151 
Chloroform,  169 

Compound,  169,  461 
Croton,  391 
Lead  Subacetate,  318 
Lime,  144 

Mustard,  Compound,  367 
Soap,  357 
Stokes’,  461 
Turpentine,  384 
Liniments,  Formulae  for,  461 
Linseed,  267 
Linum,  267 

Lips. — See  Chapped  Lips,  513 
Lip-salve,  Red,  388 
Liquid-ambar  orientalis,  376 
Liquids,  Normal,  424 
Liquores  (See  Solution  of),  420 
Liquorice  Root,  228 
Wild,  55 
Lithaemia,  60S 
Litharge,  318 
Lithium,  268 
Lithontriptics,  45 
Liver. — See  Hepatalgia,  etc.,  587 
Liver  of  Sulphur,  378 
Lixiviation,  417 
Lobelacrin,  269 
Lobelia,  269 
Lobelin,  269 
Lobeline,  269 

Lochia. — See  Labor  and  Puerperal  Disor¬ 
ders,  603,  65 1 

Lock-jaw. — See  Tetanus,  671 
Locomotor  Ataxia,  608 
Log- wood,  64,  234 
Lotion,  460 

Black,  of  Mercury,  241 
Yellow,  of  Mercury,  241 
Loxopterygium  Lorentzii,  332 
Lozenges,  431,  469 
Lugol’s  Solution,  252 
Lumbago,  609 

Lumbrici. — See  Worms,  688 
Lungs,  Diseases  of,  609 
Gangrene  of,  610 
Lupulin,  238 
Lupuline,  238 
Lupus,  610 


Lycopodium,  270 
Lyctonine,  76 
Lymphangeitis,  61 1 


Mace,  285 

Oil  of,  285 
Maceration,  417 
Macis,  285 
Macrotin,  175 
Magendie’s  Solution,  294 
Magenta,  222 
Magma,  415 
Magnesia,  27 1 

Ponderosa,  271 
Magnesium,  271 
Magnolia,  273 
Magnolin,  273 
Maize,  402 
Malaria,  61 1 
Male  Fern,  12 1 
Mallotus  phillipinensis,  260 
Malt,  273 

Extract,  HofPs,  273 
Maltum,  273 
Mammary  Abscess,  481 
Manaca,  274 
Mandrake,  320 
Manganese,  274 
Oxide,  274 
Manganum,  274 
Mangifera  indica,  276 
Mango,  276 
Mango-fruit,  276 
Mangosteen,  276 
Mania,  612 

Puerperal,  652 
Manna,  276 
Mannit,  276 
Manzanita,  393 

Marasmus.  —  See  Atrophy,  Emaciation, 
Tabes  Mesenterica. 

Marc,  423 

Marginal  Shield  Fern,  121 
Marigold,  145 
Marjoram,  Wild,  300 
Marrubiin,  277 
Marrubium,  277 
Marsh-mallow,  91 
Mass  of  Copaiba,  189 

of  Ferrum  Carbonate,  215 
of  Mercury,  239 
Massm,  430 
Mastic,  277 
Mastiche,  277 
Mastichin,  277 
Mastitis,  612 
Mastodynia,  613 

Masturbation. — See  Emissions,  Spermator¬ 
rhoea,  550,  664 
Mate,  140 


INDEX. 


749 


Materia  Medica,  17,  55 
Matico,  277 
Matricaria,  278 

Chamomilla,  278 
May  Apple,  320 

McMunn’s  Elixir  of  Opium,  293 
Meadow  Anemone,  328 
Saffron,  184 
Measles,  613 

Diagnosis  of,  715 
False. — See  Roseola,  659 
Measures,  Approximate,  438 
Domestic,  438 
and  Weights,  435,  726 
Meconidine,  292 
Meconoiosin,  292 
Meconin,  292 

Medicines,  Administration  of,  20 
Classification  of,  23 
Meerschaum,  367 
Mel,  278 

Despumatum,  278 
Rosae,  278 

Melaleuca  Cajuputi,  142 
Melancholia,  614 
Puerperal,  652 
Melia  Azedarach,  123 
Melissa,  278 
Mellin’s  Food,  273 
Mellita,  421 

Meningitis,  Cerebral,  614 
Cerebro-spinal,  615 
Spinal,  615 

Tubercular. — See  Hydrocephalus,  592 
Menispermin,  279,  310 
Menispermum,  279 
Cocculus,  310 

Menopause. — See  Climacteric,  518 
Menorrhagia,  616 
Menstrual  Disorders,  617 
Menstruum,  417 
Mentagra,  617 
Mentha  Piperita,  279 
Viridis,  280 
Menthol,  280 
Mercurial  Ointment,  239 
Plaster,  239 

Mercuric  Chloride,  239 
Iodide,  240 
Mercurio- vegetal,  274 
Mercurous  Chloride,  240 
Iodide,  240 
Mercury,  239 

Ammoniated,  240 
with  Chalk,  239 

Mesenteric  Disease. — See  Tabes  Mesen- 
terica,  670 

Metabolism,  Agents  affecting,  41 
Meta-dihydroxy-benzene,  334 
Methane,  81 
Methene  Chloride,  81 
Methyl  Alcohol,  81 


Methyl  Bromide,  81 
Chloride,  170 

Bichlorinated,  168 
Coniine,  186 
Creasol,  1 9 1 

Ether  of  Protocatechuic  Aldehyde,  393 
Hydrate,  87 
Salicylate,  224 
Terchloride,  168 
Methylal,  166 
Methylene  Bichloride,  170 
Methylic  Alcohol,  87 
Ether,  81 
Methysticin,  261 
Metric  Prescriptions,  437 

System  of  Weights,  etc.,  436 
Table  for  Converting,  727 
Metritis,  Acute,  617 
Metrorrhagia,  617 
Mezereon,  281 
Mezereum,  281 
Microbe-killer,  706 
Migraine,  582 
Miliary  Fever,  618 
Milk. — See  Agalactia,  Lactation. 

Milk  Fever. — See  Lactation,  604 
Mindererus,  Spirit  of,  94 
Mineral  Waters,  109 
Mint,  279 

Miscarriage. — See  Abortion,  480 
Mistletoe,  400 
Misturse,  421,  453 
Mixture,  Almond,  97 
Ammoniac,  93 
Asafetida,  1 19 
Bismuth,  457 
Chalk,  143 
Chloroform,  169 
Copaiba,  Compound,  189 
Coxe’s  Hive,  102,  360 
Ferro-saline,  218 
Gentian,  Alkaline,  226 
and  Senna,  226 
Iron,  Aromatic,  218 

and  Ammon.  Acetate,  217 
Iron,  Compound,  215 
Iron,  Laxative,  218 
Laville’s,  185,  656 
Liquorice,  Compound,  228 
Magnesia  and  Asafetida,  1 1 9,  272 
Neutral,  323 
Quinine,  455,  457 
Potassium  Citrate,  323 
Rhubarb  and  Soda,  336 
Mixtures,  421,  453 

Compounding  of,  456 
Substances  suitable  to,  454 
Moccasin- plant,  197 
Molasses,  348 
Mole. — See  Naevus,  619 
Mollities  Ossium  — See  Bone  Diseases, 
Rachitis,  497,  653 


INDEX. 


750 

Monoxide  of  Carbon,  81 
Monsel’s  Solution,  216 
Moonseed,  Canadian,  279 
Morbilli. — See  Measles,  613 
Morphine,  293 

and  Atropine,  299,  702 
Habit,  628 
Morrhuse  Oleum,  282 
Morrison’s  Pills,  146,  705 
Moschus,  283 
Mosquitoes,  667 
Motor  Depressants,  24 
Excitants,  24 
Mouth  Diseases. — See  Aphthae,  Cancrum 
Oris,  Gums,  Parotitis,  Ptyalism,  Stom¬ 
atitis,  Toothache,  Tongue. 

Mouth  Washes,  Formula;,  573 
Mucilage  of  Acacia,  56 
of  Cydonium,  197 
of  Elm,  392 
of  Sassafras-pith,  358 
of  Tragacanth,  391 
Mucilagines,  421 
Mullein,  398 
Mumps,  634 

Muriate  — See  Hydrochlorate, 
of  Berberine,  130 
of  Cocaine,  208 
Muscae  Volitantes,  618 
Muscarine,  84 

Muscular  Disorders. — See  Atrophy,  Cho¬ 
rea,  Hydrophobia,  Laryngismus,  Lum¬ 
bago,  Myalgia,  Pleurodynia,  Rheum¬ 
atism,  Tetanus,  Torticollis. 

Musk,  283 
Mustard,  367 
Black,  367 
Flour  of,  367 
Oil  of,  367 
White,  367 
Myalgia,  618 
Mydriasis,  127 
Mydriatics,  28 
Myelitis,  618 
Mykose,  204 
Myopia,  619 
Myotics,  29 
Myrcia,  284 
Myrica,  64 

cerifera,  160 
Myricin,  160 
Myristica,  284 
Myristicol,  285 
Myronate  of  Potassium,  367 
Myrosin,  367 
Myroxylon  toluifera,  1 24 
Pereiroe,  1 24 
Myrrh,  285 
Myrrhin,  286 
Myrrhol,  286 
Myrtle,  64 
Myrtol,  503 


Naevus,  619 
Nails,  Ingrowing,  619 
Napelline,  76 
Naphthaline,  1 79,  286 
Naphthol,  286 
Narceine,  292 
Narcotics,  26 
Narcotine,  292 
Nasal  Affections,  619 

Injections,  Formulae,  539 
Natrium,  368 
Nausea,  620 
Necrosis,  620 
Nectandra,  301 
Nervous  Affections,  620 
Exhaustion,  621 
Nervousness,  621 

Nervous  System,  Agents  affecting,  24 
Neuralgia,  622 
Ovarian,  631 
Neutral  Mixture,  323 
Nicotiana  Tabacum,  381 
Nicotianin,  381 
Nicotine,  381 
Nightshade,  Black,  203 
Deadly,  125 
Woody,  203 
Night-mare,  625 

Night  Sweats. — See  Hectic  Fever,  Per 
ration,  Phthisis. 

Nipples,  Sore,  625 
Fissured,  625 
Nitrate  of  Ammonium,  94 
of  Iron,  216 
of  Lead,  317 
of  Mercury,  240 
of  Muscarine,  84 
of  Potassium,  323 
of  Silver,  1 12 
Fused,  1 12 
of  Sodium,  369 
Nitre,  323,  369 
Chili,  369 
Sweet  Spirit  of,  79 
Nitrite  of  Amyl,  98 
of  Ethyl,  79,  98 
of  Potassium,  98 
of  Sodium,  98 
Nitro-benzene,  179 
Nitro-benzol,  97 
Nitro-glycerin,  98 
Nitrous  Ether,  79,  82 
Oxide,  81 
Nodes,  625 
Normal  Liquids,  424 
Norwood’s  Tincture,  396 
Norway  Spruce,  315 
Nucin,  259 
Nutgall,  64,  223 
Nutmeg,  284 
Nux  Vomica,  287 
Nyctalopia,  581 


INDEX. 


Nymphsea,  64 
Odorata,  290 
Nymphomania,  625 


Oak- bark,  64,  332 
Black,  333 
Oak,  Dyer’s,  223 
Poison,  338 
White,  332 
Oat,  123 
Obesity,  626 

Obstetrical  Memoranda,  719 
Odontalgia,  626 
CEsophagus,  Affections  of,  627 
Official  Operations,  410 
Preparations,  419 
Officinal. — See  Preface. 

Oil  of  Allspice,  313 

of  Almond,  Bitter,  98 
Expressed,  98 
of  Amber,  377,  385 
of  Anise,  101 
of  Anthemis,  101 
of  Aurantium  Cortex,  122 
Flores,  122 
of  Bay,  284 
Benne,  366 
of  Bergamot,  13 1 
of  Cade,  259 
of  Cadinum,  259 
of  Cajuput,  142 
of  Caraway,  156 
of  Car um,  156 
Carron,  144,  268 
Castor,  340 
of  Caryophyllus,  156 
of  Cedar,  354 
Chaulmoogra,  161 
of  Chenopodium,  162 
of  Cinnamon,  183 
of  Cloves,  156 
Cod-liver,  282 
of  Copaiba,  189 
of  Coriander,  190 
of  Cotton-seed,  229,  290 
Croton,  390 
of  Cubeb,  193 
ofErigeron,  207 
Ethereal,  79 
of  Eucalyptus,  212 
of  Fennel,  221 
of  Gaultheria,  223 
of  Gossypium-seed,  229,  290 
of  Hedeoma,  236 
of  Hemlock,  316 
of  Juniper,  259 
Kurung,  321 
Lard,  78 
of  Lavender,  265 
Flowers,  265 


Oil,  of  Lemon,  266 
of  Linseed,  267 
of  Linum,  267 
of  Mace,  285 
of  Mentha  Piperita,  280 
of  Mentha  Viride,  281 
of  Mirbane,  97 
of  Morrhua,  282 
of  Mustard,  Volatile,  367 
of  Myrcia,  284 
of  Myristica,  285 
of  Neroli,  122 
of  Nutmeg,  285 
Olive,  290 

of  Orange-flowers,  122 
of  Orange-peel,  122 
of  Origanum,  300 
of  Pennyroyal,  236 
of  Pepper  mint,  280 
Phosphorated,  304 
of  Pimenta,  313 
of  Pinus  Sylvestris,  316 
of  Pix  Liquida,  315 
of  Pongamia,  321 
of  Ricinus,  340 
of  Rose,  342 
of  Rosemary,  343 
of  Rue,  345 
of  Ruta,  345 
of  Sabina,  346 
Salad,  290 
of  Sandalwood,  354 
of  Santal,  354 
of  Sassafras,  358 
of  Scotch  Fir,  316 
of  Sesamum,  366 
of  Sinapis,  Volatile,  367 
of  Spearmint,  281 
of  Spruce,  316 
Sweet,  290 

of  Succinum,  377,  385 
of  Tabacum,  381 
of  Tanacetum,  383 
of  Tansy,  383 
of  Tar,  315 
of  Terebinthina,  384 
of  Theobroma,  387 
of  Thuja,  385,  388 
of  Thyme,  389 
of  Tiglium,  390 
of  Turpentine,  384 
of  Valerian,  394 
of  Wintei green,  223 
Wood,  233 
Oils,  Expressed,  417 
Fixed,  417 
Ointment,  160 

Basilicon,  334 
Belladonna,  126 
Boracic,  59 
Calamine,  405 
Carbolic  Acid,  60 


INDEX. 


752 

Ointment,  Chrysarobin,  174 
Citrine,  240 
Diachylon,  318 
Gallic  Acid,  63 
Gall,  223 
Hamamelis,  235 
Iodine,  252 
Iodoform,  252 
Lead  Carbonate,  318 
Iodide,  318 
Mercurial,  239 

of  Mercury,  Ammoniated,  240 
Nitrate,  240 
Red,  241 
Oxide,  Red,  240 
Yellow,  240 
Mezereum,  281 
Nutgall,  223 
Petroleum,  304 
of  Pix  Liquida,  316 
of  Potassium  Iodide,  252 
of  Rose-water,  342 
of  Staphisagria,  372 
Stramonium,  374 
Sulphur,  378 

Alkaline,  378 
of  Tannic  Acid,  74 
Tar,  316 
Thymol,  389 
Veratrine,  396 
White  Precipitate,  240 
Witch-hazel,  235 
of  Zinc  Oxide,  403 
Ointments,  432,  475 
Compounding,  475 
Formulae  for,  476 
Olea  Europaea,  290 
Oleaginous  Preparations,  427 
Oleata,  71,  428 
Oleate  of  Aconitine,  71,  76 
of  Aluminium,  71 
of  Arsenic,  71 
of  Atropine,  71 
of  Bismuth,  71 
of  Cocaine,  208 
of  Copper,  71 
of  Iron,  71 
of  Lead,  71,  318 
of  Mercury,  71,  240 
of  Morphine,  71,  294 

and  Mercury,  71 
of  Quinine,  71 
of  Silver,  71 
of  Strychnine,  71 
of  Veratrine,  71,  396 
of  Zinc,  7 1 
Oleates,  71,  428 
Olein,  290 
Oleoresina,  427 
Oleoresin  of  Aspidium,  1 21 
of  Capsicum,  153 
of  Cubeb,  193 


Oleoresin  of  Lupulin,  238 
of  Pepper,  314 
of  Zingiber,  406 
Oleoresins,  427 
Onion,  89 
Onychia,  627 
Operations,  Official,  410 
Ophelia  Chirata,  164 
Ophthalmia,  627 
Opisthotonos. — See  Tetanus,  671 
Opium,  291 

Denarcotized,  292 
Habit,  628 
Opodeldoc,  357 
Orange,  121,  266 
Blossom,  705 
Orchitis,  630 
Ordeal  Bark,  157 
Origanum,  300 
Otalgia,  630 
Otitis,  630 
Otorrhoea,  631 
Ovarian  Neuralgia,  631 

Tumors. — See  Cysts,  531 
Ovaritis,  631 
Ovis  Aries,  366 
Oxalate  of  Cerium,  161 
of  Iron,  216 
Oxaluria,  632 
Ox-gall,  214 
Oxide  of  Antimony,  102 
of  Calcium,  143 
of  Ethyl,  78 
of  Iron,  Hydrated,  216 

with  Magnesia,  216 
of  Lead,  318 
of  Magnesium,  27 1 
of  Manganese,  Black,  274 
of  Mercury,  Red,  240 
of  Mercury,  Yellow,  240 
of  Propyl,  282 
of  Silver,  113 
of  Zinc,  403 
Oxidizers,  450 
Oxy-benzene,  60 
Oxymel,  279,  421 
Oxytocics,  48 
Oyster-shell,  143 
Ozaena,  632 


Pagliari’s  Styptic,  585 
Pain,  632 

Chest,  513 
Gastric,  37 
Pains,  False,  559 
Paints,  477 

Palmitate  of  Cetyl,  161 
Palmitin,  290 
Pancoast’s  Styptic,  585 
Pancreas,  Agents  affecting,  40 


INDEX. 


753 


Pancreatin,  300 

Pancreopepsin,  303 

Pannus. — See  Corneal  Opacities,  525 

Pansy,  399 

Papain,  300 

Papaiva,  300 

Papaver  Somniferum,  291 
Papaverine,  292 
Papaw  Milk,  301 
Paper  of  Cantharides,  151 
of  Mustard,  367 
of  Potassium  Nitrate,  323 
Papers  (Chartte),  434 
Papine,  293 
Parachinanisols,  179 
Paraconi'ine,  186 
Paracoto  Bark,  1 9 1 
Paracotoin,  19 1 
Paraldehyde,  166,  301 
Paralysis,  633,  665 
Paramenispermin,  310 
Paramorphine,  292 
Paraphimosis. — See  Phimosis,  639 
Paraplegia. — See  Paralysis,  633 
Parasiticides,  52 
Paregoric,  293 
Pareira,  301 
Parigenin,  357 
Parillin,  357 
Paris  Green,  1 1 7,  709 
Paronychia,  627 
Parotitis,  634 
Parsley,  106 

Parrish’s  Chemical  Food,  305 
Participles,  700 
Parvule,  463 
Paste,  Black,  571 
Pastilles,  431,  469 
Pasque-flower,  328 
Patent  Medicines,  704 
Paullinia  curare,  196 
Paullinia  sorbilis,  233 
Pearson’s  Solution,  116 
Pectin,  332 
Pediculi,  635 
Pelletierine,  230 
Pellitory,  330 

Persian,  330 
Pelosine,  301 
Pelvic  Diameters,  720 
Pemphigus,  635 
Pencils,  474 

Penis. — See  Chancre,  Chancroid,  Chordee, 
Gleet,  Gonorrhoea,  Phimosis,  Urethra. 
Pennyroyal,  236 
Pennywort,  247 
Pepo,  302 
Pepper,  Black,  313 
Cayenne,  153 
Water,  321 
Peppermint,  279 
Pepsin,  302 

48 


Pepsin,  Liquid,  303 
Saccharated,  303 
Pepsinum,  302 

Peptogenic  Milk  Powder,  303 
Perchloride  of  Iron,  215 
Percolation,  417 
Pericarditis,  635 

Diagnosis  of,  713 
Periostitis,  636 
Peritonitis,  636 

Puerperal,  652 

Permanganate  of  Potassium,  274 
Pernicious  Fever. — See  Intermittent  Fever, 
Remittent  Fever. 

Peroxide  of  Hydrogen,  385 
Perry  Davis’s  Pain-Killer,  705 
Persimmon,  64 
Perspiration,  636 
Pertussis,  637 
Peruvian  Bark,  176 
Petrolatum,  304 
Petroleum  Ether,  128 
Ointment,  304 
Petroselinum  sativum,  106 
Peumus  Boldo,  132 
Phaeoretin,  336 

Phagedena. — See  Chancre,  Chancroid, 
Gangrene,  Ulcers. 

Pharmaceutical  Incompatibility,  448,  450 
Rules,  447 

Pharmaceutists. — Their  objectionable  prac¬ 
tices,  444 
Pharmacology,  1 7 
Pharmacopoeias,  List  of,  407 
Pharmacy,  17,  407 

Extemporaneous,  434 
Official,  410 

Rules  for  neophytes,  447,  452 
Pharyngitis,  638 
Phaseo-mannit,  347 
Phenacetine,  180 
Phenol,  60,  179 
Iodized,  252 
Salicyl,  350 
Sodique,  60 
Pheno-resorcin,  180 
Phenyl-acetamide,  57 
Phenylic  Alcohol,  60,  179 
Phimosis,  639 
Phlebitis,  639 

Phlegmasia  Alba  Dolens,  639 
Phlegmon,  640 
Phlorol,  19 1 

Phosphate  of  Ammonium,  94 

of  Calcium,  Precipitated,  305 
of  Iron,  216 

of  Iron  and  Manganese,  218 
of  Sodium,  305 
Phosphates,  304 

Syrup  of  the,  305 
Phosphide  of  Zinc,  305 
Phosphites,  304 


754 

Phosphorus,  304 
Photophobia,  640 
Phthisis,  640 

Diagnosis  of,  715 
Physeter  macrocephalus,  161 
Physiological  Antagonists,  451 
Physostigma,  307 
Physostigmine,  307 
Phytolacca,  309 
Pichi,  310 

Picraena  excelsa,  330 
Picrates,  72 
Picroglycion,  203 
Picropodophyllin,  320 
Picrotoxin,  310 

Pierce’s  Favorite  Prescription,  705 
Golden  Discovery,  706 
Pigmenta,  477 
Piles,  586 
Pill  of  Aloes,  90 

of  Aloes  and  Asafetida,  90,  119 
of  Aloes  and  Iron,  90 
of  Aloes  and  Mastic,  90 
of  Aloes  and  Myrrh,  90 
of  Antimony,  Compound,  102 
of  Asafetida,  1 1 9 
Blue,  239 

Compound  Cathartic,  185 
of  Galbanum  Comp.,  119,  223 
of  Iodide  of  Iron,  216 
of  Iron,  Compound,  215 
Lady  Webster’s,  90 
of  Mercury,  239 
of  Opium,  292 
of  Phosphorus,  304 
of  Rhubarb,  336 
of  Rhubarb,  Compound,  336 
Tanjore,  66 7 
Pill-masses,  430,  463 
Pills,  430,  462 
Coated,  466 
Compressed,  467,  469 
Excipients  for,  463 
Formulae  for,  468 
Process  of  making,  463 
Official,  430 

Substances  suitable  for,  465 
Pilocarpine,  31 1 
Pilocarpus,  31 1 
Pilulae,  430,  462 
Pimenta,  313 
Pimpinella  Anisum,  100 
Pimples. — See  Acne,  482 
Pine,  Prince’s,  163 
Yellow,  384 
Pines,  315 
Pinipicrin,  3S8 
Piniies  Succinifer,  377,  385 
Pink,  Carolina,  372 
Pink-root,  372 
Pinus,  315 

Australis,  384,  385 


INDEX. 

Pinus,  Palustris,  315 
Sylvestris,  316 
Taeda,  385 
Piper,  313 

angustifolium,  277 
methysticum,  261 
Piperine,  314 
Pipsissewa,  162 
Piscidia,  314 
Piscidin,  314 
Pissenlit,  383 
Pistaceae  Terebinthus,  384 
Pistacia  Lentiscus,  277 
Pitch,  315 

Burgundy,  315 
Canada,  315 
Hemlock,  315 
Pityriasis,  642 
Pix,  315 

Pix  Liquida,  315 
Planat’s  Tincture,  310 
Plantago,  317 
Plantain,  317 
Plaster  Adhesive,  334 
Ammoniac,  93 

with  Mercury,  93 
Arnica,  1 15 
Asafetida,  119 
Belladonna,  126 
Capsicum,  153 
Carbolic  Acid,  60 
Diachylon,  318 
Galbanum,  223 
Ichthyocolla,  249 
Iron,  216 
Lead,  318 
Mercurial,  239 
Opium,  293 
Pitch,  Burgundy,  316 
Pitch  with  Canthandes,  151,  316 
Pitch,  Canada,  316 
Resin,  334 
Soap,  357 
Strengthening,  216 
Warming,  316 
Plasters,  433,  476 

Formulae  for,  476 
Preparation  of,  433 
Plethora,  643 

Abdominal,  480 
Pleurisy,  643 

Diagnosis  of,  7 1 5 
Pleurisy  root,  120 
Pleuritis,  643 
Pleurodynia,  644 
Pleuro-pneumonia,  644 
Plum,  327 
Plumbum,  31 7 
Plummer’s  Pills,  102 
Pneumonia,  644 

Diagnosis  of,  715 
Podophyllin,  320 


INDEX. 


75 


Podophyllitoxin,  320 
Podophyllum,  320 
Poison  Ivy,  338 
Oak,  338 
Sumach,  338 
Poisoning  by  Acids,  66 
Acid,  Acetic,  708 

Arsenious,  118,  708 
Carbolic,  61,  708 
Chromic,  63 
Gallic,  64 

Hydrocyanic,  68,  708 
Mineral,  66,  708 
Oxalic,  708 
Sulphuric,  708 
Sulphurous,  73 
Tannic,  74 
Aconite,  76,  708 
Agaricus,  84 
Alcohol,  88,  708 
Alkalies,  370,  708 
Alum,  708 
Ammonia,  95,  708 
Antimony,  103,  708 
Arsenic,  1 18,  708 
Atropine,  127,  709 
Barium,  709 
Bees,  709 

Belladonna,  127,  709 
Bromides,  134 
Camphor,  148,  709 
Cannabis  Indica,  150,  709 
Cantharis,  152,  709 
Chloral,  167,  709 
Chlorine,  172,  709 
Chloroform,  81,  170,  709 
Cinchona,  181 
Cocaine,  210 

Cocculus  Indicus,  31 1,  710 

Colchicum,  184,  709 

Conium,  186,  709 

Copper,  195,  709 

Crea^ote,  709 

Curare,  196 

Cyanide  of  Pot.,  68 

Digitalis,  200,  709 

Duboisine,  202 

Ergot,  206 

Ether,  81 

Fish,  709 

Gamboge,  709 

Gas,  Carbonic  Acid,  709 

Sulphuretted  Hydrogen,  709 
Gelsemium,  225,  709 
Glass,  709 

Gold  Salts,  123,  709 
Hyoscyamus,  249,  709 
Insects,  709 
Iodine,  253,  709 
Ipecacuanha,  256 
Iron,  709 
Lead,  319,  709 


Poisoning  by  Lime,  144,  710 
Lobelia,  270 
Mercury,  244,  710 
Mezereum,  710 
Muscarine,  84 
Morphine,  297,  710 
Mushrooms,  710 
Nitrites,  99 

Nux  Vomica,  289,  71 1 
Oak  or  Ivy,  339 
Opium,  297,  710 
Phosphorus,  306,  710 
Physostigma,  308,  710 
Picrotoxin,  31 1,  710 
Pilocarpine,  312 
Potassa,  324 

Potassium  Salts,  324,  710 
Pulsatilla,  329 
Quinine,  181,  710 
Reptiles,  400,  710 
Resorcin,  334 
Rhus,  339,  71 1 
Sanguinaria,  353 
Silver  Salts,  1 13,  71 1 
Snakes,  400 
Sodium,  370 
Stramonium,  374,  71 1 
Strychnine,  289,  71 1 
Sulphites,  73 
Sulphur,  378 

Sulphuretted  Hydrogen,  379 
Sumach,  339 
Tin,  71 1 

Tobacco,  382,  71 1 
Turpentine,  386 
Vegetable  Poisons,  71 1 
Veratrum  Viride,  397,  71 1 
Zinc  Salts,  404,  71 1 
Poisoning,  52,  707 

Antidotes  and  Antagonists,  53 
Indications  for  Treatment,  53 
General  Principles,  707 
Poisonous  Compounds,  450 
Poisons,  Energetic,  707 
Poke-berry,  309 
Poke,  Indian,  395 
Poke-root,  309,  395 
Polygala  Senega,  363 
Polygonum  Hydropiperoides,  321 
Polyporus  fomentanus,  83 
Polypus,  645 

Polyuria. — See  Diabetes  Insipidus,  534 

Pomade  de  Bareges,  643 

Pomegranate,  64,  230 

Pond’s  Extract,  235 

Pond  Lily,  64 

Pongamia,  321 

Poppy,  White,  291 

Porphyrization,  413 

Porphyroxine,  292,  353 

Porrigo  Capitis. — Tinea  Tonsurans,  673 

Porter,  86 


INDEX. 


756 

Port  Wine,  86 
Potassa,  322 
Alum,  91 
cum  Calce,  322 
Sulphurata,  378 
Potassio  Cupric-Tartrate,  194 
Potassium,  322 
Potato,  203 

Potentilla  Sarmentosa,  636 
Potus,  459 
Poultices,  477,  646 

List  of  Br.  official,  477 
Powder  of  Aloes  and  Canella,  90 
Antimonial,  102 
Aromatic,  183 
Chalk,  Compound,  143 
Dover’s,  256 
Effervescing,  Comp.,  323 
Gray,  239 

Ipecac  and  Opium,  256,  293 
Jalap,  Compound,  258 
James’,  102 
Kino,  Compound,  261 
Liquorice,  Compound,  228,  364 
Morphine,  Compound,  293 
Opium,  292 

Rhubarb,  Compound,  336 
Seidlitz,  323 
Tullo’s,  293 
Powders,  431,  470 
Formulae  for,  472 
Substances  suitable  to,  471 
Precipitant  Solutions,  Table  of,  449 
Precipitate,  White,  240 
Precipitation,  415 
Pregnancy,  Disorders  of,  646 
Signs  of,  719 
Vomiting  of,  686 
Premna  tatiensis,  391 
Preparations,  Acetous,  428 
Alcoholic,  423 
Aqueous,  419 
Ethereal,  427 
Extemporaneous,  453 
Gaseous,  477 
Glycerin,  428 
Liquid,  453 
Official,  419 
Oleaginous,  427 
Solid,  428,  462 
Prepositions,  700 
Prescriptions,  439 
Analysis  of,  439 
Blanks  for,  443 
Filling  of,  445 
Metric,  437 
Renewals,  444 
Tonic,  484,  488,  622 
Prescription  Writing,  442 

Latin  Words  used  in,  691 
Prickly  Heat. — See  Lichen,  607 
Prince’s  Pine,  162 


Prinos,  327 

Proctitis. — See  Rectum,  654 
Prolapsus  Ani,  647 
Uteri,  647 
Pronunciation,  699 
Propyl  Oxide,  282 
Propylamine,  1 15 

Prosopalgia. — See  Neuralgia,  Odontalgia 
Tic  Douloureux. 

Prostate,  Hypertrophied,  647 
Prostatitis,  647 
Prostatorrhoea,  647 
Protectives,  51 
Protiodide  of  Mercury,  240 
Protopine,  292 
Prune,  327 
Prunum,  327 
Prunus  domestica,  327 
Laurocerasus,  67 
serotina,  327 
Virginiana,  327 
Prurigo,  648 
Pruritus,  648 
Pseudaconitine,  76 
Pseudo-jervine,  396 
Pseudo-morphine,  292 
Pseudotropine,  247 
Psoriasis,  649 
Ptelea  trifoliata,  339 
Pterocarpus  marsupium,  261 
santaiinus,  354 
Pterygium,  650 
Ptosis,  650 
Ptyalism,  650 
Puccine,  353 

Puerperal  Convulsions,  650 
Disorders,  651 
Fever,  651 
Mania,  652 
Melancholia,  652 
Peritonitis,  652 
Puff-ball,  265 
Pulmonary  Sedatives,  31 
Pulsatilla,  328 
Pulse,  652 
Pul veres,  431,  470 
Pulverization,  413 
Pumpkin-seed,  302 
Punica  Granatum,  230 
Purgatives,  38 
Purging  Agaric,  83 
Cassia,  158  * 

Purpura,  652 
Pustule,  Malignant,  653 
Pustules. — See  Ecthyma,  Eruptions,  Im 
petigo,  Pustule  Malignant. 

Pustulants,  49 
Pyaemia,  653 
Pyrethrine,  330 
Pyrethrum,  330 
Roseum,  330 
Pyridine,  179,  381 


INDEX. 


757 


Pyrocatechin,  179,  180 
Pyrogallol,  63,  179 
Pyrol,  252 

Pyrophosphate  of  Iron,  216 
of  Sodium,  305 
Pyrosis,  653 
Pyroxylin,  229 


Quassia,  330 

Surinam,  330 
Quassin,  330 
Quebrachine,  331 
Quebracho,  331 
Queen’s  Delight,  378 
Root,  373 
Quercin,  332 
Quercitrin,  333 
Quercus  Alba,  64,  332 
Lusitanica,  223,  333 
Tinctoria,  333 
Quicksilver,  239 
Quillaia,  333 
Quince-seed,  197 
Quinetum,  178 
Quinicine,  179 
Quinidine,  177 
Quinine,  177 

Mixture,  457 
Quinoidin,  178 
Quinquinine,  178 
Quinsy. — See  Tonsillitis,  674 


Rabies. — See  Hydrophobia,  592 
Rachitis,  653 

Radam’s  Microbe-killer,  706 
Radway’s  Ready  Relief,  706 
Resolvent,  706 

Raspail’s  Eau  Sedative,  94,  147 
Raspberry,  344 
Recamier  Balm,  etc.,  704 
Rectum,  Absorption  by,  20 
Diseases  of,  654 
Ulceration  of,  654 
Red  Gum. — See  Strophulus,  668 
References  and  Bibliography,  479 
Refrigerants,  35 
Relapsing  Fever,  654 
Remittent  Fever,  655 
Diagnosis  of,  717 
Renal  Depressants,  44 
Renewals  of  Prescriptions,  444 
Repercolation,  418 
Resin.  334,  385 
Cerate,  334 
of  Copaiba,  189 
of  Jalap,  258 
Plaster,  334 
of  Podophyllum,  320 


Resin  of  Scammony,  359 
Resina,  334,  385 
Resinse,  430 
Resolvents,  42 
Resorcin,  61,  179,  334 
Respiration. — See  Bronchitis,  Croup,  Dysp¬ 
noea,  Emphysema,  Pneumonia,  etc. 
Respiration,  Agents  affecting,  30 
Artificial,  721 

Respiratory  Depressants,  30 
Stimulants,  30 
Restoratives,  41 
Retina,  Affections  of,  655 
Rhamnoxanthin,  221 
Rhamnus  Frangula,  221 
Purshiana,  158 
Rhaphidophora  vitiensis,  39 1 
Rhatanine,  262 
Rhatany,  64,  261 
Rheum,  336 

Rheumatic  Arthritis,  655 
Rheumatism,  Acute,  656 
Chronic,  657 
Diagnosis  of,  714 
Gonorrhoeal,  659 
Muscular,  659 
Rhinacanthin,  337 
Rhinacanthus,  337 

Rhinitis. — See  Catarrh,  Acute  Nasal,  also 
Nasal  Affections. 

Rhoeadine,  292 
Rhubarb,  336 
Rhus  Aromatica,  337 
diversiloba,  339 
glabra,  338 
pumila,  339 
radicans,  338 
Toxicodendron,  338 
venenata,  339 
t  Ricinus  communis,  340 
Rickets. — See  Rachitis,  653 
Rigors. — See  under  Fever,  560 
Ring-worm,  673 
Roasting,  412 
Rochelle  Salt,  323 
Rosa  centifolia,  342 
Damascena,  342 
Gallica,  64,  342 
Rosanilin,  222 
Rose,  64,  342 

Attar  of,  342 
Cabbage,  342 
Pale,  342 
Red,  64,  342 
Roseine,  222 
Rosemary,  64,  343 
Roseola,  659 
Rosin,  334 
Rosmarinus,  343 
Rottlera,  260 

tinctoria,  260 
Rottlerin,  260 


INDEX. 


758 


Rubefacients,  49 
Rubeola. — See  Measles,  613 
Rubijervine,  396 
Rubini’s  Tincture,  147 
Rubus,  64,  343 

Canadensis,  343 
Idaeus,  344 
occidentalis,  344 
trivialis,  343 
strigosus,  344 
villosus,  343 
Rue,  345 

Rules  for  Incompatibility,  452 
for  Pharmaceutists,  447 
Rum,  86 

Bay,  284 
Rumex,  344 
Rumicin,  344 

Rupia. — See  Pemphigus,  635 
Ruta,  345 
Russian  Spirit,  658 
Rye,  204 


Sabadilla,  396 
Sabina,  346 
Saccharine,  347 
Saccharum,  347 
Lactis,  348 
Sacred  Bark,  158 
Safflower,  193 
Saffron,  192 

American,  182 
Meadow,  184 
Saffron-tea,  192 
Sage,  352 

Sage’s  Catarrh  Remedy,  706 
Salicin,  349 

Salicylate  of  Cinchonidine,  178 
of  Cocaine,  208 
of  Lithium,  298,  349 
of  Methyl,  224 
of  Phenol,  350 
of  Physostigmine,  308,  349 
of  Sodium,  349 
Saligenin,  349 
Saline  Mineral  Waters,  109 
Purgatives,  38 
Salipyrin,  35° 

Saliva,  Agents  affecting,  35 
Salivation,  35,  242,  650,  710 
Salix,  349 
Salol,  350 
Salt,  common,  369 
Epsom,  271 
Glauber’s,  369 
Rochelle,  323 
Salt-petre,  323 
Chili,  369 

Salt-rheum. — See  Eczema,  547 
Salts,  Deliquescent,  List  of,  466 


Salts,  Efflorescent,  List  of,  466 
Salve,  Red  Lip,  388 
Salvia,  352 
Salviol,  352 
Sambucus,  352 
Sandal-wood  Oil,  354 
White,  354 
Yellow,  354 

Sanford’s  Catarrh  Cure,  706 
Sanguinaria,  352 
Sanguinarine,  352 
Sanitas,  385 
Santalum  Album,  354 
citrinum,  354 
Rubrum,  354 
Santonica,  355 
Santonin,  355 

Santoninate  of  Sodium,  355 
Sapo,  356 

Animalis,  356 
Medicatus,  356 
Mollis,  356 
Viridis,  356 
Sapogenin,  363 
Saponification,  356 
Saponin,  159,  333 
Sarcinae,  659 

Sarcocele. — See  under  Cancer,  Testicles. 
Sarothamnus  Scoparius,  360 
Sarsaparilla,  357 
Sassafras,  358 

Medulla,  358 
Swamp,  273 
Sassy  Bark,  157 
Saunders,  Red,  354 
Savine,  346 

Sayre’s  Method  for  Chloroform,  171 
Scabies,  659 

Scald-head. — See  Eczema,  Tinea. 
Scalds,  504 
Scammonium,  359 
Scammony,  359 
Scarlet  Fever,  660 
Diagnosis  of,  715 
Scheele’s  Acid,  67 
Green,  1 17 
Sciatica,  661 
Scilla,  359 
Scillin,  359 
Scillipicrin,  359 
Scillitin,  359 
Scillitoxin,  359 
Scirrhus. — See  Cancer,  506 
Diagnosis  of,  713 
Sclererythrin,  204 
Scleroderma,  662 
Scleromucin,  204 
Scleroxanthin,  204 
Scoparin,  360 
Scoparius,  360 
Scorbutus. — See  Scurvy,  663 
Screaming. — See  Nightmare,  625 


INDEX. 


759 


Scrofulosis,  662 
Scudamore’s  Mixture,  572 
Scurvy,  663 
Scutellaria,  362,  399 
Scutellarin,  363 
Sea-sickness,  663 
Seborrhoea,  663 
Sea-wrack,  222 
Secale  cereale,  204 
Secaline,  402 
Sedatives,  24,  37 
Cardiac,  33 
Gastric,  37 
Pulmonary,  31 
Urinary,  45 
Uterine,  468 
Vascular,  34 
Vesical,  45 
Seidlitz  Powder,  323 
Senega,  363 
Senegin,  363 
Senna,  364 
Sennacrol,  364 
Sennapicrin,  364 
Separation,  415 
Septicaemia,  653 
Serpentaria,  365 

Serpent-bites. — See  Poisoning  by  Reptiles, 
also  Stings. 

Sesamum,  Oil  of,  366 
Sevum,  366 
Shampoo  Mixtures,  642 
Sheep,  366 
Sherry  Wine,  86 

Shingles. — See  Herpes  Zoster,  591 
Sialogogues,  35 

Sickness  at  Stomach. — See  Nausea,  Sea¬ 
sickness,  Vomiting. 

Siddhi,  150 

Silicate  of  Magnesium,  366 
Hydrated,  367 
of  Potassium,  323,  366 
of  Sodium,  366 
Silicious  Mineral  Waters,  109 
Silver,  1 12 
Sinalbin,  367 
Sinapine,  367 
Sinapis,  367 
Alba,  367 
Nigra,  367 

Singultus. — See  Hiccough,  591 
Sinigrin,  367 
Sinistrin,  359 

Skin,  Agents  affecting,  49 
as  an  Absorbent,  21 

Skin  Diseases. — See  Acne,  Boils,  Burns, 
Carbuncles,  Chapped  Hands  and  Lips, 
Chilblains,  Condylomata,  Ecchymosis, 
Ecthyma,  Eczema,  Elephantiasis, 
Eruptions,  Erysipelas,  Erythema, 
Freckles,  Herpes,  Herpes  Zoster,  Ich¬ 
thyosis,  Impetigo,  Intertrigo,  Lichen, 


Lupus,  Mentagra,  Naevus,  Onychia, 
Pemphigus,  Phlegmon,  Pityriasis, 
Prurigo,  Pruritus,  Psoriasis,  Roseola, 
Scabies,  Scleroderma,  Seborrhoea, 
Strophulus,  Syphilis,  Tinea,  Ulcer, 
Urticaria,  Wart,  Wen. 

Skull  cap,  362 

Sleep,  Abnormal. — See  Delirium,  Insom¬ 
nia,  Nightmare,  Somnambulism. 

Slippery  Elm  Bark,  392 
Small-pox,  684 

Diagnosis  of,  715 
Smart-weed,  32 1 
Smell,  Agents  affecting,  30 
Smilacin,  357 
Smilax,  357 
Snake-root,  Black,  174 
Virginia,  365 
Sneezing,  664 

Agents  producing,  32 
See  also  Catarrh,  Hay  Fever,  Influ¬ 
enza. 

Soaloin,  90 
Soap.  356 

Bark,  333 

Curd,  356 

Green,  356 

Insoluble,  356 

of  Lead  Monoxide,  356 

of  Lime,  356 

Soft,  356 

Soda,  Caustic,  368 
Chlorata,  172 
Chlorinated,  172 
Soda-water,  108,  1 1 1 
Sodium,  368 
Solanine,  203 
Solanum  Dulcamara,  203 
Solid  Preparations,  428,  462 
Soluble  Substances,  454 
Solution,  413 

Aids  to,  454 

Circulatory,  414 

of  Aluminium  Benzoate,  93 

of  Ammonium  Acetate,  94 

of  Arsenious  Acid,  1 16 

of  Arsenic  and  Mercuric  Iodide,  116 

of  Arsenite  of  Bromine,  1 1 7 

of  Arsenite  of  Potassium,  116 

of  Carbolic  Acid,  108 

Clemen’s,  1 1 7 

Donovan’s,  117 

Fehling’s,  194 

Fowler’s,  1 1 6 

of  Gutta-percha,  234 

of  Iodine,  Compound,  252 

of  Iron  Acetate,  215 

of  Iron  Citrate,  215 

of  Iron  Chloride,  215 

of  Iron  Nitrate,  216 

of  Iron  and  Quinine  Citrate,  217 

of  Iron  Subsulphate,  216 


INDEX. 


760 

Solution  of  Iron  Tersulphate,  217 
of  Lead  Subacetate,  318 
of  Lead  Subacet.,  Dilute,  318 
of  Lime,  144 
of  Lime,  Chlorinated,  172 
of  Lime,  Saccharated,  144 
Labarraque’s,  172 
Lugol’s,  252 
Magendie’s,  294 
of  Magnesium  Citrate,  272 
of  Mercuric  Nitrate,  240 
of  Morphine  Sulphate,  294 
of  Opium,  Compound,  293 
Pancreatic,  300 
Pearson’s,  1 1 6 
of  Pepsin,  303 
of  Potassa,  322 
of  Potassium  Arsenite,  1 1 6 
of  Potassium  Citrate,  323 
of  Potassium  Silicate,  366 
of  Soda,  368 
of  Soda  Chlorinated,  143 
of  Sodium  Arseniate,  116 
of  Sodium  Silicate,  366 
of  Thymol,  389 
of  Zinc  Chloride,  403 
Solutions  (Liquores),  420 
Hypodermic,  702 
Precipitant,  Table  of,  449 
Stock,  447 
Solvents,  414 
Somnal,  371 
Somnambulism,  664 
Sores,  678 
Sorghum,  347 
Sorrel,  344 
Sozodont,  707 
Spanish  Flies,  15 1 
Sparteine,  360 
Spasmodic  Affections,  664 
Spearmint,  281 

Specific  Gravity  and  Volume,  439 
Table  of,  725 
Spermaceti,  161 
Spermatorrhoea,  664 
Spigelia,  372 
Spina  Bifida,  665 
Spinal  Concussion,  665 
Congestion,  665 
Inflammation. — See  Meningitis,  Mye¬ 
litis. 

Irritation,  665 
Paralysis,  665 
Softening,  665 
Spirit  of  Ammonia,  93 

of  Ammonia,  Aromatic,  93 
of  Ammonia,  Fetid,  119 
of  Anise,  101 
of  Camphor,  147 
of  Chloroform,  169 
of  Cinnamon,  183 
of  Ether,  79,  83 


Spirit  of  Ether,  Compound,  79,  83 
of  Nitrous  Ether,  79,  83 
of  Gaultheria,  224 
Grain,  85,  87 
of  Hedeoma,  236 
of  Juniper,  259 
of  Juniper,  Compound,  259 
of  Lavender,  265 
of  Lemon,  266 
of  Mentha  Piperita,  280 
of  Mentha  Viride,  281 
of  Mindererus,  94 
of  Myrcia,  284 
of  Myristica,  285 
of  Nutmeg,  285 
of  Orange,  122 
of  Pennyroyal,  236 
of  Peppermint,  280 
Potato,  87 
Proof,  86 
Rectified,  86 
Russian,  658 
of  Spearmint,  281 
of  Turpentine,  384 
Wood,  87 

Spirits  (Spiritus),  426 
Spleen,  Affections  of,  666 
Spongia  Usta,  662 

Spotted  Fever. — See  Typhus  Fever,  Men 
ingitis  Cerebro-spinal 
Sprains,  666 
Spruces,  315 
Spunk,  83 

Squamae. — See  Ichthyosis,  Pityriasis,  Pso 
riasis 

Squaw-root,  160 
Squibb’s  Mixture,  293,  515 
Squill,  359 

St.  Ignatius’  Bean,  250 
St.  Jacob’s  Oil,  76,  706 
St.  Mary’s  Thistle,  156 
Stains,  666 
Stammering,  666 
Staphisagria,  372 
Star  Anise,  100,  250 
Starch,  100,  348 

Iodized,  100,  252 
Statice,  64 
Stavesacre,  362 
Sterility,  666 
Sternutatories,  32 
Stigmata  Maydis,  402 
Stillingia,  373 
Stimulants,  23 
Cardiac,  33 
Hepatic,  39 
Local,  25 
Pancreatic,  40 
Respiratory,  30 
Vascular,  34 
Stings,  667 
Stock  Solutions,  447 


INDEX. 


76i 


Stomach  Diseases. — See  Dyspepsia,  Gas- 
tralgia,  Gastric  Ulcer,  Gastritis,  etc. 
Stomachics,  35 
Stomatitis,  667 
Stone. — See  Calculi,  505 
Storax,  376 
Strabismus,  668 
Straining,  414 
Stramonium,  374 

Strangury. — See  Cystitis,  Dysuria 
Stricture. — See  Rectum,  Urethral  Stric¬ 
ture 

of  Urethra,  679 
Strophanthin,  375 
Strophanthus,  375 
Strophulus,  268 
Struma. — See  Scrofulosis,  662 
Strychnine,  237,  250,  288 
Strychnos  Ignatii,  250 
Gaultheriana,  237 
Nux-Vomica,  287 
Sturgeon,  249 
Stye. — See  Eyelids,  559 
Styptic  Collodion,  74 
Styptics,  50,  585 
Styracin,  376 
Styrax,  376 

Benzoin,  129 
Styrol,  376 

Subacetate  of  Lead,  318 
Subcarbonate  of  Bismuth,  13 1 
Subchloride  of  Mercury,  240 
Subiodide  of  Bismuth,  132 
Sublimation,  41 1 
Subnitrate  of  Bismuth,  13 1 
Substances  best  given  alone,  453 
difficult  to  combine  in  pill,  465 
suitable  for  mixtures,  454 
suitable  for  pills,  465 
suitable  for  powders,  471 
unsuited  to  pill-form,  466 
Subsulphate  of  Iron,  216 

of  Mercury,  Yellow,  240 
Succinum,  377,  385 
Sudorifics,  46 
Suet,  366 
Sugar,  347 
Beet,  347 
Cane,  347 
Diabetic,  348 
Fruit,  348 
Grape,  348 
of  Lead,  317 
of  Milk,  348 
Starch,  348 

in  Urine,  Tests  for,  723 
Sulphate  of  Aluminium,  92 

of  Aluminium  and  Ammonium,  91 
of  Aluminium  and  Potassium,  91 
of  Ammonium,  94 
of  Atropine,  126 
of  Cadmium,  137 


Sulphate  of  Cinchonidine,  178 
of  Cinchonine,  178 
of  Copper,  194 
of  Duboisine,  202 
of  Hyoscyamine,  248 
of  Iron,  216 
of  Iron,  Dried,  216 
of  Iron,  Precipitated,  216 
of  Iron  and  Ammonium,  217 
of  Magnesium,  271 
of  Manganese,  274 
of  Morphine,  293 
of  Potassium,  323 
of  Quinidine,  178 
of  Quinine,  177 
of  Sodium,  369 
of  Sparteine,  360 
of  Strychnine,  288 
of  Tetra-hydromethyl-chinoline,  179 
of  Zinc,  403 
Sulphide  of  Allyl,  1 1 9 
of  Antimony,  102 
of  Antimony,  Purified,  102 
of  Calcium,  378 
of  Hydrogen,  378 
of  Mercury,  Red,  240 
Sulphite  of  Magnesium,  73,  271 
of  Potassium,  73 
of  Sodium,  73  <- 

Sulpho-carbolate  of  Sodium,  61,  62 
Sulpho-cyanate  of  Acrinyl,  367 
Sulpho- cyanide  of  Allyl,  367 
Sulphonal,  166 
Sulphur,  377 

Liver  of,  378 
Lotum,  377 
Milk  of,  378 
Precipitated,  378 
Sublimed,  377 
Washed,  377 

Sulphurated  Antimony,  102 
Lime,  378 
Potassa,  378 

Sulphuretted  Hydrogen,  378 
Sulphurous  Mineral  Waters,  no 
Sumach,  Poison,  338 
Smooth,  338 
Swamp,  339 
Sweet,  337 
Sumbul,  380 
Sun-dew,  202 
Sunstroke,  668 
Suppositoria,  432,  473 
Suppositories,  Formula?,  475 
Official  in  Br.  Phar.,  474 
of  Tannic  Acid,  74 
Suppuration,  668 
Surgeon’s  Agaric,  83 
Surgical  Fever,  668 
Svapnia,  292 

Swallowing. — See  Dysphagia;  Oesopha¬ 
gus,  Disorders  of. 


INDEX. 


762 

Swamp  Sassafras,  273 
Sweet  Bay,  273 
Flag,  143 
_  Gum,  376 

Swift’s  Specific,  S.  S.  S.,  706 
Sycosis,  668 

Sydenham’s  Laudanum,  293 
Syncope,  668 
Synovitis,  669 
Syphilis,  669 
Syrup  of  Acacia,  56 
of  Allium,  89 
of  Almond,  97 
of  Althaea,  91 
of  Amygdala,  97 
of  Citric  Acid,  266 
of  Garlic,  89 
of  Ginger,  406 
of  Hydriodic  Acid,  252 
of  Hypophosphites,  305 
of  Hypophos.  with  Iron,  305 
of  Ipecacuanha,  256 
of  Iron  Bromide,  215 
of  Iron  Iodide,  216 
of  Iron  and  Mang.  Iodide,  218,  274 
of  Iron  and  Mang.  Phosphate,  218 
of  Iron,  Quinine  and  Strychnine 
Phosphates,  305 
of  Krameria,  262 
of  Lactophosphate  of  Calcium,  305 
of  Lactucarium,  263 
of  Lemon,  266 
of  Lime,  144 
of  Manganese  Iodide,  274 
of  Orange,  122 
of  Orange-flowers,  122 
of  Phosphates,  Compound,  305 
of  Prunus  Virginiana,  328 
of  Rhubarb,  336 
of  Rhubarb,  Aromatic,  336 
of  Raspberry,  344 
of  Rose,  343 
of  Rubus,  344 
of  Rubus,  Aromatic,  344 
of  Rubus  Idaeus,  344 
of  Sarsaparilla,  357 
of  Sarsaparilla,  Comp.,  3^7 
of  Scilla,  356 
of  Squill,  359 

of  Squill,  Compound,-  102,  360 
of  Senega,  363 
of  Senna,  364 
of  Stillmgia,  Comp.,  373 
of  Tar,  316 
of  Tolu,  125 
of  Wild  Cherry,  328 
of  Zingiber,  406 
Syrupi  (Syrups),  420 

Tabacum,  381 

Tabellae  Nitroglycerini,  98 


Tabes  Mesenterica,  670 
Table  of  Drops,  etc.,  in  f^j,  439,  726 
of  Latin  Words,  Phrases,  etc.,  691 
of  Metric  Conversion,  727 
of  Precipitant  Solutions,  449 
of  Specific  Gravities  and  Volumes,  725 
Tables  of  Differential  Diagnosis,  712 
of  Weights  and  Measures,  435,  726 
Tablets,  431 

Compressed,  List  of,  469,  470 
Hypodermic,  List  of,  470 
Tag  Alder,  89 
Tamarind,  382 
Tamar-Indien,  364,  706 
Tamarindus,  382 
Tanacetin,  383 
Tanacetum,  383 
Tanjore  Pill,  667 

Tannate  of  Cannabin,  149,  15 1,  165 
of  Pelletierine,  231 
Tannin,  74 

and  Iron,  453 
Tansy,  383 
Oil  of,  383 
Tea  of,  383 

Tapeworm,  121,  231,  688 
Tar,  315 
Tar- water,  316 
Taraxacerin,  383 
Taraxacin,  383 
Taraxacum,  383 
Tartar,  Crude,  322 
Emetic,  102 

Tartra-borate  of  Potassium,  59 
Tartrate  of  Antimony  and  Potas.,  102 
of  Chinoline,  163 
of  Iron  and  Ammonium,  217 
of  Iron  and  Potassium,  217 
Potassio- Cupric,  194 
of  Potassium,  323 
of  Potassium,  Acid,  323 
of  Potassium  and  Sodium,  323 
Tartrates,  75 

Taste,  Agents  affecting,  30 
Disordered,  671 
Taurocholate  of  Sodium,  214 
Taeniafuges,  40 
Taeniae. — See  Worms,  688 
Tea,  139 

Flaxseed,  268 
German  Breast,  57 
Saffron,  193 
Tansy,  383 
Worm,  371 
Teeth,  671 

Agents  affecting,  34 
Teething. — See  Dentition,  533 
Temperature  of  the  Body,  717 
Tenesmus. — See  Dysentery,  541 
Terchloride  of  Methyl,  168 
Terebene,  385 
Terebinthene,  385 


INDEX. 


763 


Terebinthina,  384 
Canadensis,  384 
Terpine,  385 
Terpinol,  385 
Tersulphate  of  Iron,  217 
Testa  Prceparata,  143 
Testicles,  671 
Testing,  417 
Tests  for  Morphine,  294 
Tetanus,  671 

Tetrachloride  of  Carbon,  81,  169 
Tetra-iodo-pyrol,  252 
Tetter. — See  Herpes,  Pityriasis,  Psoriasis. 
Thalline,  179 
Thebaine,  292 
Theine,  138,  141 
Theobroma  Cacao,  140,  387 
Theobromine,  141,  387 
Therapeutical  Incompatibility,  461 
Therapeutics,  17,  479 
Applied,  18,  479 
Empirical,  18 
Natural,  17 
Rational,  18 
Special,  479 
Theriaca,  348 

Thermometer,  Clinical,  717 
Thimble  berry,  344 
Thirst,  672 

Agents  allaying,  35 
Thistle,  Blessed,  156 
Thompson’s  Eye-water,  706 
Thorn-apple,  374 
Thorough- wort,  213 

Throat. — See  Aphonia,  Croup,  Diphtheria, 
Laryngitis,  Pharyngitis,  Scarlet  Fever, 
Tonsillitis,  etc. 

Sore,  672 

Thrush. — See  Aphthae,  491 
Thuja,  385,  388 
Thujetin,  388 
Thujin,  388 

Thus  Americanum,  385 
Thyme,  Garden,  389 
Thymene,  389 
Thymol,  389 
Thymus  vulgaris,  389 
Tic  Douloureux,  672 
Tiglii  Oleum,  390 
Tincture  of  Aconite,  76 
of  Ailanthus,  85 
of  Aloes,  90 
of  Aloes  and  Myrrh,  90 
of  Arnica-flowers,  1 1 5 
of  Arnica-root,  1 1 5 
of  Asafetida,  1 19 
of  Aurantium  Amarum,  122 
of  Aurantium  Dulce,  122 
of  Baptisia,  125 
of  Belladonna,  126 
of  Benzoin,  129 

of  Benzoin,  Compound,  129,  376 


Tincture  of  Berberis,  130 
of  Bryonia,  136 
of  Calendula,  145 
of  Calumba,  145 
of  Camphor,  147 
of  Cannabis  Indica,  149 
of  Cantharides,  15 1 
of  Capsicum,  153 
of  Cardamom,  155 
of  Cascarilla,  158 
of  Catechu,  Compound,  159 
of  Chirata,  164 

of  Chloroform  and  Morphine,  169, 
294 

of  Chloroform,  Compound,  169 

of  Cimicifuga,  175 

of  Cinnamon,  183 

of  Cinchona,  177 

of  Cinchona,  Compound,  177 

of  Cocculus,  310 

of  Colchicum,  184 

of  Conium,  1S6 

of  Coto,  19 1 

of  Crocus,  193 

of  Cubeb,  193 

of  Digitalis,  199 

of  Duboisia,  202 

of  Eucalyptus,  212 

of  Euphrasia,  214 

of  Galls,  223 

of  Gelsemium,  224 

of  Gentian,  Compound,  226 

of  Ginger,  406 

of  Guaiac,  232 

Ammoniated,  232 
of  Hemp,  Indian,  149 
of  Hops,  238 
of  Humulus,  23S 
of  Hydrastis,  246 
of  Hyoscyamus,  248 
of  Ignatia,  250 
of  Iodine,  251 

of  Ipecac  and  Opium,  256,  293 

of  Iron  Acetate,  215 

of  Iron  Chloride,  215 

of  Kino,  261 

of  Krameria,  262 

of  Lavender,  Compound,  265 

of  Lobelia,  269 

of  Lupulin,  238 

of  Matico,  277 

of  Musk,  284 

of  Myrrh,  286 

of  Nitro-glycerin,  98 

Norwood’s,  396 

of  Nutgall,  223 

of  Nux  Vomica,  288 

of  Opium,  292 

of  Opium,  Camphorated,  293 

of  Opium,  Compound,  293 

of  Opium,  Deodorized,  292 

of  Opium  and  Ipecac,  293 


INDEX. 


Tincture  of  Orange  Peel,  Bitter,  122 
of  Orange  Peel,  Sweet,  122 
of  Phosphorus,  304 
of  Physostigma,  308 
of  Phytolacca,  309 
of  Pulsatilla,  328 
of  Pyrethrum,  330 
Pyrexialis,  178 
of  Quassia,  331 
of  Quebracho,  332 
of  Rhubarb,  336 
of  Rhubarb,  Aromatic,  336 
of  Rhubarb,  Sweet,  336 
of  Rhus  Toxicodendron,  339 
of  Sanguinaria,  353 
of  Serpentaria,  365 
of  Soap,  Green,  357 
oT  Squill,  359 
of  Stillingia,  373 
of  Stramonium,  374 
of  Strophanthus,  375 
of  Sumbul,  380 
of  Thuja,  388 
of  Tolu,  125 
of  Valerian,  394 
of  Valerian,  Ammoniated,  394 
of  Vanilla,  395 
of  Veratrum  Viride,  396 
of  Viscum,  400 
of  Zingiber,  406 
Tincturae,  425 
Tinea  Circinata,  673 
Decalvans,  673 
Favosa,  673 

Sycosis. — See  Mentagra,  617 
Tonsurans,  673 
Tobacco,  381 
Indian,  269 

Symptoms. — See  Nervousness,  621 
Toe-nails. — See  Nails,  619 
Tolene,  125 
Toluene,  347 
Tomato,  203 
Tonga,  391 
Tongine,  391 
Tongue,  674 
Tonics,  41 

Cardiac,  33 

Formulae,  484,  488,  622 
Gastric,  35 
Hair,  486 
Nerve,  622,  630 
Pills  for  Women,  469 
Uterine,  48 
Vascular,  34 
Vesical,  45 
Tonsillitis,  674 
Tonsils,  Enlarged,  674 
Ulcerated,  675 

Toothache. — See  Odontalgia,  626 
Toothrash. — See  Strophulus,  668 
Torrefaction,  412 


Torticollis,  675 
Torulae. — See  Sarcinae,  659 
Tracheitis. — See  Croup,  528 
Trachoma. — See  Conjunctivitis  Granular, 
Ophthalmia,  522,  627 
Tragacantha,  391 
Traumaticine,  234 
Traumatic  Fever,  668 
Treacle,  348 
Tree  of  Heaven,  85 
Tri-chlor-aldehyde,  164 
Tricophytosis  Capitis. — See  Tinea,  673 
Trimethylamine,  114,  1 1 5 ,  238 
Trinitrophenol,  72 
Trinitrate  of  Glyceryl,  98 
Trinitrin,  98 
Trismus,  675 
Triticin,  392 
Triticum,  392 

Vulgare,  100 
Trituration,  413 

of  Elaterinum,  204 
Triturationes,  432,  472 
Triturations,  Advantages  of,  472 
Formulae,  473 
of  Mercury,  240 
1  Troches,  431,  469 

of  Ammonium  Chloride,  94 
of  Catechu,  1 59 
of  Chalk,  143 
of  Cubeb,  193 
of  Ginger,  406 
of  Ipecac,  256 
of  Iron,  216,  395 
of  Krameria,  262 
of  Liquorice  and  Opium,  2.28,  293 
List  of,  469 
of  Magnesia,  272 
of  Morphine  and  Ipecac,  256,  294 
of  Peppermint,  280 
of  Potassium  Chlorate,  322 
of  Santonin,  355 
of  Sodium  Bicarbonate,  369 
of  Sodium  Santoninate,  355 
of  Tannic  Acid,  74 
of  Zingiber,  406 
Trochisci,  431 
Tropeius,  126 

Tropical  Fruit  Laxative,  364 
Tropin,  126 
Trypsin,  300 

Tubercular  Meningitis. — See  Hydroceph¬ 
alus,  Acute,  592 
Tuberculin,  641 

Tuberculosis. — See  Phthisis,  Scrofulosis, 
640,  662 

Tully’s  Powder,  293 
Tumors,  675 

Diagnosis  of,  713 
Uterine,  683 

Turnera  aphrodisiaca,  197 
Turpentine,  384 


INDEX. 


765 


Turpentine,  Canada,  384 
Chian,  384 
Oil  of,  384 
Venice,  385 
Turpeth  Mineral,  240 
Tympanites,  675 
Typhlitis,  676 
Typhoid  Fever,  676 
Diagnosis  of,  716 

Typho  malarial  Fever. — See  Typhoid 
Typhus  Fever,  677 
Diagnosis  of,  716 


Ulcers  and  Sores,  678 
of  Rectum,  654 
Stomach,  567 
of  Tonsils,  675 
of  Uterus,  683 
Ulmus,  392 
Umbelliferon,  222 
Umbrella-tree,  273 
Unguenta,  432,  475 
Unguentum,  160,  432 
Uraemia,  679 

Urea,  Agents  affecting,  40 
Urethane,  166 
Urethra,  Stricture  of,  679 
Urethral  Injections,  569,  57 1 
Urethritis,  679 
Urginea  Scilla,  359 

Uric  Acid  Diathesis. — See  Lithaemia,  608 
Urinary  Astringents,  45 
Disorders,  680 
Sedatives,  45 
Urine,  Acidifiers  of,  45 
Alkalinizers  of,  44 
Examination  of,  722 
Urticaria,  681 
Ursone,  223,  393 
Ustilago,  402 
Uterine  Alteratives,  48 
Cancer,  681 
Congestion,  681 
Depressants,  48 
Diseases,  682 
Displacements,  682 
Hypertrophy,  681 
Prolapse,  647 
Tonics,  48 
Tumors,  683 
Ulceration,  683 
Uva  Ursi,  392 
Uvula,  683 


Vaccination,  683 
Vaginismus,  683 
Vaginitis,  684 
Valerene,  393 


Valerian,  197,  393 
Valerianate  of  Ammonium,  94,  395 
of  Butyl,  101 
of  Iron,  217 
of  Quinine,  177 
of  Zinc,  395,  403 
Valerianates,  394 
Valerol,  238,  393 
Vallett’s  Mass,  215 
Van  Buskiik’s  Sozodont,  707 
Vanilla,  395 
Vanillin,  395 
Vao,  196 
Vapores,  477 
Vaporization,  410 
Vapors,  477 
Varicella,  684 
Varicocele,  684 
Varicosis,  684 
Variola,  684 

Diagnosis  of,  715 
Vascular  Sedatives,  34 
Stimulants,  34 
Tonics,  34 
Vaseline,  304 

Vegetable  Drugs,  their  Constituents,  408 
Veins. — See  Phlebitis,  Phlegmasia,  Vari¬ 
cosis. 

Veins,  Transfusion  by,  20 
Veloutine,  182,  207 
Vellarine,  247 
Venous  Medication,  20 
Veratralbine,  396 
Veratrine,  396 
Veratroidine,  396 
Veratrum  Album,  396 
Sabadilla,  396 
Viride,  395 
Verbascum,  398 
Verbs,  699 
Vermicides,  40 
Vermifuges,  40 
Vertigo,  685 

Verucca. — See  Warts,  687 
Vesical  Tonics,  45 
Sedatives,  45 
Vesicants,  49 
Viburnin,  399 
Viburnum,  399 

Compound,  399 
Opulus,  399 
Prunifolium,  399 
Vienna  Paste,  322 
Villate’s  Solution,  195 
I  Vina  (See  also  Wines),  426 
Vinegar,  58 

Bitters,  707 
of  Lobelia,  269 
of  Opium,  293 
of  Sanguinaria,  353 
of  Squill,  359 
Vinegars  (Aceta),  428 


INDEX. 


766 


Vinum,  86 

Album,  86 
Aromaticum,  86 
Official  (See  Wine  of  — ) 
Portense,  86 
Rubrum,  86 
Xericum,  86 
Viola  cucullata,  400 
Tricolor,  399 
Violine,  399 
Viscin,  400 
Viscum,  400 

Visions,  Agents  producing,  29 
Vitellin,  400 
Vitellus,  400 
Vitriol,  Elixir  of,  72 
Volkmann’s  Antiseptic  Fluid,  389 
Vomiting,  685 

of  Pregnancy,  686 
Diagnosis  of,  717 
Vulva,  Eczema,  etc.,  of,  687 
Vulvitis,  687 


Wade’s  Bougies,  475 
Wafers,  471 
Wahoo,  213 

Walker’s  Vinegar  Bitters,  707 
Warburg’s  Tincture,  178,  182 
Warming-plaster,  120 
Warner's  Safe  Cure,  707 
Warts,  687 
Wash,  460 

Black,  241 
Mouth,  5 73 
Yellow,  241 
Washing,  414 

Waste,  Agents  promoting,  42 
Wasting. — See  Atrophy,  Emaciation,  494, 
549 

Wasting  Diseases,  549 
Water,  108 

Almond,  Bitter,  97 
of  Ammonia,  93 
of  Ammonia,  Stronger,  93 
Anise,  101 
Camphor,  1 47 
Carbolic  Acid,  60 
Carbonated,  108 
Cherry-laurel,  69 
Chlorine,  17  2 
Cinnamon,  183 
Creasote,  19 1 
of  Crystallization,  416 
Distilled,  108 
Elder-flower,  352 
Fennel,  221 
Hunyadi,  524 
Laurel,  67 
Orange-flower,  1 22 
Peppermint,  280 


Water,  Rose,  342 
Soda,  108 
Spearmint,  281 
Tar,  316 
Water-lily,  290 
Water-pepper,  321 
Waters  (Aquce),  419 
Mineral,  109,  1 12 
Nomenclature,  108 
Wax,  160 
Wax  Myrtle,  64 

Weakness. — See  Adynamia,  Exhaustion, 

483,  557 

Weights  and  Measures,  435,  726 
Apothecaries’,  436,  726 
British  Pharmacopoeial,  436 
Metric,  436,  727 
Wen,  688 
Whiskey,  85 

White-leg. — See  Phlegmasia,  639 
Wrhite-swelling. — See  Joints,  Synovitis,  602, 
669 

Whitlow. — See  Onychia,  627 
Whooping-cough,  637 
Willow,  349 
Wine,  86 

of  Aloes,  90 
of  Antimony,  102 
Aromatic,  86 
of  Cocaine,  208 
of  Colchicum-root,  184 
of  Colchicum-seed,  184 
of  Ergot,  205 
of  Ipecac,  256 
of  Iron,  Bitter,  217 
of  Iron  Citrate,  215 
of  Opium,  293 
Port,  86 

of  Quebracho,  332 
Red,  86 

of  Rhubarb,  336 
Sherry,  86 
of  Tar,  316 
of  Tobacco,  381 
White,  86 

W7ines  (Vina),  86,  426 
W7inter-berry,  327 
W’intergreen,  223 
Witch -hazel,  64,  233 
Wood  Oil,  233 
Woorara,  196 

Words  and  Phrases,  Latin,  691 
Sundry,  700 
W7orms,  40,  688 
Worm-grass,  372 
Wormseed,  162 
Levant,  355 
Worm  Tea,  371 
Wormwood,  56 
Wounds,  689 

Writer’s  Cramp. — See  Spasmodic  Affec¬ 
tions,  664 


Xantho-puccine,  246 
Xanthoxyline,  401 
Xanthoxylum,  401 
Xeroderma. —  See  Ichthyosis,  594 


Yam,  Wild,  201 
Yellow  Fever,  689 
Diagnosis  of,  717 


INDEX.  767 

Yerba  Santa,  207 
Yolk  of  Egg,  400 


Zea  Mays,  402 
Zincite,  J03 
Zincum,  403 
Zingiber,  405 

Zona. — See  Herpes  Zoster,  591 


* 

' 


CATALOGUE 


NOVEMBER.  1891. 


CATALOGUE 
No.  1. 

_ _  ! 


MEDICAL,  DENTAL, 

Pharmaceutical  and  Scientific  Publications, 

ft  7 

WITH  A  SUBJECT  INDEX, 

PUBLISHED  BY 

P.  BLAKISTON,  SON  &  CO., 

(Successors  to  Lindsay  &  Blaiciston) 

PUBLISHERS,  IMPORTERS  AND  BOOKSELLERS, 

IOI2  WALNUT  ST.,  PHILADELPHIA. 


THE  FOLLOWING  CATALOGUES  WILL  BE  SENT  FREE  TO  ANY  ADDRESS, 

UPON  APPLICATION. 

This  Catalogue,  No.  I,  including  all  of  our  own  publications. 

A  Catalogue  of  Books  for  Dental  Students  and  Practitioners. 

A  Catalogue  of  Books  on  Chemistry,  Technology,  Pharmacy,  Microscopy,  Hygiene, 
Sanitary  Science,  etc. 

Students’  Catalogue,  including  the  “  Quiz-Compends  ”  and  the  most  prominent  Text¬ 
books  and  Manuals  for  medical  students. 

A  Complete  Classified  Catalogue  (68  pages)  of  all  Books  on  Medicine,  Dentistry, 
Pharmacy  and  Collateral  Branches.  English  and  American. 

A  Monthly  Bulletin  containing  lists  of  all  new  Medical  Books  issued  by  various 
publishers. 


P.  Blakiston,  Son  &  Co.’s  publications  may  be  had  through  Booksellers  in  all 
the  principal  cities  of  the  United  States  and  Canada,  or  any  bock  will  be  sent  by 
them,  postpaid,  upon  receipt  of  the  price.  They  will  forward  parcels  by  express, 
C.  O.  D.,  upon  receiving  a  remittance  of  25  per  cent,  of  the  amount  ordered,  to  cover 
express  charges.  Money  should  be  remitted  by  Express,  money  order,  registered 
letter,  or  bank  draft. 

jJgy^All  new  books  received  as  soon  as  published.  Special  facilities  for  import¬ 
ing  books  from  England,  Germany  and  France. 


Gould’s  New  Medical  Dictionary  now  ready.  See  page  4. 


CLASSIFIED  LIST,  WITH  PRICES, 

OF  ALL  BOOKS  PUBLISHED  BY 

P.  BLAKISTON,  SON  &  CO.,  PHILADELPHIA. 

When  the  price  is  not  given  below,  the  hook  is  out  of  print  or  about  to  be  published. 

Cloth  binding,  unless  otherwise  specified.  For  full  descriptions,  see  following  Catalogue. 


ANAESTHETICS. 

Buxton.  Anaesthetics.  -  $ - 

Sansom.  Chloroform.  -  1.25 

Turnbull.  3d  Ed.  -  3.00 

ANATOMY. 

Ballou.  Veterinary  Anat.  1.00 
Heath.  Practical.  7th  Ed.  5.00 
Holden.  Dissector.  Oil-cloth,  4.50 

-  Osteology.  -  -  6  00 

-  Landmarks.  4th  Ed.  1.25 

Macalister’s  Text-Book. 

816  Ilius.  Clo.  7.50;  Sh.  8.50 


Potter.  Compend  of.  5th 
Ed.  133  Illustrations.  -  1.00 

Sutton.  Ligaments.  -  1.25 

ATLASES  AND  DIAGRAMS. 

Flower.  Of  Nerves.  -  3.50 

Marshall’s  Phys.  and  Anat. 

Diagrams.  £40. 00  and  60.00 

BRAIN  AND  INSANITY. 
Bucknill  and  Tuke.  Psycho¬ 


logical  Medicine.  -  -  8.00 

Gowers.  Diagnosis  of  Dis¬ 
eases  of  the  Brain.  New  Ed.  2.00 
Lewis,  (Bevan).  Mental 
Diseases.  ...  6.00 

Mann’s  Psychological  Med.  5.00 
Wood.  Brain  and  Overwork.  .50 


CHEMISTRY. 

See  Technological  Books. 

Allen.  Commercial  Organic 
Analysis.  2d  Ed.  Volume  I.  - 


-  Volume  II.  -  -  - 

-  Volume  III.  Part  I.  4.50 

Bartley.  Medical.  2d  Ed.  2.50 
Bloxam’s  Text- Book.  7th  Ed.  4.50 
Bowman’s  Practical.  -  2.00 

Groves  and  Thorp.  Chemi¬ 
cal  Technology  Vol.  I.  Fuels  7.50 
Holland’s  Urine,  Poisons  and 
Milk  4th  Ed.  -  -  1. 00 

Leffmann's  New  Compend.  1.00 

- ,  Progressive  Exercises.  1.00 

Muter.  Pract.  and  Anal.  2.00 
Ramsay.  Inorganic.  Illus.  4.50 
Richter’s  Inorganic.  3d  Ed.  2.00 

- Organic.  2d  Ed.  4.50 

Smith.  Eiectro-Chem.  Anal.  1.00 
Smith  and  Keller.  Experi¬ 
ments.  2d  Ed.  Illus.  Net,  .60 
Stammer.  Problems.  -  .75 

Sutton.  Volumetric  Anal.  5.00 
Symonds.  Manual  of.  2.00 

Trimble.  Analytical.  -  1.50 

Watts.  (Fowne’s)  Inorg.  2.25 

-  (Fowne’s)  Organ.  2.25 

Wolff.  Applied  Medical.  1.00 
Woody.  Essentials  of.  3d  Ed.  1.25 

CHILDREN. 

Goodhart  and  Starr.  3.00;  Sh.  3.50 
Hale.  Care  of.  -  .75 

Hatfield.  Compend  of.  1.00 

Meigs.  Infant  Feeding  and 
Milk  Analysis.  -  1.00 

Meigs  and  Pepper’s  Treatise. 5. 00 
M  oney.  Treatment  of.  -  3.00 

Muskett.  Treatment  of.  1.75 
Osier.  Cerebral  Palsies  of.  2.00 

Smith.  Wasting  Diseases  of.  3.00 
Starr.  Digestive  Organs  of.  2.25 
- Hygiene  of  the  Nursery.  1.00 


CLINICAL  CHARTS. 
Davis.  Obstetrical.  Pads,  $  .50 


Griffiths.  Graphic.  “  .50 

Temperature  Charts.  ,*  .50 

COM PENDS 
And  The  Quiz- Compends . 
Ballou.  Veterinary  Anat.  1.00 
Brubaker’s  Physiol.  6th  Ed.  1.00 
Fox  and  Gould.  The  Eye.  1.00 
Hatfield.  Children.  -  1.00 

Horwitz.  Surgery.  4th  Ed.  1.00 
Hughes.  Practice.  2  Pts.  Ea.  1.00 
Landis.  Obstetrics.  4th  Ed.  1.00 
Leffmann’s  Chemistry.  3d  Ed.  1.00 
Mason.  Electricity.  -  1.00 

Morris.  Gynaecology.  -  1.00 

Potter’s  Anatomy,  5th  Ed.  x.oo 

- Materia  Medica.  5th  Ed.  1. 00 

Stewart,  Pharmacy.  3d  Ed.  1.00 
Warren.  Dentistry.  -  1.00 


DEFORMITIES. 
Reeves.  Bodily  Deformities 


and  their  Treatment.  Illus.  2.25 
DENTISTRY. 

Barrett.  Dental  Surg.  -  1.25 

Blodgett.  Dental  Pathology.  1.75 
Flagg.  Plastic  Filling.  -  4.00 

Fillebrown.  Op.  Dent.  Illus.  2.50 
Gorgas.  Dental  Medicine.  3.50 
Harris.  Principles  and  Prac.  7.00 

- Dictionary  of.  5th  Ed.  5.00 

Heath.  Dis.  of  Jaws.  -  4-5o 

- Lectures  on  Jaws.  Bds.  1.00 

Leber  and  Rottenstein. 

Caries.  Paper  75 

Richardson.  Mech.  Dent.  4.50 
Sewell.  Dental  Surg.  -  3.00 

Stocken.  Materia  Medica.  2.50 
Taft.  Operative  Dentistry.  4.25 

- ,  Index  of  Dental  Lit.  2.00 

Talbot.  Irregularity  of  Teeth.  3.00 
Tomes.  Dental  Surgery.  5.00 

-  Dental  Anatomy.  4.00 

Warren’s  Compend  of.  -  1.00 

White.  Mouth  and  Teeth.  .50 


DICTIONARIES. 
Cleveland’s  Pocket  Medical.  .75 
Gould’s  New  Medical  Diction¬ 
ary.  y2  Lea.,  3.25;  y2  Mor. 


Thumb  Index.  -  4.25 

Harris’  Dental.  Clo.  5.00;  Shp.  6.00 
Longley’s  Pronouncing  -  1.00 

Maxwell.  Terminologia  Med¬ 
ica  Polyglotta.  -  -  4.00 

Treves.  German  English.  3.75 


DIRECTORY. 

Medical,  of  Philadelphia,  2.50 
EAR. 


Burnett.  Hearing,  etc.  .50 

Pritchard.  Diseases  of.  1.50 

ELECTRICITY. 
Bigelow.  Plain  Talks  on  Medi¬ 
cal  Electricity.  43  Illus.  1.00 

Mason’s  Compend  of  Electric¬ 
ity  and  its  Medical  and  Sur¬ 
gical  Uses.  ...  1. 00 

EYE. 

Arlt.  Diseases  of.  -  -  2.50 

Fox  and  Gould.  Compend.  1.00 

Gower’s  Ophthalmoscopy.  5.50 

Harlan.  Eyesight.  -  .50 

Hartridge.  Refraction.  5th Ed.  1.75 
-  Ophthalmoscope.  -  1  50 


Higgins.  Practical  Manual.  $1.75 
Liebreich.  Atlas  of  Ophth.  15.00 
Macnamara.  Diseases  of.  4.00 
Meyer  and  Fergus.  Com¬ 
plete  Text-Book,  with  Colored 
Plates.  270  Illus.  Clo.  4.50:  Sh.5.50 
Morton.  Refraction.  4th  Ed.  1.00 
Ophthalmic  Review. 

Monthly.  -  3.00 

Swanzy’s  Handbook.  3d  Ed.  3.00 

FEVERS. 

Collie,  On  Fevers.  -  2.50 

HEADACHES. 

Day.  Their  Treatment,  etc.  1.25 


HEALTH  AND  DOMESTIC 
MEDICINE. 


Bulkley.  The  Skin. 

Burnett.  Hearing. 

Cohen.  Throat  and  Voice. 
Dulles.  Emergencies.  3d  Ed, 
Harlan.  Eyesight. 
Hartshorne.  Our  Homes. 
Hufeland.  Long  Life.  - 
Lincoln.  Hygiene. 

Osgood.  Dangers  of  Winter. 
Packard.  Sea  Air,  etc. 
Richardson’s  Long  Life. 
Tanner.  On  Poisons.  6th  Ed. 
White.  Mouth  and  Teeth. 
Wilson.  Summer  and  its  Dis. 
Wilson’s  Domestic  Hygiene. 
Wood.  Brain  Work. 


•50 

•5o 

•  So 
•75 
•50 
•50 

1. 00 

•  50 

•50 

.50 

•50 

75 

•50 

•5o 

1. 00 

•  50 


HISTOLOGY. 

See  Microscope  and  Pathology. 


HYGIENE. 

See  lVater. 

Fox.  Water,  Air,  Food.  4.00 

Lincoln.  School  Hygiene.  .50 
Parke’s  (E.)  Hygiene.  8th  Ed.  5x0 

-  (L.  C.),  Manual.  2.50 

Starr.  Hygiene  of  the  Nursery.  1. 00 

Wilson’s  Handbook  of.  -  - 

-  Domestic.  -  -  1.00 


JOURNALS,  Etc. 
Archives  of  Surgery.  4  Nos.  3.00 
Jl.  of  Dermatology.  “  “  3.00 

Ophthalmic  Review.  “  “  3.00 

New  Sydenham  Society’s 
Publications  -  8.00 


KIDNEY  DISEASES. 
Beale.  Renal  and  Urin.  1.75 
Ralfe.  Dis.  of  Kidney,  etc.  2.75 
Thornton.  Surg.  of  Kidney.  1.75 
Tyson.  Bright’s  Disease 

and  Diabetes,  Illus.  -  3.50 

LUNGS  AND  CHEST. 

See  Phy.  Diagnosis  and  Throat. 
Hare.  Mediastinal  Disease.  2.00 
Harris.  On  the  Chest.  -  2.50 

MASSAGE. 

Murrell.  Massage.  5th  Ed.  1.50 
Ostrom.  Massage.  87  Illus.  1.00 

MATERIA  MEDICA. 
Biddle,  nth  Ed.  Clo.  4.25 

Gorgas.  Dental.  4th  Ed.  3.50 
Merrell’s  Digest.  -  4.00 

Potter’s  Compend  of.  5th  Ed.  i.co 


':V*  FOR  SELF  EXAMINATION,  “3000  Questions  on  Medical  Subjects.” 

Just  Ready.  Price,  10  cents  net. 


CLASSIFIED  LIST  OF  P.  BLAKISTON,  SON  CO.'S  PUBLICATIONS. 


Potter’s  Handbook  of.  Third 
Ed.  Clo.  4.00;  Sheep,  -  $5.00 

MEDICAL  JURISPRUDENCE. 

Reese.  Medical  Jurisprudence 
&Toxicology,  3d  Ed.  3.00;  Sh  3.50 

MICROSCOPE. 

Beale.  How  to  Work  with.  7.50 

-  In  Medicine.  -  7.50 

Carpenter.  The  Microscope. 

7th  Ed.  780  Ulus.  Cl.  6.50  Lea.  7.50 
Lee.  Vade  Mecum  of.  2d  Ed.  4.00 
MacDonald.  Examination  of 


Water  by.  -  2.75 

MISCELLANEOUS. 

Beale.  Slight  Ailments.  1.25 
Black.  Micro-organisms.  1.50 
Burnet.  Food  and  Dietaries.  1.75 
Davis.  Text-book  of  Biology.  4.00 
Duckworth.  On  Gout.  -  7.00 

Garrod.  Rheumatism,  etc.  6.00 
Gross.  Life  of  J.  Hunter.  Pa.  .75 
Haddon.  Embryology.  -  6.00 

Haig.  Uric  Acid.  -  -  - 

Henry.  Anaemia.  -  .75 

NERVOUS  DISEASES,  Etc. 

Flower.  Atlas  of  Nerves.  3.50 
Bowlby.  Injuries  of.  -  4.50 

Gowers.  Manual  of.  2d  Ed. 

2  vols.  350  Illustrations.  - 

-  Dis.  of  Spinal  Cord  - 

-  Diseases  of  Brain.  2.00 

-  Syphilis  and  the  Ner¬ 
vous  System.  -  -  - 

Obersteiner.  Central  Nervous 
System.  -  6.00 

Osier.  Cerebral  Palsies.  2.00 

Page.  Injuries  of  Spine.  - 

- Railway  Injuries.  -  2.25 

Thorburn.  Surgery  of  the 
Spinal  Cord  -  4-5° 

Watson.  Concussions.  1.00 

NURSING. 

Cullingworth.  Manual  of.  .75 

-  Monthly  Nursing.  .50 


Domville’s  Manual.  7th  Ed.  .75 
Fullerton.  Obst.  Nursing.  1.25 

-  Nursing  in  Abdominal 

Surg.  and  Dis.  of  Women, - 

Humphrey.  Manual  of  1.25 
Luckes.  Hospital  Sisters.  1.00 
Parvin.  Obstetric  Nursing.  .75 
Starr.  Hygiene  of  the  Nursery.  1.00 
Temperature  Charts.  -  .50 

OBSTETRICS. 

Bar.  Antiseptic  Obstet.  1.75 

Cazeaux  and  Tarnier.  Stu¬ 
dents’  Ed.  Colored  Plates.  5.00 
Davis.  Obstetrical  Chart.  .50 
Davis.  Obstetrics,  lllus.  2.00 
Galabin’s  Manual  of.  3.00 

Landis.  Compend  4’h  Ed.  1.00 
Rigby.  Obstetric  Mem.  .50 

Strahan.  Extra-Uterine  Preg.  1.50 
Winckel’s  Text-book.  6.00 

PATHOLOGY  &  HISTOLOGY. 
Blodgett.  Dental  Pathology  1.75 
Bowlby.  Surgical  Path.  2.00 

Gibbes.  Practical.  -  1.75 

Gilliam.  Essentials  of.  -  2.00 

Stirling’s  Practical.  -  4.00 

Virchow.  Post-mortems.  1.00 

-  Cellular  Pathology.  4.00 

Wynter  &  Wethered.  Path.  4.00 

PHARMACY. 

Beasley’s  Druggists’  Rec’ts.  2.25 

- Formulary.  -  -  2.25 

Fliickiger.  Cinchona  Barks.  1.50 
Mackenzie.  Phar.  of  Throat.  1.25 
Merrell’s  Digest.  -  -  4.00 

Proctor.  Practical  Pharm.  4.50 


Robinson.  Latin  Grammar  of  $2.00 
Stewart’s  Compend.  3d  Ed.  1.00 
Tuson.  Veterinary  Pharm.  2.50 

PHYSICAL  DIAGNOSIS. 
Fenwick’s  Student’s  Guide.  2.25 
Tyson’s  Manual.  -  -  1.25 

PHYSIOLOGY. 
Brubaker’s  Compend.  Illus¬ 
trated.  6th  Ed.  -  -  1. 00 

Kirkes’  12th  Ed.  (Author’s 
Ed.)  Cloth,  4.00;  Sheep,  5.00 
Landois’  Text-book.  845  Illus¬ 
trations.  4th  Ed.  Cl.  7.00;  Sh.  8.00 
Sanderson’s  Laboratory  B’k.  5.00 
Sterling.  Practical  Phys.  2.25 
Tyson’s  Cell  Doctrine.  -  2.00 

Yeo’s  Manual.  321  Illustrations 
5th  Ed  Cloth,  3.00;  Sheep,  3.50 

POISONS. 

Aitken.  The  Ptomaines,  etc.  1.25 
Black.  Formation  of.  -  1  50 

Reese.  Toxicology.  3d  Ed.  3.00 

Tanner.  Memoranda  of.  .75 

PRACTICE. 

Beale.  Slight  Ailments.  1.25 

Charteris,  Guide  to.  -  3.00 

Fagge’s  Practice.  2  Vols.  8.00 
Fowler’s  Dictionary  of.  -  5.00 

Hughes.  Compend  of.  2  Pts.  2.00 

-  Physicians’  Edition. 

1  Vol.  Morocco,  Gilt  edge.  2.50 
Roberts.  Text-book,  bth  Ed.  5.50 
Taylor’s  Manual  of.  -  400 

PRESCRIPTION  BOOKS. 
Beasley's  3000  Prescriptions.  2.25 

-  Receipt  Book.  -  2.25 

-  Formulary.  -  -  2.25 

Pereira’s  Pocket-book.  1.00 

Wythe’s  Dose  and  Symptom 
Book.  17th  Ed.  -  -  1. 00 

SKIN  AND  HAIR. 
Anderson’s  Text-Book.  4.50 
Bulkley.  The  Skin.  -  .50 

Crocker.  Dis.  of  Skin.  Ulus.  5.50 
Van  Harlingen.  Diagnosis 
and  Treatment  of  Skin  Dis. 

Col.  Plates  &  Engravings.  2.50 

STIMULANTS  &  NARCOTICS. 
Lizars.  On  Tobacco.  -  .50 

Miller.  On  Alcohol  .50 

Parrish.  Inebriety.  -  1.25 

SURGERY  AND  SURGICAL 
DISEASES. 

Caird  and  Cathcart.  Surgi¬ 
cal  Handbook.  Leather,  2.50 
Dulles.  Emergencies.  -  .75 

Heath’s  Minor.  9th  Ed.  2.00 

-  Diseases  of  Jaws.  4.50 

-  Lectures  on  Jaws.  1.00 

Horwitz.  Compend.  4th  Ed.  1.00 
Jacobson.  Operations  of.  -  5.00 

Moullin.  Complete  Text¬ 
book,  497  Ulus. 

Subscription  only.  Colored 
Plates.  Net ,  Cl.  700;  Sh.  8.00 


Rus.  -  -  9.00 

Porter’s  Surgeon’s  Pocket- 
book.  -  -  Leather  2.25 

Smith.  Abdominal  Surg.  - 

Swain.  Surg.  Emergencies.  1.50 
Walsham.  Practical  Surg.  300 
Watson’s  Amputations.  5.50 


TECHNOLOGICAL  BOOKS. 


See  also  Chemistry . 
Cameron.  Oils  &  Varnishes.  2.50 

-  Soap  and  Candles.  2.25 

Gardner.  Brewing,  etc.  1.75 
Gardner.  Acetic  Acid,  etc.  1.75 

-  Bleaching  &  Dyeing.  1.75 

Groves  and  Thorp.  Chemi¬ 
cal  Technology.  Vol.  I. 
Millson  Fuels.  Cl.  7.50;  ]4M.  9.00 
Overman.  Mineralogy.  1.00 
Piggott.  On  Copper.  -  r.oo 


THERAPEUTICS. 

Allen,  Harlan,  Harte,  Van 

Harlingen.  Local  Thera.  - 

Biddle,  nth  Ed.  Cl.  4.25;  Sh.  $5.00 
Burnet.  Food  and  Dietaries.  1.75 
Field.  Cathartics  and  Emetics.  1.75 


Headland.  Action  of  Med.  3.00 
Jaworski.  Carlsbad  Salts.  2.00 
Mays.  Therap.  Forces.  1.25 

-  Theine  -  -  -  50 

Napheys’  Medical.  -  - 

- Surgical.  -  -  - 

Ott.  Action  qf  Medicines.  2.00 


Potter’s  Compend.  5th  Ed.  1.00 

- ,  Handbook  of.  4.00  ;  Sh.  5.00 

Waring’s  Practical.  4th  Ed.  3.00 

THROAT  AND  NOSE. 
Cohen.  Throat  and  Voice.  .50 
Greenhow.  Bronchitis.  1.25 
Hutchinson.  Nose  &  Throat.  1.25 
McBride.  Clinical  Manual, 

Colored  Plates,  -  -  - 

Mackenzie.  The  Oesophagus, 


Naso-Pharynx,  etc.  -  3.00 

- Pharmacopoeia.  -  1.25 

Murrell.  Bronchitis.  -  1.50 

Potter.  Stammering,  etc.  1.00 


Woakes.  Post-Nasal  Catarrh.  1.50 
- Deafness,  Giddiness,  etc. - 

TRANSACTIONS  AND 
REPORTS. 

Penna.  Hospital  Reports.  1.25 
Power  and  Holmes’  Reports.  1.25 
Trans.  College  of  Physicians.  3.50 


-  Amer.  Surg.  Assoc.  3.00 

-  Assoc.  Amer.  Phys.  3.50 

URINE  &  URINARY  ORGANS. 
Acton.  Repro.  Organs.  2.00 

Beale.  Urin.  &  Renal  Dis.  1.75 

- Urin.  Deposits.  Plates.  2.00 

Holland.  The  Urine,  Milk  and 
Common  Poisons.  4th  Ed.  1.00 
Legg.  On  Urine.  -  -  .75 

Marshall  and  Smith.  Urine.  1.00 
Ralfe.  Kidney  and  Uri.  Org.  2.75 
Schnee.  Diabetes.  -  2.00 

Thompson.  Urinary  Organs.  3.50 

-  Surg.  of  Urin.  Organs.  1.25 

-  Calculous  Dis.  3d.  Ed.  1.00 

-  Lithotomy.  -  -  3.50 

- Prostate.  6th  Ed.  2.00 

Thornton.  Surg.  of  Kidney.  1.75 
Tyson.  Exam,  of  Urine.  1.5^ 
Van  Niiys.  Urine  Analysis.  2.00 


VENEREAL  DISEASES. 
Hill  and  Cooper’s  Manual.  1.00 

VETERINARY. 
Armatage.  Vet.  Rem.  1.25 

Ballou.  Anat.  and  Phys.  1.00 
Tuson.  Vet.  Pharm.  2.50 

VISITING  LISCS. 
Lindsay  and  Blakiston’s 

Regular  Edition.  Send  /or 
Circular.  -  -  1.00  to  3.00 

-  Perpetual  Ed.  1.25  to  1.50 

-  Monthly  Ed. 

Plain,  .75;  Tucks,  1.00 

WATER. 

Blair.  Potable  Waters,  -  i.co 
Fox.  Water,  Air,  Food.  400 
Frankland.  Analysis  of.  1.00 
Leffmann  &  Beam.  Exam.  of.  1.25 
MacDonald.  Examination  of.  2.75 

WOMEN,  DISEASES  OF. 
Byford’s  Text-book.  4th  Ed.  5.00 


- Uterus.  -  -  -  1.25 

Edis.  Sterility.  -  -  1.75 

Lewers.  Dis.  of  Women.  2.25 

Morris.  Compend.  Ulus.  1.00 

Tilt.  Change  of  Life.  -  1.25 


Winckel,  by  Parvin.  Manual 
of.  Ulus.  Clo.,  3.00:  Sh.  3.50 


From  PROF.  J.  M.  DaCOSTA. 

I  find  it  an  excellent  work,  doing  credit  to  the  learning  and  discrimination  of  the  author .** 

A  New  Medical  Dictionary. 

A  compact,  concise  Vocabulary,  including 
all  the  Words  and  Phrases  used  in  medicine, 
with  their  proper  Pronunciation  and  Defini¬ 
tions. 

BASED  ON  RECENT  MEDICAL 
LITERATURE. 

BY 

GEORGE  M.  GOULD,  A.B.,  M.D., 

Ophthalmic  Surgeon  to  the  Philadelphia  Hospital,  Clinical 
Chief  Ophthalmological  Dept.  German  Hos¬ 
pital,  Philadelphia. 

It  is  not  a  mere  compilation  from  other 
dictionaries.  The  definitions  have  been 
made  by  the  aid  of  the  most  recent  stan¬ 
dard  text-books  in  the  various  branches  of 
medicine.  It  includes 

SEVERAL  THOUSAND  NEW  WORDS  NOT  CONTAINED  IN 

ANY  SIMILAR  WORK. 

IT  CONTAINS  TABLES  of  the  ABBREVIATIONS  used  in  Medicine,  of  the 
ARTERIES,  of  the  BACILLI,  giving  the  Name,  Habitat,  Characteristics,  etc.;  of  GAN-. 
GLIA,  LEUCOMAINES,  MICROCOCCI,  MUSCLES,  NERVES,  PLEXUSES, 
PTOMAINES,  with  the  Name,  Formula,  Physiological  Action,  etc.;  and  the  COMPARI¬ 
SON  OF  THERMOMETERS,  of  all  the  most  used  WEIGHTS  AND  MEASURES 
of  the  world,  of  the  MINERAL  SPRINGS  OF  THE  U.  S.,  VITAL  STATISTICS, 
etc.  Much  -of  the  material  thus  classified  is  not  obtainable  by  English  readers  in  any  other  work. 

OPINIONS  OF  PROMINENT  MEDICAL  PAPERS. 

“  One  pleasing  feature  of  the  book  is  that  the  reader  can  almost  invariably 
find  the  definition  under  the  word  he  looks  for,  without  being  referred  from 
one  place  to  another,  as  is  too  commonly  the  case  in  medical  dictionaries. 
The  tables  of  the  bacilli,  micrococci,  leucomaines  and  ptomaines  are  excellent, 
and  contain  a  large  amount  of  information  in  a  limited  space.  The  anatomical 
tables  are  also  concise  and  clear.  .  .  .  We  should  unhesitatingly  recom¬ 

mend  this  dictionary  to  our  readers,  feeling  sure  that  it  will  prove  of  much 
value  to  them.” — American  Joinnal  of  Medical  Science ,  Sept.  1890 . 

“As  a  handy,  concise  and  accurate,  and  complete  medical  dictionary  it 
decidedly  claims  a  very  high  place  among  works  of  this  description.  In  fact, 
taking  handiness  and  cheapness  into  account,  we  certainly  think  this  is  the 
general  practitioner’s  model  dictionary,  and  we  cordially  recommend  it  to  our 
readers.  The  definitions  are  for  the  most  part  terse  and  accurate,  and  the 
derivations  up  to  modern  lights.” — British  Medical Journal ,  London ,  Sept.  1890. 

May  be  obtained  through  all  Booksellers.  Sample  pages  free. 


Small  8vo,  Half  Morocco,  as  above,  with 

Thumb  Index,  .....  $4.25 

Plain  Dark  Leather,  without  Thumb  Index,  3.25 


P.  BLAKISTON,  SON  &  CO.’S 
Medical  and  Scientific  Publications, 

No.  1012  Walnut  St.,  Philadelphia. 


ACTON.  The  Functions  and  Disorders  of  the  Reproductive  Organs  in  Childhood, 
Youth,  Adult  Age  and  Advanced  Life,  considered  in  their  Physiological,  Social 
and  Moral  Relations.  By  Wm.  Acton,  m.d.,  m.r.c.s.  7th  Edition.  Cloth,  $ 2.00 

AITKEN.  Animal  Alkaloids,  the  Ptomaines,  Leucoma'fnes  and  Extractives  in 
their  Pathological  Relations.  By  William  Aitken,  m.d.,  f.r.s.,  Prof,  of  Path, 
in  the  Army  Medical  School,  Netley,  England.  2d  Ed.  Enlarged.  Cloth,  $1.25 

ALLEN,  HARLAN,  HARTE,  VAN  HARLINGEN.  Local  Therapeutics. 

A  Handbook  of  Local  Therapeutics,  being  a  practical  description  of  all  those 
agents  used  in  the  local  treatment  of  disease,  such  as  Ointments,  Plasters, 
Powders,  Lotions,  Inhalations,  Suppositories,  Bougies,  Tampons,  etc.,  and  the 
proper  methods  of  preparing  and  applying  them.  By  Harrison  Allen,  m.d., 
Emeritus  Professor  of  Physiology  in  the  University  of  Penna. ;  Laryngologist  to 
the  Rush  Hospital  for  Consumption  ;  late  Surgeon  to  the  Philadelphia  and  St. 
Joseph’s  Hospitals.  George  C.  Harlan,  m.d.,  late  Professor  of  Diseases  of  the 
Eye  in  the  Philadelphia  Polyclinic  and  College  for  Graduates  in  Medicine; 
Surgeon  to  the  Wills  Eye  Hospital,  and  Eye  and  Ear  Department  of  the  Penn¬ 
sylvania  Hospital.  Richard  H.  Harte,  m.d.,  Demonstrator  of  Osteology, 
University  of  Pennsylvania ;  Assistant  Surgeon,  University  Hospital,  and  Arthur 
Van  Harlingen,  m.d.,  Professor  of  Diseases  of  the  Skin  in  the  Philadelphia 
Polyclinic  and  College  for  Graduates  in  Medicine;  late  Clinical  Lecturer  on 
Dermatology  in  Jefferson  Medical  College;  Dermatologist  to  the  Howard  Hos¬ 
pital.  In  One  Handsome  Compact  Volume.  Nearly  Ready. 

ALLEN.  Commercial  Organic  Analysis.  A  Treatise  on  the  Modes  of  Assaying 
-the  Various  Organic  Chemicals  and  Products  employed  in  the  Arts,  Manufactures, 
Medicine,  etc.,  with  Concise  Methods  for  the  Detection  of  Impurities,  Adultera¬ 
tions,  etc.  Second  Edition.  Revised  and  Enlarged.  By  Alfred  Allen,  f.c.s. 

Vol.  I.  Alcohols,  Ethers,  Vegetable  Acids.  Starch,  etc.  Out  of  Print. 

Vol.  II.  Fixed  Oils  and  Fats,  Hydrocarbons  and  Mineral  Oils,  Phenols  and 
their  Derivatives,  Coloring  Matters,  etc.  Out  of  Print. 

Vol.  III. —  Part  I.  Acid  Derivatives  of  Phenols,  Aromatic  Acids,  Tannins, 
Dyes,  and  Coloring  Matters.  8vo.  Cloth,  $4.50 

ANDERSON.  A  Treatise  on  Skin  Diseases.  With  special  reference  to  Diagnosis 
and  Treatment,  and  including  an  Analysis  of  11,000  consecutive  cases.  By  T. 
McCall  Anderson,  m.d.,  Professor  of  Clinical  Medicine,  University  of  Glasgow. 
With  several  Full-page  Plates,  two  of  which  are  Colored  Lithographs,  and  nu¬ 
merous  Wood  Engravings.  Octavo.  650  pages.  Cloth,  $4.50;  Leather,  $5.50 

ARCHIVES  OF  SURGERY.  Edited  by  Jonathan  Hutchinson,  f.r.s.  Colored 
Illustrations.  Published  Quarterly.  75  cents  a  number.  Per  Vol.  $3.00 

ARLT.  Diseases  of  the  Eye.  Clinical  Studies  on  Diseases  of  the  Eye.  Including  the 
Conjunctiva,  Cornea  and  Sclerotic,  Iris  and  Ciliary  Body.  By  Dr.  Ferd.  Ritter 
von  Arlt,  University  of  Vienna.  Authorized  Translation  by  Lyman  Ware, 
m.d.,  Surgeon  to  the  Illinois  Charitable  Eye  and  Ear  Infirmary,  Chicago. 
Illustrated.  8vo.  Cloth,  $2.50 

ARMATAGE.  The  Veterinarian’s  Pocket  Remembrancer:  being  Concise 
Direciions  for  the  Treatment  of  Urgent  or  Rare  Cases,  embracing  Semeiology,- 
Diagnosis,  Prognosis,  Surgery,  Therapeutics,  Toxicology,  Detection  of  Poisons 
by  their  appropriate  tests,  Hygiene,  etc.  By  George  Armatage,  m.r.c.v.s. 
Second  Edition.  321T10.  Boards,  $1.2$ 


5 


t> 


P.  B LA  K IS  TON,  SON  CO.'S 


BALLOU.  Veterinary  Anatomy  and  Physiology.  By  Wm.  R.  Ballou,  m.d., 
Prof,  of  Equine  Anatomy,  New  York  College  of  Veterinary  Surgeons,  Physician 
to  Bellevue  Dispensary,  and  Lecturer  on  Genito-Urinary  Surgery,  New  York 
Polyclinic,  etc.  With  29  Graphic  Illustrations.  i2mo.  No.  12  ?  Quiz-Compend 
Series.?  Cloth,  $1.00.  Interleaved,  for  the  addition  of  notes,  $1.25 

BAR.  Antiseptic  Midwifery.  The  Principles  of  Antiseptic  Methods  Applied  to 
Obstetric  Practice.  By  Dr.  Paul  Bar,  Obstetrician  to,  formerly  Interne  in,  the 
Maternity  Hospital,  Paris.  Authorized  Translation  by  Henry  D.  Fry,  m.d. 
with  an  Appendix  by  the  author.  Octavo.  Cloth,  $1.75 

BARRETT.  Dental  Surgery  for  General  Practitioners  and  Students  of  Medicine 
and  Dentistry.  Extraction  of  Teeth,  etc.  By  A.  W.  Barrett,  m.d.  Second 
Edition.  Illustrated  Practical  Series.  [See  page  ip.]  Cloth,  $1.25 

BARTLEY.  Medical  Chemistry.  Second  Edition.  A  Text-book  for  Medical  and 
Pharmaceutical  Students.  By  E.  H.  Bartley,  m.d.,  Professor  of  Chemistry  and 
Toxicology  at  the  Long  Island  College  Hospital;  President  of  the  American 
Society  of  Public  Analysts;  Chief  Chemist,  Board  of  Health,  of  Brooklyn,  N.Y. 
Revised  and  enlarged.  With  62  Illustrations.  Glossary  and  Complete  Index. 
423  pages.  i2mo.  Cloth,  $2.50 

BEALE.  On  Slight  Ailments ;  their  Nature  and  Treatment.  By  Lionel  S.  Beale, 
m.d.,  f.r.s.,  Professor  of  Practice,  King’s  Medical  College,  London.  Second 
Edition.  Enlarged  and  Illustrated.  8vo.  Cloth,  $1.25 

Urinary  and  Renal  Diseases  and  Calculous  Disorders.  Hints  on  Diagnosis 
and  Treatment.  Demi-8vo.  356  pages.  Cloth,  $1.75 

The  Use  of  the  Microscope  in  Practical  Medicine.  For  Students  and 
Practitioners,  with  full  directions  for  examining  the  various  secretions,  etc., 
in  the  Microscope.  Fourth  Edition.  500  Illustrations.  8vo.  Cloth,  $7. 50 
How  to  Work  with  the  Microscope.  A  Complete  Manual  of  Microscopical 
Manipulation,  containing  a  full  description  of  many  new  processes  ot 
investigation,  with  directions  for  examining  objects  under  the  highesf 
powers,  and  for  taking  photographs  of  microscopic  objects.  Fifth  Edition. 
Containing  over  400  Illustrations,  many  of  them  colored.  8vo.  Cloth,  $y. 50 

One  Hundred  Urinary  Deposits,  on  eight  sheets,  for  the  Hospital,  Labora¬ 
tory,  or  Surgery.  New  Edition.  4to.  Paper,  $2.00 

BEASLEY’S  Book  of  Prescriptions.  Containing  over  3100  Prescriptions,  collected 
from  the  Practice  of  the  most  Eminent  Physicians  and  Surgeons — English, 
French  and  American;  a  Compendious  History  of  the  Materia  Medica,  Lists  of 
the  Doses  of  all  Officinal  and  Established  Preparations,  and  an  Index  of  Diseases 
and  their  Remedies.  By  Henry  Beasley.  Sixth  Edition.  Cloth,  $2.25 

Druggists’  General  Receipt  Book.  Comprising  a  copious  Veterinary  Formu¬ 
lary  ;  Recipes  in  Patent  and  Proprietary  Medicines,  Druggists’  Nostrums, 
etc.;  Perfumery  and  Cosmetics  ;  Beverages,  Dietetic  Articles  and  Condi¬ 
ments ;  Trade  Chemicals,  Scientific  Processes,  and  an  Appendix  of  Useful 
Tables.  Ninth  Edition.  Revised.  Cloth,  $2.25 

Pocket  Formulary  and  Synopsis  of  the  British  and  Foreign  Pharmacopoeias. 
Comprising  Standard  and  Approved  Formulas  for  the  Preparations  and 
Compounds  Employed  in  Medical  Practice.  Eleventh  Edition.  Cloth,  $2.25 

BIDDLE’S  Materia  Medica  and  Therapeutics.  Eleventh  Edition.  For  the  Use  of 
Students  and  Physicians.  By  Prof.  John  B.  Biddle,  m.d.,  Professor  of  Materia 
Medica  in  Jefferson  Medical  College,  Philadelphia.  The  Eleventh  Edition,  thor¬ 
oughly  revised,  and  in  many  parts  rewritten,  by  his  son,  Clement  Biddle,  m.d,, 
Assistant  Surgeon,  U.  S.  Navy,  and  Henry  Morris,  m.d.,  Fellow  of  the  College 
of  Physicians,  of  Philadelphia,  etc.  Cloth,  $4.25;  Sheep,  $5.00 

BIGELOW.  Plain  Talks  on  Medical  Electricity  and  Batteries,  with  a  Thera¬ 
peutic  Index  and  a  Glossary.  Prepared  for  Practitioners  and  Students  of  Medi¬ 
cine.  By  Horatio  R.  Bigelow,  m.d.,  Fellow  of  the  British  Gynaecological 
Society ;  of  the  American  Electro-Therapeutic  Association  ;  Member  American 
Medical  Association,  etc.  43  Illustrations,  and  a  Glossary.  i2mo.  Cloth,  $1.00 


MEDICAL  AND  SCIENTIFIC  PUBL1CA  TIONS. 


7 


BLACK.  Micro-Organisms.  The  Formation  of  Poisons.  A  Biological  study  of 
the  Germ  Theory  of  Disease.  By  G.  V.  Black,  m.d.,  d.d.s.  Cloth,  $1.50 

BLAIR.  Potable  Waters.  The  Original  Analysis  of.  By  J.  A.  Blair,  m.  b., 
C.  m.,  d.  sc.  Edin.,  etc.  i2mo.  1.00 

BLODGETT’S  Dental  Pathology.  By  Albert  N.  Blodgett,  m.d.,  Late  Prof,  of 
Pathology  and  Therapeutics,  Boston  Dental  Coll.  33  Illus.  i2mo.  Cloth,  $1.75 

BLOXAM.  Chemistry,  Inorganic  and  Organic.  With  Experiments.  By 
Charles  L.  Bloxam.  Edited  by  J.  M.  Thompson,  Professor  of  Chemistry  in 
King’s  College,  London,  and  A.  G.  Bloxam,  Dem,  of  Chem.,  Royal  Agricultural 
College,  Cirencester.  Seventh  Edition.  Revised  and  Enlarged.  With  281 
Engravings.  8vo.  Cloth,  $4.50;  Leather,  $5.50 

BOWLBY.  Injuries  and  Diseases  of  the  Nerves,  and  their  surgical  treatment. 
By  Anthony  A.  Bowlby,  f.r.c.s.,  Dem.  of  Practical  Surgery  at  St.  Bartholo¬ 
mew’s  Hospital.  Illus.  by  4  Colored  and  20  full-page  plates.  8vo.  Cloth,  $4.50 
Surgical  Pathology  and  Morbid  Anatomy.  135  Illustrations.  Cloth,  $2.00 

BOWMAN.  Practical  Chemistry,  including  analysis,  with  about  100  Illustrations. 
By  Prof.  John  E.  Bowman.  Eighth  English  Edition.  Revised  by  Prof.  Bloxam, 
Professor  of  Chemistry,  King’s  College,  London.  Cloth,  $ 2.00 

BRUBAKER.  Physiology.  A  Compend  of  Physiology,  specially  adapted  for  the 
use  of  Students  and  Physicians.  By  A.  P.  Brubaker,  m.d.,  Demonstrator  of 
Physiology  at  Jefferson  Medical  College,  Prof,  of  Physiology,  Penn’a  College  of 
Dental  Surgery,  Philadelphia.  Sixth  Edition.  Revised,  Enlarged  and  Illus¬ 
trated.  A  ro.  4 ,  ?  Quiz-  Compend  Series?  i2mo.  Cloth,  $1.00;  Interleaved,  $1.25 

BUCKNILL  AND  TUKE’S  Manual  of  Psychological  Medicine :  containing 
the  Lunacy  Laws,  the  Nosology,  ^Etiology,  Statistics,  Description,  Diagnosis, 
Pathology  (including  morbid  Histology)  and  Treatment  of  Insanity.  By  John 
Charles  Bucknill,  m.d.,  f.r.s.,  and  Daniel  Hack  Tuke,  m.d.,  f.r.c.p. 
Fourth  Edition.  Numerous  illustrations.  8vo.  Cloth,  $8.00 

BULKLEY.  The  Skin  in  Health  and  Disease.  By  L.  Duncan  Bulkley,  m.d., 
Attending  Physician  at  the  New  York  Hospital.  Illustrated.  Cloth,  .50 

BUXTON.  On  Anaesthetics.  A  Manual.  By  Dudley  Wilmot  Buxton,  m.r.c.s., 
m.r.c.p.,  Asst,  to  Prof,  of  Med.,  and  Administrator  of  Anaesthetics,  University 
College  Hospital,  London.  Practical  Series.  [Seepage  sp.]  Cloth,  $1.25 

BURNET.  Foods  and  Dietaries.  A  Manual  of  Clinical  Dietetics.  By  R.  W. 
Burnet,  m.d.,  m.r.c.p.,  Physician  to  the  Great  Northern  Central  Hospital. 
General  Contents — Diet  in  Derangementa  of  the  Digestive,  Nervous  and  Res¬ 
piratory  Organs;  in  Gout,  Rheumatism,  Anaemia,  Fevers,  Obesity,  etc.;  in  Dis¬ 
eases  of  Children,  Alcoholism,  etc.  With  Appendix  on  Predigested  Foods  and 
Invalid  Cookery.  Full  directions  as  to  hours  of  taking  nourishment,  quantity, 
etc.,  are  given.  i2mo.  Cloth,  $1.75 

BURNETT.  Hearing,  and  How  to  Keep  It.  By  Chas.  H.  Burnett,  m.d.,  Prof, 
of  Diseases  of  the  Ear,  at  the  Philadelphia  Polyclinic.  Illustrated.  Cloth,  .50 

BYFORD.  Diseases  of  Women.  The  Practice  of  Medicine  and  Surgery,  as 
applied  to  the  Diseases  and  Accidents  Incident  to  Women.  By  W.  H.  Byford, 
a.m.,  m.d.,  Professor  of  Gynaecology  in  Rush  Medical  College  and  of  Obstetrics 
in  the  Woman’s  Medical  College  ;  Surgeon  to  the  Woman’s  Hospital ;  Ex-Presi¬ 
dent  American  Gynaecological  Society,  etc.,  and  Henry  T.  Byford,  m.d.,  Sur¬ 
geon  to  the  Woman’s  Hospital  of  Chicago;  Gynaecologist  to  St.  Luke’s  Hos¬ 
pital  ;  President  Chicago  Gynaecological  Society,  etc.  Fourth  Edition.  Revised, 
Rewritten  and  Enlarged.  With  306  Illustrations,  over  100  of  which  are  original. 
Octavo.  832  pages.  Cloth,  $5.00;  Leather,  $6.00 

On  the  Uterus.  Chronic  Inflammation  and  Displacement.  Cloth,  $1.25 

CAIRD  and  CAT  HC ART.  Surgical  Handbook  for  the  use  of  Practitioners  and 
Students.  By  F.  Mitchell  Caird,  m.b.,  f.r.c.s.,  and  C.  Walker  Cathcart, 
m.b.,  F.R.C.S.,  Asst.  Surgeons  Royal  Infirmary.  With  over  200  Illustrations. 
32mo.  400  pages.  Pocket  size.  Leather  covers,  $2.50 


8 


P.  BLAKISTON,  SON  &*  CO.'S 


CAMERON.  Oils  and  Varnishes.  A  Practical  Handbook,  by  James  Cameron, 
f.i.c.  With  Illustrations,  Formulae,  Tables,  etc.  ierno.  Cloth,  $2.50 

Soap  and  Candles.  A  New  Handbook  for  Manufacturers,  Chemists,  Ana¬ 
lysts,  etc.  Compiled  from  all  reliable  and  recent  sources.  54  Illustrations. 
121110.  Cloth,  $2.25 

CARPENTER.  The  Microscope  and  Its  Revelations.  By  W.  B.  Carpenter, 
m.d.,  f.r.s.  Seventh  Edition.  By  Rev.  Dr.  Dollinger,  f.  r.  s.  Revised  and 
Enlarged,  with  800  Illustrations  and  many  Lithographs.  Octavo  1050  Pages. 

Cloth,  $6  50;  Sheep,  $7.50 

CAZEATJX  and  TARNIER’S  Midwifery.  With  Appendix,  by  Munde.  Eighth 
Revised  and  Enlarged  Edition.  With  Colored  Plates  and  numerous  other 
Illustrations.  The  Theory  and  Practice  of  Obstetrics  ;  including  the  Diseases 
of  Pregnancy  and  Parturition,  Obstetrical  Operations,  etc.  By  P.  Cazeaux, 
Member  of  the  Imperial  Academy  of  Medicine,  Adjunct  Professor  in  the  Faculty 
of  Medicine  in  Paris.  Remodeled  and  rearranged,  with  revisions  and  additions, 
by  S.  Tarnier,  m.d.,  Professor  of  Obstetrics  and  Diseases  of  Women  and 
Children  in  the  Faculty  of  Medicine  of  Paris.  Eighth  American,  from  the 
Eighth  French  and  First  Italian  Edition.  Edited  and  Enlarged  by  Robert 
J.  Hess,  m.d.,  Physician  to  the  Northern  Dispensary,  Phila.,  etc.,  with  an  Ap¬ 
pendix  by  Paul  F.  Munde,  m.d.,  Professor  of  Gynaecology  at  the  New  York 
Polyclinic,  and  at  Dartmouth  College ;  Vice-President  American  Gynaecological 
Society,  etc.  Illustrated  by  Chromo-Lithographs,  Lithographs,  and  other  Full- 
page  Plates,  seven  of  which  are  beautifully  colored,  and  numerous  Wood  En¬ 
gravings.  Students'  Edition.  One  Vol.,  8vo.  Cloth,  $5.00;  Full  Leather,  $6.00 

CHARTERIS.  Practice  of  Medicine.  The  Student’s  Guide.  By  M.  Charteris, 
m.d.,  Professor  of  Therapeutics  and  Materia  Medica,  Glasgow  University,  etc. 
Sixth  Edition,  with  Therapeutical  Index  and  many  Illustrations.  Cloth,  $3.00 

CLEVELAND’S  Pocket  Dictionary.  A  Pronouncing  Medical  Lexicon,  containing 
correct  Pronunciation  and  Definition  of  terms  used  in  medicine  and  the  col¬ 
lateral  sciences,  abbreviations  used  in  prescriptions,  list  of  poisons,  their  anti¬ 
dotes,  etc.  By  C.  H.  Cleveland,  m.d.  Thirty-third  Edition.  Very  small 
pocket  size.  Cloth,  .75;  Tucks  with  Pocket,  $1.00 

COHEN.  The  Throat  and  Voice.  By  J.  Solis-Cohen,  m.d.  Illus.  i2mo.  Cloth,  .50 

COLLIE,  On  Fevers.  A  Practical  Treatise  on  Fevers,  Their  History,  Etiology, 
Diagnosis,  Prognosis  and  Treatment.  By  Alexander  Collie,  m.d.,  m.r.c.p., 
Lond.  With  Colored  Plates.  Practical  Series.  See  Page  19.  Cloth,  $2.50 

CROCKER.  Diseases  of  the  Skin.  Their  Description,  Pathology,  Diagnosis  and 
Treatment.  By  H.  Radcliffe  Crocker,  m.d.,  Physician  to  the  Dept,  of  Skin 
Dis.  University  College  Hospital,  London.  With  Illustrations.  Cloth,  $5.50 

CDLLINGWORTH.  A  Manual  of  Nursing,  Medical  and  Surgical.  By  Charles 
J.  Cullingworth,  m.d.,  Physician  to  St.  Thomas’  Hospital,  London.  Third 
Revised  Edition.  With  18  Illustrations.  i2mo.  Cloth,  .75 

A  Manual  for  Monthly  Nurses.  Third  Edition.  321110.  Cloth,  .50 

DAVIS.  Biology.  An  Elementary  Treatise.  By  J.  R.  Ainsworth  Davis,  of 
University  College,  Aberystwyth,  Wales.  Thoroughly  Illustrated.  i2mo.  $4.00 

DAVIS.  A  Manual  of  Obstetrics.  Being  a  complete  manual  for  Physicians  and 
Students.  By  Edward  P.  Davis,  m.d.,  Demonstrator  of  Obstetrics,  Jefferson 
Medical  College ;  Physician  to  the  Philadelphia  Hospital ;  Editor  American 
Journal  Medical  Sciences;  etc.  With  11  Colored  and  other  Lithograph  Plates 
and  128  other  Illustrations.  i2mo.  Cloth,  $2.00 

Clinical  Obstetrical  Chart.  Designed  by  Ed.  P.  Davis,  m.d.,  and  J.  P.  Crozer 
Griffith,  m.d.  Sample  copies  free.  Put  up  in  loose  packages  of  50,  .50 

Price  to  Hospitals,  500  copies,  $4.00;  1000  copies,  $7. 50.  With  name  of 
Hospital  printed  on,  50  cents  extra. 

DAY.  On  Headaches.  The  Nature,  Causes  and  Treatment  of  Headaches.  By 
Wm.  H.  Day,  m.d.  Fourth  Edition.  Illustrated.  8vo.  Paper,  .75;  Cloth,  $1.25 

DERMATOLOGY,  Journal  of.  Edited  by  Malcolm  Morris,  m.r.c.s.  London, 
and  D.  G.  Brooke,  m.r.c.s.  Manchester,  Eng.  Monthly.  Per  Annum,  $3.00 


MEDICAL  AND  SCIENTIFIC  PUBLICA  TIONS. 


9 


DOMVILLE.  Manual  for  Nurses  and  others  engaged  in  attending  to  the  sick.  By 
Ed.  J.  Domville,  m.d.  7th  Edition.  Revised.  With  Becipes  for  Sick-room 
Cookery,  etc.  i2mo.  Cloth,  .75 

DUCKWORTH.  On  Gout.  Illustrated.  A  treatise  on  Gout.  By  Sir  Dyce 
Duckworth,  m.d.  (Edin.),  f.r.c.p.,  Physician  to,  and  Lecturer  on  Clinical 
Medicine  at,  St.  Bartholomew’s  Hospital,  London.  With  Chromo-lithographs 
and  Engravings.  Octavo.  Cloth,  $ 7.00 

DULLES.  What  to  Do  First,  In  Accidents  and  Poisoning.  By  C.  W.  Dulles,  m.d. 
Third  Edition,  Enlarged,  with  new  Illustrations.  Cloth.  .75 

EDIS.  Sterility  in  Women.  By  A.  W.  Edis,  m.d.,  f.r.c.p.,  late  President  British 
Gynaecological  Society;  Senior  Physician,  Chelsea  Hospital  for  Women;  Physician 
to  British  Lying-in  Hospital,  etc.  Illustrated.  8vo.  Cloth,  $1.75 

FAGGE.  The  Principles  and  Practice  of  Medicine.  By  C.  Hilton  Fagge,  m.d., 
f.r.c.p.,  f.r.m.c.s.,  Examiner  in  Medicine,  University  of  London;  Physician  to, 
and  Lecturer  on  Pathology  in,  Guy’s  Hospital ;  Senior  Physician  to  Evelina  Hos¬ 
pital  for  Sick  Children,  etc.  Arranged  for  the  press  by  Philip  H.  Pye-Smith, 
m.d.,  Lect.  on  Medicine  in  Guy’s  Hospital.  Including  a  section  on  Cutaneous 
Affections,  by  the  Editor;  Chapter  on  Cardiac  Diseases,  by  Samuel  Wilkes,  m.d., 
f.r.s.,  and  Complete  Indexes  by  Robert  Edmund  Carrington.  2  vols.  Royal 
8vo.  Cloth,  $8.00;  Leather,  $10.00  ;  Half  Russia,  $12.00. 

FENWICK.  Student’s  Guide  to  Physical  Diagnosis.  By  Saml.  Fenwick,  m.d., 
m.r.c.p.,  Physician  to  the  London  Hospital.  Seventh  Edition.  117  Illustrations. 
i2mo.  Cloth,  $2.25 

FIELD.  Evacuant  Medication — Cathartics  and  Emetics.  By  Henry  M.  Field, 
m.d.,  Professor  of  Therapeutics,  Dartmouth  Medical  College,  Corporate  Mem¬ 
ber  Gynaecological  Society  of  Boston,  etc.  i2mo.  288  pp.  Cloth,  $1.75 

FILLEBROWN.  A  Text-Book  of  Operative  Dentistry.  Written  by  invitation 
of  the  National  Association  of  Dental  Faculties.  By  Thomas  Fillebrown,  m.d., 
d.m.d.,  Professor  of  Operative  Dentistry  in  the  Dental  School  of  Harvard  Uni¬ 
versity ;  Member  of  the  American  Dental  Assoc.,  etc.  Illus.  8vo.  Clo.,  $2.50 

FLAGG.  Plastics  and  Plastic  Fillings,  as  pertaining  to  the  filling  of  all  Cavities 
of  Decay  in  Teeth  below  medium  in  structure,  and  to  difficult  and  inaccessible 
cavities  in  teeth  of  all  grades  of  structure.  By  J.  Foster  Flagg,  d.d.s.,  Professor 
of  Dental  Pathology  in  Philadelphia  Dental  College.  Fourth  Revised  Edition. 
With  many  Illustrations.  8vo.  Cloth,  $4.00 

FLOWER’S  Diagrams  of  the  Nerves  of  the  Human  Body.  Exhibiting  their 
Origin,  Divisions  and  Connections,  with  their  Distribution  to  the  various  Regions 
of  the  Cutaneous  Surface  and  to  all  the  Muscles.  By  William  H.  Flower, 
f.r.c.S.,  f.r.s. ,  Hunterian  Professor  of  Comparative  Anatomy,  and  Conservator 
of  the  Museum  of  the  Royal  College  of  Surgeons.  Third  Edition,  thoroughly 
revised.  With  six  Large  Folio  Maps  or  Diagrams.  4to.  Cloth,  $3.50 

FLUCKIGER.  The  Cinchona  Barks  Pharmacognostically  Considered.  By 
Professor  Friedrich  Fluckiger,  of  Strasburg.  Translated  by  Frederick  B. 
Power,  ph.d.  With  8  Lithographic  Plates.  Royal  octavo.  Cloth,  $1.50 

FOWLER’S  Dictionary  of  Practical  Medicine.  By  Various  Writers.  An  Ency¬ 
clopedia  of  Medicine.  Edited  by  James  Kingston  Fowler,  m.a.,  m.d.,  f.r.c.p., 
Senior  Asst.  Physician  to,  and  Lecturer  on  Pathological  Anatomy  at,  the  Mid¬ 
dlesex  Hospital  and  the  Hospital  for  Consumption  and  Diseases  of  the  Chest, 
Brompton,  London.  8vo.  Cloth,  $5.00  ;  Half  Morocco,  $6.00 

FOX.  Water,  Air  and  Food.  Sanitary  Examinations  of  Water,  Air  and  Food. 
By  Cornelius  B.  Fox,  m.d.  iio  Engravings.  2d  Ed.,  Revised.  Cloth,  $4.00 


10 


P.  BLAKISTON,  SON  &*  CO.'S 


FOX  AND  GOULD.  Compend  on  Diseases  of  the  Eye  and  Refraction, 

including  Treatment  and  Surgery.  By  L. Webster  Fox,  m.d.,  Chief  Clinical 
Assistant,  Ophthalmological  Department,  Jefferson  Medical  College  Hospital ; 
Ophthalmic  Surgeon,  Germantown  Hospital,  Philadelphia  ;  late  Clinical  Assistant 
at  Moorfields,  London,  England,  etc.,  and  Geo.  M.  Gould,  m.d.  Second  Edition. 
Enlarged.  71  Illustrations  and  39  Formulae.  Being  No.  8,  ?  Quiz- Compend  f 
Series.  Cloth,  $1.00.  Interleaved  for  the  addition  of  notes,  #1.25 

FRANKLAND’S  Water  Analysis.  For  Sanitary  Purposes,  with  Hints  for  the  In¬ 
terpretation  of  Results.  By  E.  Frankland,  m.d.,  f.r.s.  Illustrated.  i2mo. 

Cloth,  $1.00 

FULLERTON.  Obstetrical  Nursing.  A  Handbook  for  Nurses,  Students  and 
Mothers.  By  Anna  M.  Fullerton,  m.d.,  Demonstrator  of  Obstetrics  in  the 
Woman’s  Medical  College;  Physician  in  charge  of,  and  Obstetrician  and 
Gynaecologist  to,  the  Woman’s  Hospital,  Philadelphia,  etc.  34  Illustrations. 
Second  Edition.  Revised  and  Enlarged.  i2mo.  Cloth,  $1.25 

Nursing  in  Abdominal  Surgery  and  Diseases  of  Women.  Comprising  the 
Regular  Course  of  Instruction  at  the  Training  School  of  the  Woman’s 
Hospital,  Philadelphia.  70  Illustrations.  i2mo.  Cloth, 

G ALABIN’S  Midwifery.  A  Manual  for  Students  and  Practitioners.  By  A.  Lewis 
Galabin,  m.d.,  f.r.c.p.,  Professor  of  Midwifery  at  and  Obstetric  Physician  to, 
Guy’s  Hospital,  London.  227  Illustrations.  Cloth,  $3.00;  Leather,  $3.50 

GARDNER.  The  Brewer,  Distiller  and  Wine  Manufacturer.  A  Handbook  for 
all  Interested  in  the  Manufacture  and  Trade  of  Alcohol  and  Its  Compounds. 
Edited  by  John  Gardner,  f.c.s.  Illustrated.  Cloth,  $1.75 

Bleaching,  Dyeing,  and  Calico  Printing.  With  Formulae.  Illustrated.  $1.75 
Acetic  Acid,  Vinegar,  Ammonia  and  Alum.  Illustrated.  Cloth,  $1.75 

GARROD.  On  Rheumatism.  A  Treatise  on  Rheumatism  and  Rheumatic  Arthritis. 
By  Archibald  Edward  Garrod,  m.a.  Oxon.,  m.d.,  m.r.c.s.  Eng.,  Asst.  Phy¬ 
sician,  West  London  Hospital.  Illustrated.  Octavo.  Cloth,  $ 6.00 

GIBBES’S  Practical  Histology  and  Pathology.  By  Heneage  Gibbes,  m.b.  121110. 
Third  Edition.  Cloth,  $1.75 

GILLIAM’S  Pathology.  The  Essentials  of  Pathology ;  a  Handbook  for  Students. 
By  D.  Tod  Gilliam,  m.d.,  Professor  of  Physiology,  Starling  Medical  College, 
Columbus,  O.  With  47  Illustrations.  i2mo.  Cloth,  $2.00 

G00DHART  and  STARR’S  Diseases  of  Children.  The  Student’s  Guide  to  the 
Diseases  of  Children.  By  J.  F.  Goodhart,  m.d.,  f.r.c.p.,  Physician  to  Evelina 
Hospital  for  Children;  Demonstrator  of  Morbid  Anatomy  at  Guy’s  Hospital. 
Second  American  from  the  Third  English  Edition.  Rearranged  and 
Edited,  with  notes  and  additions,  by  Louis  Starr,  m.d.,  Clinical  Professor  of  Dis¬ 
eases  of  Children  in  the  University  of  Pennsylvania  ;  Physician  to  the  Children’s 
Hospital.  With  many  new  prescriptions.  Cloth,  $3.00;  Leather,  $3.50 

GORGAS’S  Dental  Medicine.  A  Manual  of  Materia  Medica  and  Therapeutics. 
By  Ferdinand  J.  S.  Gorgas,  m.d.,  d.d.s.,  Professor  of  the  Principles  of  Dental 
Science,  Dental  Surgery  and  Dental  Mechanism  in  the  Dental  Dep.  of  the  Univ. 
of  Maryland.  4th  Edition.  Revised  and  Enlarged.  8vo.  Cloth,  $3.50 

GOULD’S  New  Medical  Dictionary.  Including  all  the  Words  and  Phrases  used 
in  Medicine,  with  their  proper  Pronunciation  and  Definitions,  based  on  Recent 
Medical  Literature.  By  George  M.  Gould,  b.a.,  m.d.,  Ophthalmic  Surgeon  to 
the  Philadelphia  Hospital,  etc.,  With  Tables  of  the  Bacilli,  Micrococci,  Leuco- 
mai'nes,  Ptomaines,  etc.,  of  the  Arteries,  Muscles,  Nerves,  Ganglia  and  Plexuses; 
Mineral  Springs  of  U.  S.,  Vital  Statistics,  etc.  Small  octavo,  520  pages. 

Half  Dark  Leather,  $3.25;  Half  Morocco,  Thumb  Index,  #4.25 

*** Sample  pages  and  descriptive  circular  of  Gould's  Dictionary  sent  free  upon 
application. 


MEDICAL  AND  SCIENTIFIC  PUBLICATIONS. 


11 


GOWERS,  Manual  of  Diseases  of  the  Nervous  System.  A  Complete  Text-book. 
By  William  R.  Gowers,  m.d.,  Prof.  Clinical  Medicine,  University  College, 
London.  Physician  to  National  Hospital  for  the  Paralyzed  and  Epileptic.  Second 
Edition..  Revised,  Enlarged  and  in  many  parts  rewritten.  With  many  new 
Illustrations.  Two  Volumes.  Octavo.  Nearly  Ready. 

Diagnosis  of  Diseases  of  the  Brain.  8vo.  Second  Ed.  Illus.  Cloth,  $2.00 

Diagnosis  of  Diseases  of  the  Spinal  Cord.  4th  Edition.  Preparing. 

Medical  Ophthalmoscopy.  A  Manual  and  Atlas,  with  Colored  Autotype  and 
Lithographic  Plates  and  Wood-cuts,  comprising  Original  Illustrations  of  the 
changes  of  the  Eye  in  Diseases  of  the  Brain,  Kidney,  etc.  Third  Edition. 
Revised,  with  the  assistance  of  R.  Marcus  Gunn,  f.r.c.s.,  Surgeon,  Royal 
London  Ophthalmic  Hospital,  Moorfields.  Octavo.  Cloth,  $5.50 

Syphilis  and  the  Nervous  System.  Being  the  Lettsomian  Lectures  for  1889. 
8vo.  hi  Press. 

GROSS’S  Biography  of  John  Hunter.  John  Hunter  and  His  Pupils.  By  Profes¬ 
sor  S.  D.  Gross,  m.d.  With  a  Portrait.  8vo.  Paper,  .75 

GREENHOW.  Chronic  Bronchitis,  as  connected  with  Gout,  Emphysema,  and 
Diseases  of  the  Heart.  By  E.  H. Greenhow,  m.d.  Paper,  .75  ;  Cloth,  $1.25 

GRIFFITH’S  Graphic  Clinical  Chart.  Designed  by  J.  P.  Crozer  Griffith, 
m.d.,  Instructor  in  Clinical  Medicine  in  the  University  of  Pennsylvania.  Printed 
in  three  colors.  Sample  copies  free.  Put  up  in  loose  packages  of  50,  .50 

Price  to  Hospitals,  500  copies,  $4.00;  1000  copies,  $7. 50.  With  name  of  Hos¬ 
pital  printed  on,  50  cents  extra. 

GROVES  AND  THORP.  Chemical  Technology.  A  new  and  Complete  Work. 
The  Application  of  Chemistry  to  the  Arts  and  Manufactures.  Edited  by 
Charles  E.  Groves,  f.r.s.,  and  Wm.  Thorp,  b.sc.,  f.i.c.  In  about  eight  vol¬ 
umes,  with  numerous  illustrations.  Each  volume  sold  separately . 

Vol.  I.  Fuel.  By  Dr.  E.  J.  Mills,  f.r.s.,  Professor  of  Chemistry,  Anderson 
College,  Glasgow ;  and  Mr.  F.  J.  Rowan,  assisted  by  an  American  expert.  607 
Illustrations  and  4  plates.  Octavo.  Cloth,  7.50;  Half  Morocco,  $9.00 

HADDON’S  Embryology.  An  Introduction  to  the  Study  of  Embryology.  For 
the  Use  of  Students.  By  A.  C.  Haddon,  m.a.,  Prof,  of  Zoology,  Royal  College 
of  Science,  Dublin.  190  Illustrations.  Cloth,  $6.00 

HAIG.  Causation  of  Disease  by  Uric  Acid.  A  Contribution  to  the  Pathology  of 
High  Arierial  Tension,  Headache,  Epilepsy,  Gout,  Rheumatism,  Diabetes, 
Bright’s  Disease,  etc.  By  Alex.  Haig,  m.a.,  m.d.  Oxon.,  f.r.c  p.,  Physician  to 
Metropolitan  Hospital,  London.  Illustrated.  Octavo.  In  Press. 

HALE.  On  the  Management  of  Children  in  Health  and  Disease.  A  Book  for 
Mothers.  By  Amie  M.  Hale,  m.d.  New  Enlarged  Edition.  i2mo.  Cloth,  .75 

HARE.  Mediastinal  Disease.  The  Pathology,  Clinical  History  and  Diagnosis  of 
Affections  of  the  Mediastinum  other  than  those  of  the  Heart  and  Aorta,  with 
tables  giving  the  Clinical  History  of  520  cases.  The  essay  to  which  was  awarded 
the  Fothergillian  Medal  of  the  Medical  Society  of  London,  1888.  By  H.  A, 
Hare,  m.d.  (Univ.  of  Par),  Professor  of  Materia  Medica  and  Therapeutics  in 
Jefferson  Medical  College,  Phila.  8vo.  Illustrated  by  Six  Plates.  Cloth,  $2.00 

HARLAN.  Eyesight,  and  How  to  Care  for  It.  By  George  C.  Harlan,  m.d., 
Prof,  of  Diseases  of  the  Eye,  Philadelphia  Polyclinic.  Illustrated.  Cloth,  .50 

HARRIS.  On  the  Chest.  Including  the  Principal  Affections  of  the  Pleune,  Lungs, 
Pericardium,  Heart  and  Aorta.  By  Vincent  D.  Harris,  f.r.c.p.,  Physician  to 
the  Victoria  Park  Hospital  for  Diseases  of  the  Chest,  London.  With  55  Illus¬ 
trations.  Cloth,  $2.50 


12 


P.  BLAKISTON,  SON  <S^  CO.'S 


HARRIS’S  Principles  and  Practice  of  Dentistry.  Including  Anatomy,  Physi¬ 
ology,  Pathology,  Therapeutics,  Dental  Surgery  and  Mechanism.  By  Chapin  A. 
Harris,  m.d.,  d.d.s.,  late  President  of  the  Baltimore  Dental  College,  author  of 
“Dictionary  of  Medical  Terminology  and  Dental  Surgery.”  Twelfth  Edition. 
Revised  and  Edited  by  Ferdinand  J.  S.  Gorgas,  a.m.,  m.d.,  d.d.s.,  author  of 
“Dental  Medicine;”  Professor  of  the  Principles  of  Dental  Science,  Dental 
Surgery  and  Dental  Mechanism  in  the  University  of  Maryland.  Two  Full-page 
Plates  and  1086  Illustrations.  1225  pages.  8vo.  Cloth,  $7.00;  Leather,  $8.00 

Dictionary  of  Dentistry.  Fifth  Edition,  Revised.  Including  Definitions  of 
such  Words  and  Phrases  of  the  Collateral  Sciences  as  Pertain  to  the  Art  and 
Practice  of  Dentistry.  Fifth  Edition.  Rewritten,  Revised  and  Enlarged. 
By  Ferdinand  J.  S.  Gorgas,  m.d.,  d.d.s.,  Author  of  “Dental  Medicine;” 
Editor  of  Harris’s  “Principles  and  Practice  of  Dentistry;”  Professor  of 
Principles  of  Dental  Science,  Dental  Surgery,  and  Prosthetic  Dentistry  in  the 
University  of  Maryland.  Octavo.  Cloth,  $5.00;  Leather,  $6.00 

HARTRIDGE.  Refraction.  The  Refraction  of  the  Eye.  A  Manual  for  Students. 
By  Gustavus  Hartridge,  f.r.c.s.,  Consulting  Ophthalmic  Surgeon  to  St.  Bar¬ 
tholomew’s  Hospital ;  Ass’t  Surgeon  to  the  Royal  Westminster  Ophthalmic  Hos¬ 
pital,  etc.  96  Illustrations  and  Test  Types.  Fifth  Edition.  Cloth,  #1.75 

On  The  Ophthalmoscope.  A  Manual  for  Physicians  and  Students.  With 
Colored  Plates  and  many  Woodcuts.  i2mo.  Cloth,  $1.50 

HARTSHORNE.  Our  Homes.  Their  Situation,  Construction,  Drainage,  etc.  By 
Henry  Hartshorne,  m.d.  Illustrated.  Cloth,  .50 

HATFIELD.  Diseases  of  Children.  By  Marcus  P.  Hatfield,  Professor  of 
Diseases  of  Children,  Chicago  Medical  College.  With  a  Colored  Plate.  Being 
No.  /y,  ?  Quiz-  Compend  f  Series.  i2mo.  Cloth,  $1.00 

Interleaved  for  the  addition  of  notes,  $1.25 

HEADLAND’S  Action  of  Medicines.  On  the  Action  of  Medicines  in  the  System. 
By  F.  W.  Headland,  m.d.  Ninth  American  Edition.  8vo.  Cloth,  $3.00 

HEATH’S  Minor  Surgery  and  Bandaging.  By  Christopher  Heath,  f.r.c.s., 
Holme  Professor  of  Clinical  Surgery  in  University  College,  London.  Ninth 
Edition.  Revised  and  Enlarged.  With  142  Illustrations.  i2mo.  Cloth,  $2.00 

Practical  Anatomy.  A  Manual  of  Dissections.  Seventh  London  Edition. 
24  Colored  Plates,  and  nearly  300  other  Illustrations.  Cloth,  $5.00 

Injuries  and  Diseases  of  the  Jaws.  Third  Edition.  Revised,  with  over 
1 50  Illustrations.  8vo.  Cloth,  $4.50 

Lectures  on  Certain  Diseases  of  the  Jaws,  delivered  at  the  Royal  College  ot 
Surgeons  of  England,  1887.  64  Illustrations.  8vo.  Boards,  $1. 00 

HENRY.  Anaemia.  A  Practical  Treatise.  By  Fred’k  P.  Henry,  m.d.,  Prof. 
Clinical  Med.  Phila.  Polyclinic,  Physician  to  Episcopal  and  Phila.  Hospitals,  to 
Home  for  Consumptives,  etc.  i2mo.  Half  Cloth,  .75 

HIGGENS’  Ophthalmic  Practice.  A  Manual  for  Students  and  Practitioners.  By 
Charles  Higgens,  f.r.c.s.  Ophthalmic  Surgeon  at  Guy’s  Hospital.  Practical 
Series.  See  Page  ig.  Cloth,  $1.75 

HILL  AND  COOPER.  Venereal  Diseases.  The  Student’s  Manual  of  Venereal 

Diseases,  being  a  concise  description  of  those  Affections  and  their  Treatment. 
By  Berkeley  Hill,  m.d.,  Professor  of  Clinical  Surgery,  University  College,  and 
Arthur  Cooper,  m.d.,  Late  House  Surgeon  to  the  Lock  Hospital,  London. 
4th  Edition.  i2mo.  Cloth, *$1. 00 


MEDICAL  AND  SCIENTIFIC  PUBLICATIONS. 


13 


HOLDEN’S  Anatomy.  A  Manual  of  the  Dissections  of  the  Human  Body.  By 
Luther  Holden,  f.r.c.s.  Fifth  Edition.  Carefully  Revised  and  Enlarged. 
Specially  concerning  the  Anatomy  of  the  Nervous  System,  Organs  of  Special 
Sense,  etc.  By  John  Langton,  f.r.c.s.,  Surgeon  to,  and  Lecturer  on  Anatomy 
at,  St.  Bartholomew's  Hospital.  208  Illustrations.  8vo. 

Oilcloth  Covers,  for  the  Dissecting  Room,  $4.50 

Human  Osteology.  Comprising  a  Description  of  the  Bones,  with  Colored 
Delineations  of  the  Attachments  of  the  Muscles.  The  General  and  Micro¬ 
scopical  Structure  of  Bone  and  its  Development.  Carefully  Revised.  By 
the  Author  and  Prof.  Stewart,  of  the  Royal  College  of  Surgeons’  Museum. 
With  Lithographic  Plates  and  Numerous  Illustrations.  7th  Ed.  Cloth,  $6.00 

Landmarks.  Medical  and  Surgical.  4th  Edition.  8vo.  Cloth,  $1.25 

HOLLAND.  The  Urine,  the  Common  Poisons  and  the  Milk.  Memoranda,  Chem¬ 
ical  and  Microscopical,  for  Laboratory  Use.  By  J.  W.  Holland,  m.d.,  Professor 
of  Medical  Chemistry  and  Toxicology  in  Jefferson  Medical  College,  of  Philadel¬ 
phia.  Fourth  Edition.  Revised  and  Enlarged.  Illustrated  and  Interleaved. 
i2mo.  Cloth,  $1.00 

HORWITZ’S  Compend  of  Surgery,  including  Minor  Surgery,  Amputations,  Frac¬ 
tures,  Dislocations,  Surgical  Diseases,  and  the  Latest  Antiseptic  Rules,  etc.,  with 
Differential  Diagnosis  and  Treatment.  By  Orville  Horwitz,  b.s.,  m.d.,  Dem¬ 
onstrator  of  Anatomy,  Jefferson  Medical  College ;  Chief,  Out-Patient  Surgical 
Department,  Jefferson  Medical  College  Hospital.  Third  Edition.  Very  much 
Enlarged  and  Rearranged.  91  Illustrations  and  77  Formulae.  i2mo.  No.gfQuiz- 
Compend ?  Series.  Cloth,  $1.00.  Interleaved  for  the  addition  of  notes,  $1.25 

HUFELAND.  Long  Life.  Art  of  Prolonging  Life.  By  C.  W.  Hufeland. 
Edited  by  Erasmus  Wilson,  m.d.  i2mo.  Cloth,  $1.00 

HUGHES.  Compend  of  the  Practice  of  Medicine.  Fourth  Edition.  Revised  and 
Enlarged.  By  Daniel  E.  Hughes,  m.d.,  Demonstrator  of  Clinical  Medicine  at 
Jefferson  Medical  College,  Philadelphia.  In  two  parts.  Being  Nos.  2  and  j, 
?  Quiz-  Compend  ?  Series. 

Part  I. — Continued,  Eruptive  and  Periodical  Fevers,  Diseases  of  the  Stomach, 
Intestines,  Peritoneum,  Biliary  Passages,  Liver,  Kidneys,  etc.,  and  General 
Diseases,  etc. 

Part  II. — Diseases  of  the  Respiratory  System,  Circulatory  System  and  Ner¬ 
vous  System  ;  Diseases  of  the  Blood,  etc. 

Price  of  each  Part,  in  Cloth,  $1.00 ;  interleaved  for  the  addition  of  Notes,  $1.25 

Physicians’  Edition. — In  one  volume,  including  the  above  two  parts,  a  sec¬ 
tion  on  Skin  Diseases,  and  an  index.  Fourth  revised ,  enlarged  Edition. 
4.62  pages.  Full  Morocco,  Gilt  Edge,  $2.50 

HUMPHREY.  A  Manual  for  Nurses.  Including  general  Anatomy  and  Physiology, 
management  of  the  sick  room,  etc.  By  Laurence  Humphrey,  m.a.,  m.b., 
m.r.c.S.,  Assistant  Physician  to,  and  Lecturer  at,  Addenbrook’s  Hospital,  Cam¬ 
bridge,  England.  4th  Edition.  i2mo.  Illustrated.  Cloth,  $1.25 

HUTCHINSON.  The  Nose  and  Throat.  A  Manual  of  the  Diseases  of  the  Nose 
and  Throat,  including  the  Nose,  Naso-Pharynx,  Pharynx  and  Larynx.  By 
Procter  S.  Hutchinson,  m.r.c.S.,  Asst.  Surgeon  to  the  London  Hospital  for 
Diseases  of  the  Throat.  Illustrated  by  several  Lithograph  Plates  and  40  other 
plates,  many  of  which  have  been  made  from  original  drawings.  1 21110.  Cloth,  #1.25 

JACOBSON.  Operations  of  Surgery.  By  W.  H.  A.  Jacobson,  b.a.  oxon., 
f.r  C.S.,  Eng. ;  Ass’t  Surgeon,  Guy’s  Hospital ;  Surgeon  at  Royal  Hospital  for 
Children  and  Women,  etc.  With  over  200  Illust.  Cloth,  $5.00  ;  Leather,  $6.00 

JAWORSKI.  Carlsbad  Sprudel  Salt.  Its  Action,  Therapeutic  Value  and  Use, 
and  its  relation  to  the  Carlsbad  Thermal  Water.  By  Dr.  W.  Jaworski,  Univer- 
sitats-Dozenten  in  Krakau,  with  a  Dietary  by  the  Translator,  A.  L.  A.  Toboldt 
m.d.,  Asst.  Demonstrator  of  Pharmacy,  University  of  Pennsylvania. 

Octavo.  Cloth,  $2.0 o 


14 


P.  PLAKISTON,  SON  CO.'S 


KIRKES’  Physiology.  (. Authorized  Edition.  121110.  Dark  Red  Cloth.)  A  Hand¬ 
book  of  Physiology.  Twelfth  London  Edition,  Revised  and  Enlarged.  By  W. 
Morrant  Baker,  m.d.,  and  Vincent  Dormer  Harris,  m.d.  502  Illustrations. 
i2mo.  880  Pages.  Cloth,  $4.00;  Leather,  $5  00 

LANDIS’  Compend  of  Obstetrics  ;  especially  adapted  to  the  Use  of  Students  and 
Physicians.  By  Henry  G.  Landis,  m.d.,  Professor  of  Obstetrics  and  Diseases 
of  Women,  in  Starling  Medical  College,  Columbus,  Ohio.  Fourth  Edition. 
Enlarged.  With  Many  Illustrations.  No.  5  ? Quiz- Compend?  Series. 

Cloth,  $1.00;  interleaved  for  the  addition  of  Notes,  $1.25 

LANDOIS.  A  Text-Book  of  Human  Physiology  ;  including  Histology  and  Micro¬ 
scopical  Anatomy,  with  special  reference  to  the  requirements  of  Practical  Medi¬ 
cine.  By  Dr.  L.  Landois,  Professor  of  Physiology  and  Director  of  the  Physio¬ 
logical  Institute  in  the  University  of  Greifswald.  Fourth  American,  translated 
from  the  Seventh  German  Edition,  with  additions,  by  Wm.  Stirling,  m.d.,  d.sc., 
Brackenbury  Professor  of  Physiology  and  Histology  in  Owen’s  College,  and  Pro¬ 
fessor  in  Victoria  University,  Manchester  ;  Examiner  in  Physiology  in  University 
of  Oxford,  England.  With  845  Illustrations,  many  of  which  are  printed  in 
Colors.  8vo.  Cloth,  $7.00 ;  Leather,  $8.00 

LEBER  AND  ROTTENSTEIN.  Dental  Caries  and  Its  Causes.  An  Investigation 
into  the  Influence  of  Fungi  in  the  Destruction  of  the  Teeth.  By  Drs.  Leber 
and  Rottenstein.  Illustrated.  Paper,  .75 

LEE.  The  Microtomist’s  Vade  Mecum.  Second  Edition.  A  Handbook  of 
Methods  of  Microscopical  Anatomy.  By  Arthur  Bolles  Lee,  Asst,  in  the  Rus¬ 
sian  Laboratory  of  Zoology,  at  Villefranche-sur-Mer  (Nice).  660  Formulae,  etc. 
Enlarged  and  Revised.  Cloth,  $4.00 

LEFFMANN’S  Compend  of  Chemistry,  Inorganic  and  Organic.  Including  Urine 
Analysis.  By  Henry  Leffmann,  m.d.,  Prof,  of  Chemistry  and  Metallurgy  in 
the  Penna.  College  of  Dental  Surgery,  and  in  the  Wagner  Free  Institute  of 
Science,  Philadelphia.  A To.  10  ?  Quiz-  Compend  ?  Series.  Third  Edition.  Re¬ 
written  and  Adapted  for  Students  of  Medicine  and  Dentistry.  i2mo. 

Cloth,  $1.00.  Interleaved  for  the  addition  of  Notes,  $1.25 

LEFFMANN  &  BEAM.  Examination  of  Water  for  Sanitary  and  Technical  Pur¬ 
poses.  By  Henry  Leffmann,  m.d.,  Professor  of  Chemistry  and  Metallurgy, 
Penna.  College  of  Dental  Surgery,  Hygienist  and  Food  Inspector  Penna.  State 
Board  of  Agriculture,  etc.;  and  William  Beam,  a.m.,  formerly  Chief  Chemist 
B.  &  O.  R.  R.  Second  Edition.  Enlarged.  Illustrated.  i2mo.  Cloth,  $1.25 

Progressive  Exercises  in  Practical  Chemistry.  A  Laboratory  Handbook. 

Illustrated.  i2mo.  Cloth,  #1.00 

LEGG  on  the  Urine.  Practical  Guide  to  the  Examination  of  the  Urine,  for 
Practitioner  and  Student.  By  J.  Wickham  Legg,  m.d.  Sixth  Edition,  Enlarged. 
Illustrated.  i2mo.  Cloth,  .75 

LEWERS.  On  the  Diseases  of  Women.  Second  Edition.  With  146  Engravings. 
Practical  Series.  See  Page  19.  i2mo.  Cloth,  $2.50 

LEWIS,  (BEVAN).  Mental  Diseases.  A  text-book  having  special  reference  to  the 
Pathological  aspects  of  Insanity.  By  Bevan  Lewis,  l.r.c.p.,  m.r.c.s.,  Medi¬ 
cal  Director,  West  Riding  Asylum,  Wakefield,  England.  18  Lithographic  plates 
and  other  Illustrations.  8vo.  Cloth,  $6.00 

LIEBREICH’S  Atlas  of  Ophthalmoscopy,  composed  of  12  Chromo-Lithographic 
Plates  (containing  59  Figures),  with  Text.  Translated  by  H.  R.  Swanzy,  m.d. 
Third  Edition.  4to.  Boards,  #15.00 

LINCOLN.  School  and  Industrial  Hygiene.  By  D.  F.  Lincoln,  m.d.  Cloth,  .50 

LIZARS,  (JOHN).  On  Tobacco.  The  Use  and  Abuse  of  Tobacco.  Cloth,  .50 

LONGLEY’S  Pocket  Medical  Dictionary  for  Students  and  Physicians.  Giving 
the  Correct  Definition  and  Pronunciation  of  all  Words  and  Terms  in  General 
Use  in  Medicine  and  the  Collateral  Sciences,  with  an  Appendix,  containing 
Poisons  and  their  Antidotes,  Abbreviations  Used  in  Prescriptions,  and  a  Metric 
Scale  of  Doses.  By  Elias  Longley.  Cloth,  $1.00;  Tucks  and  Pocket,  $1.25 

LUCRES.  Hospital  Sisters  and  their  Duties.  By  Eva  C.  E.  Luckes,  Matron  to 
the  London  Hospital ;  Author  of  “  Lectures  on  Nursing.”  i2mo.  Cloth,  $i.co 


MEDICAL  AND  SCIENTIFIC  PUBLIC  A  TIONS. 


15 


MACNAMARA.  On  the  Eye.  A  Manual  of  the  Diseases  of  the  Eye.  By  C. 
Macnamara,  m.d.  Fifth  Edition,  Carefully  Revised ;  with  Additions  and 
Numerous  Colored  Plates,  Diagrams  of  Eye,  Wood-cuts,  and  Test  Types. 
Demi  8vo.  Cloth,  $4.00 

MACALISTER’S  Human  Anatomy.  800  Illustrations.  A  New  Text-book  for 
Students  and  Practitioners.  Systematic  and  Topographical,  including  the 
Embryology,  Histology  and  Morphology  of  Man.  With  special  reference  to  the 
requirements  of  Practical  Surgery  and  Medicine.  By  Alex.  Macalister,  m.d., 
f.r.s.,  Professor  of  Anatomy  in  the  University  of  Cambridge,  England ;  Examiner 
in  Zoology  and  Comparative  Anatomy,  University  of  London  ;  formerly  Professor 
of  Anatomy  and  Surgery,  University  of  Dublin.  With  816  Illustrations,  400  of 
which  are  original.  Octavo.  Cloth,  $7.50;  Leather,  $8.50 

MACDONALD’S  Microscopical  Examinations  of  Water  and  Air.  A  Guide  to  the 
Microscopical  Examination  of  Drinking  Water,  with  an  Appendix  on  the  Micro¬ 
scopical  Examination  of  Air.  By  J.  D.  Macdonald,  m.d.  With  25  Litho¬ 
graphic  Plates,  Reference  Tables,  etc.  Second  Ed.,  Revised.  8vo.  Cloth,  $2.75 

MACKENZIE.  The  (Esophagus,  Nose,  Naso-Pharynx,  etc.  By  Sir  Morell 
Mackenzie,  m.d.,  Senior  Physician  to  the  Hospital  for  Diseases  of  the  Chest 
and  Throat,  London.  Illus.  Being  Vol.  II  of  the  First  Edition  of  his  Treatise 
on  the  Throat  and  Nose.  Complete  in  itself.  Cloth,  $3.00;  Leather,  $4.00 

The  Pharmacopoeia  of  the  Hospital  for  Diseases  of  the  Throat  and  Nose. 
Fourth  Edition,  Enlarged,  Containing  250  Formulae,  with  Directions  for  their 
Preparation  and  Use.  i6mo.  Cloth,  $1.25 

MANN’S  Manual  of  Psychological  Medicine  and  Allied  Nervous  Diseases.  Their 
Diagnosis,  Pathology,  Prognosis  and  Treatment,  including  their  Medico-Legal 
Aspects  ;  with  chapter  on  Expert  Testimony,  and  an  abstract  of  the  laws  relating 
to  the  Insane  in  all  the  States  of  the  Union.  By  Edward  C.  Mann,  m.d., 
member  of  the  New  York  County  Medical  Society.  With  Illustrations  of  Typical 
Faces  of  the  Insane,  Handwriting  of  the  Insane,  and  Micro-photographic  Sec¬ 
tions  of  the  Brain  and  Spinal  Cord.  Octavo.  Cloth,  $5.00 

MARSHALL’S  Physiological  Diagrams,  Life  Size,  Colored.  Eleven  Life-size 
Diagrams  (each  7  feet  by  3  feet  7  inches).  Designed  for  Demonstration  before 
the  Class.  By  John  Marshall,  f.r.s.,  f.r.c.s.,  Professor  of  Anatomy  to  the 
Royal  Academy  ;  Professor  of  Surgery,  University  College,  London,  etc. 

In  Sheets  Unmounted,  net,  $40.00 
Backed  with  Muslin  and  Mounted  on  Rollers,  net,  $60.00 
Ditto,  Spring  Rollers,  in  Handsome  Walnut  Wall  Map  Case  (Send  for 

Special  Circular), . Net,  $100.00 

Single  Plates,  Sheets,  net ,  $5.00;  Mounted,  $7. 50;  Explanatory  Key,  50  cents. 

No.  1 — The  Skeleton  and  Ligaments.  No.  2 — The  Muscles  and  Joints,  with 

Animal  Mechanics.  No.  3 — The  Viscera  in  Position.  The  Structure  of  the  Lungs. 

No.  4 — The  Heart  and  Principal  Blood-vessels.  No.  5 — The  Lymphatics  or  Absorb¬ 
ents.  No.  6 — The  Digestive  Organs.  No.  7 — The  Brain  and  Nerves.  Nos.  8  and  9 — 

The  Organs  of  the  Senses.  Nos.  10  and  11 — The  Microscopic  Structure  of  the 

Textures  and  Organs.  ( Send  for  Special  Circular.) 

MARSHALL  &  SMITH.  On  the  Urine.  The  Chemical  Analysis  of  the  Urine. 
By  John  Marshall,  m.d.,  and  Prof.  Edgar  F.  Smith,  of  the  Chemical  Labora¬ 
tories,  University  of  Pennsylvania.  Phototype  Plates.  i2mo.  Cloth,  $1.00 

MASON’S  Compend  of  Electricity,  and  its  Medical  and  Surgical  Uses.  By 
Charles  F.  Mason,  m.d.,  Assistant  Surgeon  U.  S.  Army.  With  an  Intro¬ 
duction  by  Charles  H.  May,  m.d.,  Instructor  in  the  New  York  Polyclinic. 
Numerous  Illustrations.  12010.  Cloth,  $1.00 

McBRIDE.  Diseases  of  the  Throat,  Nose  and  Ear.  A  Clinical  Manual  tor  Stu¬ 
dents  and  Practitioners.  By  P.  McBride,  m.  d.,  f.  r.  c.  p.  Edin.,  Surgeon  to  the 
Ear  and  Throat  Department  of  the  Royal  Infirmary;  Lecturer  on  Diseases  of 
Throat  and  Ear,  Edinburgh  School  of  Medicine,  etc.  With  Colored  Illustrations 
from  Original  Drawings.  Octavo.  In  Press. 


16 


P.  B LA  K IS  TON,  SON  6-  CO.'S 


MAXWELL.  Terminologia  Medica  Polyglotta.  By  Dr.  Theodore  Maxwell, 
assisted  by  others  in  various  countries.  8vo.  Cloth,  $4.00 

The  object  of  this  work  is  to  assist  the  medical  men  of  any  nationality  in  reading  medical  literature  written 
in  a  language  not  their  own.  Each  term  is  usually  given  in  seven  languages,  viz. :  English,  French,  German, 
Italian,  Spanish,  Russian  and  Latin. 

MAYS’  Therapeutic  Forces ;  or,  The  Action  of  Medicine  in  the  Light  of  the  Doc¬ 
trine  of  Conservation  of  Force.  By  Thomas  J.  Mays,  m.d.  Cloth,  $1.25 

Theine  in  the  Treatment  of  Neuralgia.  Being  a  Contribution  to  the  Thera¬ 
peutics  of  Pain.  i6mo.  ]/z  bound,  .50 

MEDICAL  Directory  of  Philadelphia  and  Camden,  1889.  Containing  lists  of 
Physicians  of  all  Schools  of  Practice ,  Dentists,  Veterinarians,  Druggists  and 
Chemists,  with  information  concerning  Medical  Societies,  Colleges  and  Associa¬ 
tions,  Hospitals,  Asylums,  Charities,  etc.  Morocco,  Gilt  edges,  $2.50 

MEIGS.  Milk  Analysis  and  Infant  Feeding.  A  Practical  Treatise  on  the  Ex¬ 
amination  of  Human  and  Cows’  Milk,  Cream,  Condensed  Milk,  etc.,  and 
Directions  as  to  the  Diet  of  Young  Infants.  By  Arthur  V.  Meigs,  m.d.,  Physi¬ 
cian  to  the  Pennsylvania  Hospital,  Philadelphia.  i2mo.  Cloth,  $1.00 

MEIGS  and  PEPPER,  on  Children.  A  Practical  Treatise  on  the  Diseases  of 
Children.  By  J.  Forsyth  Meigs,  m.d.,  Fellow  of  the  College  of  Physicians  of 
Philadelphia,  etc.,  etc.,  and  William  Pepper,  m.d.,  Professor  of  the  Principles 
and  Practice  of  Medicine  in  the  Medical  Department,  University  of  Pennsyl¬ 
vania.  Seventh  Edition.  Cloth,  $5.00;  Leather,  $6.00 

MERRELL’S  Digest  of  Materia  Medica.  Forming  a  Complete  Pharmacopoeia  for 
the  use  of  Physicians,  Pharmacists  and  Students.  By  Albert  Merrell,  m.d. 
Octavo.  Half  dark  Calf,  $4.00 

MEYER.  Ophthalmology.  A  Manual  of  Diseases  of  the  Eye.  By  Dr.  Edouard 
Meyer,  Prof,  a  L’Ecole  de  la  Faculte  de  Medicine  de  Paris,  Chev.  of  the  Legion 
of  Honor,  etc.  Translated  from  the  Third  French  Edition,  with  the  assistance 
of  the  author,  by  A.  Freedland  Fergus,  m.b.,  Assistant  Surgeon  Glasgow 
Eye  Infirmary.  With  270  Illustrations,  and  two  Colored  Plates  prepared 
under  the  direction  of  Dr.  Richard  Liebreich,  m.r.c-S.,  Author  of  the  “  Atlas 
of  Ophthalmoscopy.”  8vo.  Cloth,  $4.50;  Leather,  $5.50 

MILLER  and  LIZAR’S  Alcohol  and  Tobacco.  Alcohol.  Its  Place  and  Power. 
By  James  Miller,  f.r.c.s.  ;  and,  Tobacco,  Its  Use  and  Abuse.  By  John  Lizars, 
m.d.  The  two  essays  in  one  volume.  Cloth,  $1.00 ;  Separate,  each  .50 

MILLS.  Fuel  and  Its  Applications.  By  E.  J.  Mills,  d.sc.,  f.r.s.,  and  E.  J. 

Rowan,  c.e.  (See  Groves  and  Thorp  Technology.)  8vo.  Clo.,  $7. 50;  Half  Mor.  $9.00 
MONEY.  On  Children.  Treatment  of  Disease  in  Children,  including  the  Outlines 
of  Diagnosis  and  the  Chief  Pathological  Differences  between  Children  and 
Adults.  By  Angel  Money,  m.d.,  m.r.c.p.,  Asst.  Physician  to  the  Hospital  for 
Sick  Children,  Great  Ormond  St.,  and  to  the  Victoria  Park  Chest  Hospital,  Lon¬ 
don.  Practical  Series.  See  Page  ig.  i2mo.  560  pages.  Cloth,  $3.00 

MORRIS.  Compend  of  Gynaecology.  By  Henry  Morris,  m.d.,  Demonstrator  of 
Obstetrics,  Jefferson  Medical  College,  Phila.,  etc.  With  Forty-five  illustrations. 
Being  ?  Quiz- Compend ?  No.  y.  Cloth,  $1.00;  Interleaved  for  Notes,  $1.25 

MOULLIN.  Surgery.  A  Complete  Text-book.  By  C.  W.  Mansell  Moullin, 
m.a.,  m.d.  oxon.,  f.r.c.s.,  Surgeon  and  Lecturer  on  Physiology  to  the  London 
Hospital;  formerly  Radcliffe  Travelling  Fellow  and  Fellow  of  Pembroke  Col¬ 
lege,  Oxford.  With  colored  Frontispiece.  497  Illustrations,  200  of  which  are 
original,  and  many  of  which  are  printed  in  Colors.  By  Subscription  only.  Royal 
Octavo.  1 190  pages.  Handsomely  Bound  in  Cloth,  Net,  $7.00 ;  Leather,  Net,  $8.00 

Half  Russia  Crushed,  Marbled  edges  and  linings,  Net,  9.00 
MTJRRELL.  Massotherapeutics.  Massage  as  a  Mode  of  Treatment.  By  Wm. 
Murrell,  m.d.,  f.r.c.p.,  Lecturer  on  Pharmacology  and  Therapeutics  at  West¬ 
minster  Hospital.  5th  Edition.  Revised.  i2mo.  Cloth,  $1.50 

Chronic  Bronchitis  and  its  Treatment.  (Authorized  Edition.)  A  Clinical 
Study.  i2mo.  176  pages.  Cloth,  $1.50 

MUSKETT.  Prescribing  and  Treatment  in  the  Diseases  of  Infants  and  Child¬ 
ren.  By  Philip  E.  Muskett,  Late  Surgeon  to  the  Sydney  Hospital,  Formerly 
Senior  Resident  Medical  Officer,  Sydney  Hospital.  321110.  Cloth,  $1.75 


MEDICAL  AND  SCIENTIFIC  PUBLICA  TIONS. 


17 


MORTON  on  Refraction  of  the  Eye.  Its  Diagnosis  and  the  Correction  of  its  Errors. 
With  Chapter  on  Keratoscopy,  and  Test  Types.  By  A.  Morton,  m.b.  Fourth 
Edition,  Revised  and  Enlarged.  Cloth,  $1.00 

MUTER.  Practical  and  Analytical  Chemistry.  By  John  Muter,  f.r.s.,  f.c.s., 
etc.  Fourth  Edition.  Revised,  to  meet  the  requirements  of  American  Medical 
Colleges,  by  Claude  C.  Hamilton,  m.d.,  Professor  of  Analytical  Chemistry 
in  University  Med.  Col.,  and  Kansas  City  Col.  of  Pharmacy.  51  Illus.  Cloth,  $2.00 

NAPHEYS’  Modern  Therapeutics.  New  Revised  Edition,  Enlarged  and  Im¬ 
proved.  In  Two  Handsome  Volumes.  Edited  by  Allen  J.  Smith,  m.d.,  Asst. 
Demonstrator  of  Morbid  Anatomy  and  Pathological  Histology,  Lecturer  on 
Urinology,  University  of  Pennsylvania;  Physician  in  the  Dispensary  for  Diseases 
of  Children,  University  Hospital,  etc. ;  and  J.  Aubrey  Davis,  m.d.,  Assistant 
Demonstrator  of  Obstetrics,  University  of  Pennsylvania.  Nearly  Ready. 

Vol.  I. — Medical  Therapeutics.  Therapeutics  of  Diseases  of  Children. 
Vol.  II. — Surgical  Therapeutics.  Therapeutics  of  Gynsecology  and 
Obstetrics. 

NEW  SYDENHAM  SOCIETY  Publications.  Three  to  Six  Volumes  published 
each  year.  List  of  Volumes  upo?i  application.  Per  annum,  $8.00 

OBERSTEINEK,  The  Anatomy  of  the  Central  Nervous  Organs.  A  Guide  to  the 
study  of  their  structure  in  Health  and  Disease,  By  Professor  H.  Obersteiner, 
of  the  University  of  Vienna.  Translated,  with  annotations  and  additions,  by 
Alex.  Hill,  m.a.,  m.d.,  Master  of  Downing  College,  Cambridge.  198  Illustrations. 
Sq.  Octavo.  Cloth,  $6.00 

OPHTHALMIC  REVIEW.  A  Monthly  Record  of  Ophthalmic  Science.  Published 
in  London.  Sample  Numbers ,  25  cents.  Per  annum,  $3.00 

OSGOOD.  The  Winter  and  Its  Dangers.  By  Hamilton  Osgood,  m.d.  Cloth,  .50 

OSLER.  Cerebral  Palsies  of  Children.  A  Clinical  Study  from  the  Infirmary  for 
Nervous  Diseases,  Philadelphia.  By  William  Osler,  m.d.,  f.r.c.p.,  London, 
etc.  8vo.  Cloth,  $2.00 

OSTROM.  Massage  and  the  Original  Swedish  Movements.  Their  Application 
to  Various  Diseases  of  the  Body.  A  Manual  for  Students,  Nurses  and  Physicians. 
By  Kurre  W.  Ostrom,  from  the  Royal  University  of  Upsala,  Sweden;  Instructor 
in  Massage  and  Swedish  Movements  in  the  Hospital  of  the  University  of 
Pennsylvania,  and  in  the  Philadelphia  Polyclinic  and  College  for  Graduates  in 
Medicine,  etc.  Second  Edition.  Enlarged.  Illustrated  by  87  Wood  Engrav¬ 
ings,  many  of  which  were  drawn  especially  for  this  purpose.  i2mo.  Cloth,  $1  00 

OVERMAN’S  Practical  Mineralogy,  Assaying  and  Mining,  with  a  Description  of 
the  Useful  Minerals,  etc.  By  Frederick  Overman,  Mining  Engineer.  Elev¬ 
enth  Edition.  i2mo.  Cloth,  $1.00 

PACKARD’S  Sea  Air  and  Sea  Bathing.  By  John  H.  Packard,  one  of  the  Phy¬ 
sicians  to  the  Pennsylvania  Hospital,  Philadelphia.  Cloth,  .50 

PAGE.  Railroad  Inj  uries.  With  Special  Reference  to  those  of  the  Back  and 
Nervous  System.  By  Herbert  Page,  m.a.,  m.c.,  cantab.,  f.r.c.s.,  Eng.  Sur¬ 
geon  to  St.  Mary’s  Hospital,  and  Lecturer  on  Surgery  at  its  Medical  School. 
Square  Octavo.  Cloth,  $2.25 

Injuries  of  the  Spine  and  Spinal  Cord,  without  apparent  Lesion  and  Nervous 
Shock.  In  their  Surgical  and  Medico-Legal  Aspects.  Third  Edition, 
Revised.  Octavo.  Preparing. 

PARKES’  Practical  Hygiene.  By  Edward  A.  Parkes,  m.d.  The  Eighth  Re¬ 
vised  and  Enlarged  Edition.  Edited  by  J.  Lane  Notter,  m.a.,  m.d.,  f.c.s., 
Professor  of  Hygiene,  Army  Medical  School,  Netley,  England.  With  10  Litho¬ 
graphic  Plates,  and  over  100  other  Illustrations.  8vo.  Cloth,  $5.00 

PARKES.  Hygiene  and  Public  Health.  A  Practical  Manual.  By  Louis  C. 
Parkes,  m.d.,  d.p.h.  London  Hospital;  Assistant  Professor  of  Hygiene  and 
Public  Health,  at  University  College,  etc.  i2tno.  Second  Edition.  Cloth,  $2.50 

PARRISH’S  Alcoholic  Inebriety.  From  a  Medical  Standpoint,  with  Illustrative 
Cases  from  the  Clinical  Records  of  the  Author.  By  Joseph  Parrish,  m.d., 
President  of  the  Amer.  Assoc,  for  Cure  of  Inebriates.  Paper,  .75  ;  Cloth,  $1.25 


18 


P.  BLAKISTON,  SON  <5-  CO.'S  PUBLICATIONS. 


PARVIN’S  Winckel’s  Diseases  of  Women.  (See  Winckel,  page  25.) 

PARVIN.  Lectures  on  Obstetric  Nursing,  Delivered  at  the  Training  School  for 
Nurses  of  the  Philadelphia  Hospital.  By  Theophilus  Parvin,  m.d.,  Professor 
of  Obstetrics  and  Diseases  of  Women  and  Children,  at  Jefferson  Medical  College ; 
Obstetrician  to  Philadelphia  Hospital.  i2mo.  Cloth,  .75 

PENNSYLVANIA  Hospital  Reports.  Edited  by  a  Committee  of  the  Hospital 
Staff:  J.  M.  DaCosta,  m.d.,  and  William  Hunt.  Containing  Original  Articles 
by  the  Staff.  With  many  other  Illustrations.  Paper,  .75  ;  Cloth,  $1.25 


PHYSICIAN’S  VISITING  LIST.  Published  Annually.  Forty-First  Year  of  its 
Publication. 


For  25  Patients  weekly. 


50 

a 

i  i 

75 

i  i 

ii 

100 

a 

a 

50 

a 

“  2  vols. 

100 

a 

“  2  vols. 

REGULAR  EDITION. 

Tucks,  pocket  and  pencil,  Gilt  Edges, 


a  a 

a  a 

a  a 

Jan.  to  June  ) 
July  to  Dec.  J 
Jan.  to  June  ) 
July  to  Dec.  j 


ii 

ii 

a 

ii 

ii 

a 

ii 

it 

a 

it 

a 

a 

ii 

a 

a 

$ 1. 00 
1.25 

1.50 
2.00 

2.50 
3.00 


INTERLEAVED  EDITION. 

For  25  Patients  weekly,  interleaved,  tucks,  pocket,  etc., 

50 


50 


2  vols  IJan-t0  June) 
{  July  to  Dec.  J 


a 

ii 


1.25 

1.50 

3-°° 


Perpetual  Edition,  without  Dates  and  with  Special  Memorandum  Pages. 
For  25  Patients,  interleaved,  tucks,  pocket  and  pencil,  ....  $1.25 

50  “  “  “  ....  1.50 


Monthly  Edition,  without  Dates.  Can  be  commenced  at  any  time  and  used 
until  full.  Requires  only  one  writing  of  patient’s  name  for  the  whole  month. 

Plain  binding,  without  flap  or  Pencil,  .75 
Leather  cover,  Pocket  and  Pencil,  $1.00 


EXTRA  Pencils  will  be  sent,  postpaid,  for  25  cents  per  half  dozen. 


This  List  combines  the  several  essential  qualities  of  strength,  compactness, 
durability  and  convenience.  It  is  made  in  all  sizes  and  styles  to  meet  the  wants  of  all 
physicians.  It  is  not  an  elaborate,  complicated  system  of  keeping  accounts,  but  a 
plain,  simple  record,  that  may  be  kept  with  the  least  expenditure  of  time  and  trouble — 
hence  its  popularity.  A  special  circular,  descriptive  of  contents  and  improvements, 
will  be  sent  upon  application. 

PEREIRA’S  Prescription  Book.  Containing  Lists  of  Terms,  Phrases,  Contrac¬ 
tions  and  Abbreviations  used  in  Prescriptions,  Explanatory  Notes,  Grammatical 
Construction  of  Prescriptions,  Rules  for  the  Pronunciation  of  Pharmaceutical 
Terms.  By  Jonathan  Pereira,  m.d.  Sixteenth  Edition.  Cloth,  $1. 00;  Tucks  $1.25 

PIGGOTT  Copper  Mining  and  Copper  Ore.  i2mo.  Cloth,  $1.00 

PORTER’S  Surgeon’s  Pocket-Book.  By  Surgeon-Major  J.  H.  Porter,  late  Pro¬ 
fessor  of  Military  Surgery  in  the  Army  Medical  School,  Netley,  England.  Revised, 
and  partly  Rewritten.  Third  Edition.  Small  i2mo.  Leather  Covers,  $2.25 

POWER,  HOLMES,  ANSTIE  and  BARNES  (Drs.).  Reports  on  the  Progress  of 
Medicine,  Surgery,  Physiology,  Midwifery,  Diseases  of  Women  and  Children, 
Materia  Medica,  Medical  Jurisprudence,  Ophthalmology,  etc.  Reported  for  the 
New  Sydenham  Society.  8vo.  Paper,  .75  ;  Cloth,  $1.25 

POTTER.  A  Handbook  of  Materia  Medica,  Pharmacy  and  Therapeutics,  in¬ 
cluding  the  Action  of  Medicines,  Special  Therapeutics,  Pharmacology,  etc.  In¬ 
cluding  over  600  Prescriptions  and  Formulae.  By  Samuel  O.  L.  Potter,  m.a., 
m.d.,  m.r.c.p.  (Lond.),  Professor  of  the  Practice  of  Medicine,  Cooper  Medical  Col¬ 
lege,  San  Francisco ;  late  A.  A.  Surgeon  U.  S.  Army.  Third  Edition,  Revised  and 
Enlarged.  8vo.  With  Thumb  Index  in  each  copy .  Cloth,  $4.00;  Leather,  $5.00 


THE  PRACTICAL  .series. 

THREE  NEW  VOLUMES. 


PARKES.  Hygiene  and  Public  Health.  A  Practical  Manual.  By  Louis  C. 
Parkes,  m.d.,  d.p.h.,  London  Hospital;  Fellow  of  the  Sanitary  Institute; 
Assistant  Professor  of  Hygiene  and  Public  Health,  at  University  College,  etc. 
i2mo.  Second  Edition.  Cloth,  $2.50 

LEWERS.  On  the  Diseases  of  Women.  A  Practical  Treatise.  By  Dr.  A.  H. 
N.  Lewers,  Assistant  Obstetric  Physician  to  the  London  Hospital;  and  Phy¬ 
sician  to  Out-patients,  Queen  Charlotte’s  Lying-in  Hospital;  Examiner  in  Mid¬ 
wifery  and  Diseases  of  Women  to  the  Society  of  Apothecaries  of  London.  With 
146  Engravings.  Second  Edition,  Revised.  Cloth,  $2.50 

BUXTON.  On  Anaesthetics.  A  Manual  of  their  Uses  and  Administration.  By 
Dudley  Wilmot  Buxton,  m.d.,  b.s.,  Ass’t  to  Prof,  of  Med.,  and  Administrator 
of  Anaesthetics,  University  College  Hospital,  London.  Illustrated. 

Seco?id  Edition  in  Press. 


MONEY.  On  Children.  Treatment  of 
Disease  in  Children,  including  the  Out¬ 
lines  of  Diagnosis  and  the  Chief 
Pathological  Differences  between  Chil¬ 
dren  and  Adults.  By  Angel  Money, 
m.d.,  m.r.c.p.,  Ass’t  Physician  to  the 
Hospital  for  Sick  Children,  Great 
Ormond  St.,  and  to  the  Victoria  Park 
Chest  Hospital,  London.  i2mo.  560 
pages.  Cloth,  $3.00 

PRITCHARD.  On  the  Ear.  Handbook 
of  Diseases  of  the  Ear.  By  Urban 
Pritchard,  m.d.,  f.r.c.s.,  Professor 
of  Aural  Surgery,  King’s  College, 
London,  Aural  Surgeon  to  King’s 
College  Hospital,  Senior  Surgeon  to 
the  Royal  Ear  Hospital,  etc.  i2mo. 
2d  Edition.  Illustrated.  Cloth,  $1.50 

BARRETT.  Dental  Surgery  for  Gen¬ 
eral  Practitioners  and  Students  of 
Medicine  and  Dentistry.  Extraction 
of  Teeth,  etc.  By  A.  W.  Barrett, 
m.d.  2d  Edition,  Revised  and  En¬ 
larged.  80  Illustrations.  Cloth,  $1.25 


COLLIE  On  Fevers.  A  Practical  Treat¬ 
ise  on  Fevers,  Their  History,  Etiology. 
Diagnosis,  Prognosis  and  Treatment. 
By  Alexander  Collie,  m.d.,  m.r.¬ 
c.p.,  Lond.  Medical  Officer  of  the  Ho- 
merton,  and  of  the  London  Fever  Hos¬ 
pitals.  Colored  Plates.  Cloth,  $2.50 

RALFE.  Diseases  of  the  Kidney  and 

Urinary  Derangements.  By  C.  H. 
Ralfe,  m.d.,  f.r.C.p.,  Ass’t  Physician 
to  the  London  Hospital.  Illustrated. 
i2mo.  Clotn,  $2.73 

REEVES.  Bodily  Deformities  and 

their  Treatment.  A  Handbook  of 
Practical  Orthopaedics.  By  H.  A. 
Reeves,  m.d.,  Senior  Ass’t  Surgeon  to 
the  London  Hospital,  Surgeon  to  the 
Royal  Orthopaedic  Hospital.  228  Illus. 

Cloth,  $2.25 

HIGGENS.  Ophthalmic  Practice.  A 

Manual  for  Students  and  Practitioners. 
By  Charles  Higgins,  f.r.c.p.,  Opthal- 
mic  Surgeon  to  Guy’s  Hospital.  Illus¬ 
trated.  274  pages.  Cloth,  $1.75 


*4*  The  volumes  of  this  series,  written  by  well-known  physicians  and  surgeons  of  large 
private  and  hospital  experience,  embrace  the  various  branches  of  medicine  and  surgery.  They 
are  of  a  thoroughly  practical  character,  calculated  to  meet  the  requirements  of  the  practitioner, 
and  present  the  most  recent  methods  and  information  in  a  compact  shape  and  at  a  low  price. 


Bound  Uniformly,  in  a  Handsome  and  Distinctive  Cloth  Binding,  and 
mailed  to  any  address,  on  receipt  of  the  price. 


20 


P.  BLA KIS T ON,  SON  &•  CO.'S 


POTTER.  Compend  of  Anatomy,  including  Visceral  Anatomy.  Based  upon 
Gray.  Fifth  Edition.  Revised,  and  greatly  Enlarged.  With  16  Lithographed 
Plates  and  117  other  Illustrations.  Being  No.  1  ?  Quiz- Compend  ?  Series. 

Cloth,  $1.00;  Interleaved  for  taking  Notes,  $1.25 

Compend  of  Materia  Medica,  Therapeutics  and  Prescription  Writing, 

arranged  in  accordance  with  the  last  Revision  U.  S.  Pharmacopoeia,  with 
special  reference  to  the  Physiological  Action  of  Drugs.  Fifth  Revised  and 
Improved  Edition,  with  Index.  Being  No.  6  ?  Quiz-  Compend ?  Series. 

Cloth,  $ 1. 00 .  Interleaved  for  taking  Notes,  $1.25 

Speech  and  Its  Defects.  Considered  Physiologically,  Pathologically  and 
Remedially ;  being  the  Lea  Prize  Thesis  of  Jefferson  Medical  College,  1882. 
Revised  and  Corrected.  i2mo.  Cloth,  $1.00 

PRITCHARD  on  the  Ear.  Handbook  of  Diseases  of  the  Ear.  By  Urban 
Pritchard,  m.d.,  f.r.c.s., Professor  of  Aural  Surgery,  King’s  College,  London, 
Aural  Surgeon  to  King’s  College  Hospital,  Senior  Surgeon  to  the  Royal  Ear 
Hospital,  etc.  Second  Edition.  Many  Illustrations  and  Formulae.  i2mo.  Prac¬ 
tical  Series.  See  Page  iq.  Cloth,  $1.50 

PROCTER’S  Practical  Pharmacy.  Lectures  on  Practical  Pharmacy.  With  43 
Engravings  and  32  Lithographic  Fac-simile  Prescriptions.  By  Barnard  S. 
Procter.  Second  Edition.  Cloth,  $4.50 

RALFE.  Diseases  of  the  Kidney  and  Urinary  Derangements.  Bv  C.  H.  Ralfe 
Illustrated.  i2mo.  Practical  Series.  See  Page  iq.  Cloth,  $2.75 

RAMSAY.  A  System  of  Inorganic  Chemistry.  By  William  Ramsay,  ph.d., 
f.r.s.,  Professor  of  Chemistry  in  University  College,  London.  Illustrated.  8vo. 

Cloth,  $4.50 

REESE’S  Medical  Jurisprudence  and  Toxicology.  A  Text-book  for  Medical  and 
Legal  Practitioners  and  Students.  By  John  J.  Reese,  m.d.,  Editor  of  Taylor’s 
Jurisprudence,  Professor  of  the  Principles  and  Practice  of  Medical  Jurisprudence, 
including  Toxicology,  in  the  University  of  Pennsylvania  Medical  Department. 
Third  Edition.  Enlarged.  Crown  Octavo.  666  pages.  Cloth,  $3.00 ;  Leather,  $3.50 

REEVES.  Bodily  Deformities  and  their  Treatment.  A  Handbook  of  Practical 
Orthopaedics.  By  H.  A.  Reeves,  m.d.  Pi'actical  Series.  See  Page  iq.  Cl.,  $2.25 

RICHARDSON.  Long  life,  and  How  to  Reach  It.  By  J.  G.  Richardson,  Prof, 
of  Hygiene,  University  of  Penna.  Cloth,  .150 

RICHARDSON’S  Mechanical  Dentistry.  A  Practical  Treatise  on  Mechanical 
Dentistry.  By  Joseph  Richardson,  d.d.s.  Fifth  Edition.  Thoroughly  Revised. 
With  569  Illustrations.  8vo.  Cloth,  $4.50  ;  Leather,  $5.50 

RIGBY’S  Obstetric  Memoranda.  4th  Ed.  By  Meadows.  32010.  Cloth,  .50 

RICHTER’S  Inorganic  Chemistry.  A  Text-book  for  Students.  By  Prof.  Victor 
von  Richter,  University  of  Breslau.  Third  American,  from  Fifth  German 
Edition.  Authorized  Translation  by  Edgar  F.  Smith,  m.a.,  ph.d.,  Prof,  of 
Chemistry,  University  of  Pennsylvania,  Member  of  the  Chemical  Societies  of 
Berlin  and  Paris.  89  Illustrations  and  a  Colored  Plate.  i2mo.  Cloth,  $2.00 

Organic  Chemistry.  The  Chemistry  of  the  Carbon  Compounds.  Second 
American  Edition,  translated  from  the  Sixth  German  by  Edgar  F.  Smith, 
m.  a.,  ph.  D.,  Professor  of  Chemistry,  University  of  Pennsylvania.  Illustrated. 
1040  pages.  i2mo.  Cloth,  $4.50 

ROBERTS.  Practice  of  Medicine.  The  Theory  and  Practice  of  Medicine.  By 
Frederick  Roberts,  m.d.,  Professor  of  Therapeutics  at  University  College, 
London.  Eighth  Edition,  with  Illustrations.  8vo.  Cloth,  $5.50;  Leather,  $6.50 

ROBINSON.  Latin  Grammar  of  Pharmacy  and  Medicine.  By  D.  H.  Robinson, 
ph.d.,  Professor  of  Latin  Language  and  Literature,  University  of  Kansas,  Law¬ 
rence.  With  an  Introduction  by  L.  E.  Sayre,  ph.g.,  Professor  of  Pharmacy  in, 
and  Dean  of  the  Dept,  of  Pharmacy,  University  of  Kansas.  i2mo.  Cloth,  $ 2.00 


MEDICAL  AND  SCIENTIFIC  PUBLICA  TIONS. 


21 


SANDERSON’S  Physiological  Laboratory.  A  Handbook  of  the  Physiological 
Laboratory.  Being  Practical  Exercises  for  Students  in  Physiology  and  Histology. 
By  J.  Burdon  Sanderson,  m.d.,  E.  Klein,  m.d.,  Michael  Foster,  m.d.,f.r.s., 
and  T.  Lauder  Brunton,  m.d.  With  over  350  Illustrations  and  Appropriate 
Letter-press  Explanations  and  References.  One  Volume.  Cloth,  $5.00 

SANSOM.  On  Chloroform.  Its  Action  and  Administration.  By  Arthur  Ernest 
Sansom,  m.d.  Illustrated.  i2mo.  Paper,  .75;  Cloth,  $1.25 

/ 

SCHNEE.  Diabetes,  its  Cause  and  Permanent  Cure.  From  the  standpoint  of  ex¬ 
perience  and  Scientific  Investigation.  By  Emil  Schnee,  Consulting  Physician 
at  Carlsbad.  Translated  from  the  German  by  R.  L.  Tafel,  a.m.,  ph.d.  Re¬ 
vised  and  Enlarged  by  the  author.  Octavo.  Cloth,  $2.00 

SELF-EXAMINATION,  being  3000  Questions  on  Medical  Subjects,  Anatomy, 
Physiology,  Materia  Medica,  Therapeutics,  Chemistry,  Surgery,  Practice,  Ob¬ 
stetrics,  Gynaecology,  Diseases  of  Children,  etc.  641T10.  Cloth,  Net,  10  cents. 

SEWELL.  Dental  Surgery,  including  Special  Anatomy  and  Surgery.  By  Henry 
Sewell,  m.r.c.s.,  l.d.s.,  President  Odontological  Society  of  Great  Britain.  3d 
Edition,  greatly  enlarged,  with  about  200  Illustrations.  Cloth,  $3.00 

SMITH’S  Wasting  Diseases  of  Infants  and  Children.  By  Eustace  Smith,  m.d., 
f.r.c.p.,  Physician  to  the  East  London  Children’s  Hospital.  Fifth  London 
Edition,  Enlarged.  8vo.  Cloth,  $3.00 

SMITH.  Abdominal  Surgery.  Being  a  Systematic  Description  of  all  the  Princi¬ 
pal  Operations.  By  J.  Greig  Smith,  m.a.,  f.r.s.e.,  Surg.  to  British  Royal  In¬ 
firmary;  Lecturer  on  Surgery,  Bristol  Medical  School ;  Late  Examiner  in  Surgery, 
University  of  Aberdeen,  etc.  Over  80  Illustrations.  Fourth  Edition.  In  Press. 

SMITH.  Electro-Chemical  Analysis.  By  Edgar  F.  Smith,  Professor  of  Chem¬ 
istry,  University  of  Penna.  26  Illustrations.  i2mo.  Cloth,  $1.00 

SMITH  AND  KELLER.  Experiments.  Arranged  for  Students  in  General  Chem¬ 
istry.  By  Edgar  F.  Smith,  Professor  of  Chemistry,  University  of  Penn’a  and 
Dr.  H.  F.  Keller,  Professor  of  Chemistry,  Michigan  School  of  Mines,  Houghton, 
Michigan.  Second  Edition.  i2mo.  Illustrated.  Cloth,  net ,  .60 

STAMMER.  Chemical  Problems,  with  Explanations  and  Answers.  By  Karl 
Stammer.  Translated  from  the  2d  German  Edition,  by  Prof.  W.  S.  Hoskinson, 
a.m.,  Wittenberg  College,  Springfield,  Ohio.  i2mo.  Cloth.  .75 

STARR.  The  Digestive  Organs  in  Childhood.  Second  Edition.  The  Diseases 
of  the  Digestive  Organs  in  Infancy  and  Childhood.  With  Chapters  on  the 
Investigation  of  Disease  and  the  Management  of  Children.  By  Louis  Starr, 
m.d.,  late  Clinical  Prof,  of  Diseases  of  Children  in  the  Hospital  of  the  University 
of  Penn’a;  Physician  to  the  Children’s  Hospital,  Phila.  Second  Edition. 
Revised  and  Enlarged.  Illustrated  by  two  Colored  Lithograph  Plates  and 
numerous  wood  engravings.  Crown  Octavo.  Cloth,  $2.25 

The  Hygiene  of  the  Nursery,  including  the  General  Regimen  and  Feed¬ 
ing  of  Infants  and  Children,  and  the  Domestic  Management  of  the  Ordinary 
Emergencies  of  Early  Life,  Massage,  etc.  Third  Edition.  Enlarged.  25 
Illustrations.  i2mo.  280  pages.  Cloth,  $1. 00 

See  also  Goodhart  and  Starr.  Page  10. 

STEWART’S  Compend  of  Pharmacy.  Based  upon  “Remington’s  Text-Book  of 
Pharmacy.”  By  F.  E.  Stewart,  m.d.,  ph.g.,  Quiz  Master  in  Chem.  and  Theoreti¬ 
cal  Pharmacy,  Phila.  College  of  Pharmacy  ;  Demonstrator  and  Lect.  in  Pharma¬ 
cology,  Medico-Chirurgical  College,  and  in  Woman’s  Medical  College.  3d.  Ed. 
With  complete  tables  of  Metric  and  English  Systems  of  Weights  and  Measures 
and  an  elaborate  Index,  ?  Quiz- Compend ?  Series.  Cloth,  $1. 00 

Interleaved  for  the  addition  of  notes,  #1.25 


22 


P.  BLAK/STON,  SON  &•  CO.'S 


STIRLING.  Outlines  of  Practical  Physiology.  Including  Chemical  and  Experi¬ 
mental  Physiology,  with  Special  Reference  to  Practical  Medicine.  By  W.  Stir¬ 
ling,  m.d.,  Sc.d.,  Prof,  of  Phys.,  Owens  College,  Victoria  University,  Manchester. 
Examiner  n  Honors  School  of  Science,  Oxford,  England.  142  Illustrations. 
309  pages.  Cloth,  $2.25 

Outlines  of  Practical  Histology.  A  Manual  for  Students.  With  344  Illus¬ 
trations.  i2mo.  Cloth,  $4.00 

STOCKEN’S  Dental  Materia  Medica.  Dental  Materia  Medica  and  Therapeutics, 
with  Pharmacopoeia.  By  James  Stocken,  d.d.s.  Third  Edition.  Cloth,  $2.50 

STRAHAN.  Extra-Uterine  Pregnancy.  The  Diagnosis  and  Treatment  of  Extra- 
Uterine  Pregnancy.  Being  the  Jenks  Prize  Essay  of  the  College  of  Physicians 
of  Philadelphia.  By  John  Strahan,  m.d.  (Univ.  of  Ireland),  late  Res.  Surgeon 
Belfast  Union  Infirmary  and  Fever  Hospital.  Octavo.  Cloth,  $1.50 

SUTTON’S  Volumetric  Analysis.  A  Systematic  Handbook  for  the  Quantitative 
Estimation  of  Chemical  Substances  by  Measure,  Applied  to  Liquids,  Solids  and 
Gases.  By  Francis  Sutton,  f.c.s.  Sixth  Edition,  Revised  and  Enlarged, 
with  Illustrations.  8vo.  Cloth,  $5.00 

SUTTON.  Ligaments.  Their  Nature  and  Morphology.  By  John  Bland  Sutton, 
f.r.c.S.,  Lecturer  on  Pathology,  Royal  College  of  Surgeons ;  Assis.  Surg.  and 
Dem.  of  Anatomy,  Middlesex  Hospital,  London.  Illustrated.  i2mo.  Cloth,  $1.25 

SWAIN.  Surgical  Emergencies,  together  with  the  Emergencies  Attendant  on 
Parturition  and  the  Treatment  of  Poisoning.  A  Manual  for  the  Use  of  General 
Practitioners.  By  W.  F.  Swain,  f.r.c.S.  Fourth  Edition.  Illustrated.  $1.50 

SWANZY.  Diseases  of  the  Eye  and  their  Treatment.  A  Handbook  for  Physi¬ 
cians  and  Students.  By  Henry  R.  Swanzy,  a.m.,  m.b.,  f.r.c.s.i.,  Surgeon  to 
the  National  Eye  and  Ear  Infirmary  ;  Ophthalmic  Surgeon  to  the  Adelaide  Hos¬ 
pital,  Dublin;  Examiner  in  Ophthalmic  Surgery  in  the  Royal  University  of 
Ireland.  Third  Edition.  Thoroughly  Revised.  158  Illustrations.  508  pages. 
i2mo.  Cloth,  $3.00 

SYMONDS.  Manual  of  Chemistry,  for  the  special  use  of  Medical  Students.  By 
Brandreth  Symonds,  a.m.,  m.d.,  Asst.  Physician  Roosevelt  Hospital,  Out- 
Patient  Department ;  Attending  Physician  Northwestern  Dispensary,  New  York. 
i2mo.  Cloth,  $ 2.00 

TAFT’S  Operative  Dentistry.  A  Practical  Treatise  on  Operative  Dentistry.  By 
Jonathan  Taft,  d.d.s.  Fourth  Revised  and  Enlarged  Edition.  Over  100  Il¬ 
lustrations.  8vo.  Cloth,  $4.25  ;  Leather,  $5.00 

Index  of  Dental  Periodical  Literature  8vo.  Cloth,  $ 2.00 

TALBOT.  Irregularities  of  the  Teeth,  and  Their  Treatment.  By  Eugene  S. 
Talbot,  m.d.,  Professor  of  Dental  Surgery  Woman’s  Medical  College,  and 
Lecturer  on  Dental  Pathology  in  Rush  Medical  College,  Chicago.  Second  Edi¬ 
tion,  Revised  and  Enlarged  by  about  100  pages.  Octavo.  234  Illustrations. 
(169  of  which  are  original).  261  pages.  Cloth,  $3.00 

TANNER’S  Memoranda  of  Poisons  and  their  Antidotes  and  Tests.  By  Thos. 
Hawkes  Tanner,  m.d.,  f.r.c.p.  Sixth  American,  from  the  Last  London  Edition. 
Revised  by  Henry  Leffmann,  m.d.,  Professor  of  Chemistry  in  Pennsylvania 
College  of  Dental  Surgery  and  in  the  Philadelphia  Polyclinic.  121110.  Cloth,  .75 

TAYLOR.  Practice  of  Medicine.  A  Manual.  By  Frederick  Taylor,  m.d., 
Physician  to,  and  Lecturer  on  Medicine  at  Guy’s  Hospital,  London  ;  Physician  to 
Evelina  Hospital  for  Sick  Children,  and  Examiner  in  Materia  Medica  and  Phar¬ 
maceutical  Chemistry,  University  of  London.  Cloth,  $4.00 ;  Sheep,  $5.00 

TEMPERATURE  Charts  for  Recording  Temperature,  Respiration,  Pulse,  Day  of 
Disease,  Date,  Age,  Sex,  Occupation,  Name,  etc.  Put  up  in  pads;  each  .50 


MEDICAL  AND  SCIENTIFIC  PUBLICA  TIONS. 


23 


THOMPSON.  Lithotomy  and  Lithotrity.  Practical  Lithotomy  and  Lithotrity  ;  or 
an  Inquiry  into  the  best  Modes  of  Removing  Stone  from  the  Bladder.  By  Sir 
Henry  Thompson,  f.r.c.s.,  Emeritus  Professor  of  Clinical  Surgery  in  Univer¬ 
sity  College.  Third  Edition.  With  87  Engravings.  8vo.  Cloth,  $3.50 

Urinary  Organs.  Diseases  of  the  Urinary  Organs.  Containing  32  Lectures. 
Eighth  London  Ed.  Octavo.  470  pages.  Cloth,  $3.50 

On  the  Prostate.  Diseases  of  the  Prostate.  Their  Pathology  and  Treatment. 
Sixth  London  Edition.  8vo.  Illustrated.  Cloth,  $2.00 

Calculous  Diseases.  The  Preventive  Treatment  of  Calculous  Disease,  and 
the  Use  of  Solvent  Remedies.  Third  Edition.  i6mo.  Cloth,  $1.00 

Surgery  of  the  Urinary  Organs.  Some  Important  Points  connected  with  the 
Surgery  of  the  Urinary  Organs.  Illus.  Paper,  .75  ;  Cloth,  $1.25 

THORBURN.  Surgery  of  the  Spinal  Cord.  A  Contribution  to  the  study  of.  By 
William  Thorburn,  b.s.,  b.Sc.,  m.d.,  Lond.,  f.r.c.s.,  Eng.  With  Illustrations. 
Octavo.  Cloth,  $4.50 

THORNTON.  The  Surgery  of  the  Kidney.  By  John  Knowsley  Thornton, 
m.b.  Edin.  With  19  Illustrations.  Cloth,  $1.75 

TILT’S  Change  of  Life  in  Women,  in  Health  and  Disease.  A  Practical  Treatise 
on  the  Diseases  incidental  to  Women  at  the  Decline  of  Life.  By  Edward  John 
Tilt,  m.d.  Fourth  London  Edition.  8vo.  Cloth,  $1.25 

TOMES’  Dental  Anatomy.  A  Manual  of  Dental  Anatomy,  Human  and  Compara¬ 
tive.  By  C.  S.  Tomes,  d.d.s.  212  Illustrations.  3d  Ed.  i2mo.  Cloth,  $4.00 

Dental  Surgery.  A  System  of  Dental  Surgery.  By  John  Tomes,  f.r.s. 
Third  Edition,  Revised  and  Enlarged.  By  C.  S.  Tomes,  d.d.s.  With 
292  Illustrations.  i2mo.  772  pages.  Cloth,  $5.00 

TRANSACTIONS  of  the  College  of  Physicians  of  Philadelphia.  Third  Series. 
Vols.  I,  II,  III,  IV,  V,  Cloth,  each,  $2.50.  VI,  VII,  Cloth,  each,  $3.50. 

Vol.  VIII,  1886,  Cloth,  $3.75.  Vol.  IX,  Cloth,  $2.50. 

TRANSACTIONS  American  Surgical  Association.  Illustrated.  Royal  8vo. 
Price  of  Vol.  I,  II,  III,  IV,  V,  each,  Cloth,  $ 3.00 .  Vol.  VI,  Cloth,  $4.50.  Vol. 
VII,  VIII,  each,  Cloth,  $3.00. 

TRANSACTIONS  of  the  Association  of  American  Physicians.  Vols.  I  and  II, 
Cloth,  $2.50  each ;  Vol.  Ill,  Cloth,  #3.50.  Vol.  IV,  Cloth,  $3.00.  Vol.  V,  Cloth,  $2.50 

TREVES.  German-English  Medical  Dictionary.  By  Frederick  Treves,  f.r.c.s., 
assisted  by  Dr.  Hugo  Lang,  b.a.,  (Munich).  i2mo.  ]/z  Russian,  $3.75 

TRIMBLE.  Practical  and  Analytical  Chemistry.  Being  a  complete  course  in 
Chemical  Analysis.  By  Henry  Trimble,  ph.g.,  Professor  of  Analytical  Chem¬ 
istry  in  the  Philadelphia  College  of  Pharmacy.  Third  Edition.  Enlarged. 
Illustrated.  8vo.  Cloth,  $1.50 

TURNBULL’S  Artificial  Ansesthesia.  The  Advantages  and  Accidents  of  Artifi¬ 
cial  Anaesthesia;  Its  Employment  in  the  Treatment  of  Disease;  Modes  of  Ad¬ 
ministration  ;  Considering  their  Relative  Risks ;  Tests  of  Purity  ;  Treatment  of 
Asphyxia;  Spasms  of  the  Glottis;  Syncope,  etc.  By  Laurence  Turnbull,  m.d., 
ph.  g.,  Aural  Surgeon  to  Jefferson  College  Hospital,  etc.  Third  Edition,  Re¬ 
vised  and  Enlarged.  40  Illustrations.  i2mo.  Cloth,  $3.00 

TUSON.  Veterinary  Pharmacopoeia.  Including  the  Outlines  of  Materia  Medica 
and  Therapeutics.  For  the  Use  of  Students  and  Practitioners  of  Veterinary 
Medicine.  By  Richard  V.  Tuson,  f.c.s.  Third  Edition.  i2mo.  Cloth,  $2.50 


24 


P.  BLAKISTON,  SON  &*  CO.'S 


TYSON.  Bright’s  Disease  and  Diabetes.  With  Especial  Reference  to  Pathology 
and  Therapeutics.  By  James  Tyson,  m.d.,  Professor  of  Clinical  Medicine  in 
the  University  of  Pennsylvania.  Including  a  Section  on  Retinitis  in  Bright’s 
Disease.  By  Wm.  F.  Norris,  m.d.,  Clin.  Prof,  of  Ophthalmology,  in  Univ.  of 
Penna.  With  Colored  Plates  and  many  Wood  Engravings.  8vo.  Cloth,  $3.50 

Guide  to  the  Examination  of  Urine.  Seventh  Edition.  For  the  Use  of 

Physicians  and  Students.  With  Colored  Plates  and  Numerous  Illustrations 
Engraved  on  Wood.  Seventh  Edition.  Revised.  i2mo.  255  pages.  Cloth,  $1.50 

Cell  Doctrine.  Its  History  and  Present  State.  With  a  Copious  Bibliography 
of  the  subject.  Illustrated.  Second  Edition.  8vo.  Cloth,  $2.00 

Handbook  of  Physical  Diagnosis.  Illustrated.  i2mo.  Cloth,  $1.25 

VAN  HARLINGEN  on  Skin  Diseases.  A  Practical  Manual  of  Diagnosis  and 
Treatment.  By  Arthur  Van  Harlingen,  m.d.,  Professor  of  Diseases  of  the 
Skin  in  the  Philadelphia  Polyclinic ;  Clinical  Lecturer  on  Dermatology  at  Jef¬ 
ferson  Medical  College.  Second  Edition.  Revised  and  Enlarged.  With  Formulae. 
Eight  Colored  and  other  full  page  plates,  and  New  Illustrations.  Cloth,  $2.50 

VAN  NUYS  on  The  Urine.  Chemical  Analysis  of  Healthy  and  Diseased  Urine, 
Qualitative  and  Quantitative.  By  T.  C.  Van  Nuys,  Professor  of  Chemistry 
Indiana  University.  39  Illustrations.  Octavo.  Cloth,  $2.00 

VIRCHOW’S  Post-mortem  Examinations.  A  Description  and  Explanation  of  the 
Method  of  Performing  them  in  the  Dead  House  of  the  Berlin  Charite  Hospital, 
with  especial  reference  to  Medico-legal  Practice.  By  Prof.  Virchow.  Trans¬ 
lated  by  Dr.  T.  P.  Smith.  Third  Edition,  with  Additions.  Cloth,  $1.00 

Cellular  Pathology,  as  based  upon  Physiological  and  Pathological  Histology. 
20  Lectures  delivered  at  the  Pathological  Institute  of  Berlin.  Translated 
from  the  2d  Ed.  by  F.  Chance,  m.d.  134  Illus.  8th  Am.  Ed.  Cloth,  $4.00 

WALSH  AM.  Manual  of  Practical  Surgery.  For  Students  and  Physicians.  By 
Wm.  J.  Walsham,  m.d.,  f.r.c.s.,  Asst.  Surg.  to,  and  Dem.  of  Practical  Surg.  in, 
St.  Bartholomew’s  Hospital,  Surg.  to  Metropolitan  Free  Hospital,  London. 
Third  Edition,  Revised  and  Enlarged.  With  318  Engravings.  New  Series  of 
Manuals.  Cloth,  $3.00  ;  Leather,  $3.50 

WARING.  Practical  Therapeutics.  A  Manual  for  Physicians  and  Students.  By 
Edward  J.  Waring,  m.d.  Fourth  Edition.  Revised,  Rewritten  and  Rearranged 
by  Dudley  W.  Buxton,  m.d.,  Assistant  to  the  Professor  of  Medicine,  University 
College,  London.  Crown  Octavo.  Cloth,  $3.00;  Leather,  $3.50 

WARREN.  Compend  Dental  Pathology  and  Dental  Medicine.  Containing  all 
the  most  noteworthy  points  of  interest  to  the  Dental  student.  By  Geo.  W. 
Warren,  d.d.s.,  Clinical  Chief,  Penn’a  College  of  Dental  Surgery,  Phila.  Illus. 
Being  No.  13  ?  Quiz-  Compend  ?  Series.  i2mo.  Cloth,  $1.00 

Interleaved  for  the  addition  of  notes,  $1.25 

WATSON  on  Amputations  of  the  Extremities  and  Their  Complications.  By 
B.  A.  Watson,  a.m.,  m.d.,  Surgeon  to  the  Jersey  City  Charity  Hospital  and  to 
Christ’s  Hospital,  Jersey  City,  N.  J. ;  Member  of  the  American  Surgical  Associ¬ 
ation.  250  Wood  Engravings  and  two  Full-page  Colored  Plates.  Cloth,  $5.50 

Concussions.  An  Experimental  Study  of  Lesions  arising  from  Severe  Con¬ 
cussions.  8vo.  Paper  cover,  #1.00 

WATTS’  Inorganic  Chemistry.  A  Manual  of  Chemistry,  Physical  and  Inorganic. 
(Being  the  14th  Edition  of  Fowne’s  Physical  and  Inorganic  Chemistry.) 
Bv  Henry  Watts,  b.a.,  f.r.s.,  Editor  of  the  Journal  of  the  Chemical  Society ; 
Author  of  “A  Dictionary  of  Chemistry,”  etc.  With  Colored  Plate  of  Spectra 
and  other  Illustrations.  i2mo.  595  pages.  Cloth,  $2.25 

Organic  Chemistry.  Second  Edition.  By  Wm.  A.  Tilden,  d.sc.,  f.r.s. 
(Being  the  13th  Edition  of  Fowne’s  Organic  Chemistry.)  Illustrated. 

1 2mo.  Cloth,  $2.25 


MEDICAL  AND  SCIENTIFIC  PUBLIC  A  TIONS. 


25 


WHITE.  The  Mouth  and  Teeth.  By  J.  W.  White,  m.d.,  d.d.s.  Editor  of  the 
Dental  Cosmos.  Illustrated.  Cloth,  .50 

WILSON’S  Text-Book  of  Domestic  Hygiene  and  Sanitary  Information.  A  Guide 
to  Personal  and  Domestic  Hygiene.  By  George  Wilson,  m.d.,  Medical  Officer 
of  Health.  Edited  by  Jos.  G.  Richardson,  m.d.,  Professor  of  Hygiene  at  the 
University  of  Pennsylvania.  Cloth,  $1.00 

WILSON.  Handbook  of  Hygiene  and  Sanitary  Science.  With  Illustrations.  Seventh 
Edition,  Revised  and  Enlarged.  8vo.  In  Press. 

WILSON.  The  Summer  and  Its  Diseases.  By  James  C.  Wilson,  m.d.  Cloth,  .50 

WINCKEL.  Diseases  of  Women.  Second  Edition.  Including  the  Dis¬ 
eases  of  the  Bladder  and  Urethra.  By  Dr.  F.  Winckel,  Professor  of 
Gynaecology,  and  Director  of  the  Royal  University  Clinic  for  Women,  in  Munich. 
Translated  by  special  authority  of  Author  and  Publisher,  under  the  supervision 
of,  and  with  an  Introduction  by,  Theophilus  Parvin,  m.d.,  Professor  of 
Obstetrics  and  Diseases  of  Women  and  Children  in  Jefferson  Mediral  Col¬ 
lege,  Philadelphia.  With  150  Engravings  on  Wood,  most  of  which  are  original 
2d  Edition,  Revised  and  Enlarged.  Cloth,  $3.00;  Leather,  $3.50 

Text-Book  of  Obstetrics  ;  Including  the  Pathology  and  Therapeutics  of  the 
Puerperal  State.  Authorized  Translation  by  J.  Clifton  Edgar,  a.m.,  m.d., 
Adjunct  Professor  to  the  Chair  of  Obstetrics,  Medical  Department,  University, 
City  of  New  York.  With  nearly  200  Handsome  Illus.,  the  majority  of  which 
are  original  with  this  work.  Octavo.  Cloth,  $6.00;  Leather,  $7.00 

WOAKES.  Post-Nasal  Catarrh  and  Diseases  of  the  Nose,  causing  Deafness.  By 
Edward  Woakes,  m.d.,  Senior  Aural  Surgeon  to  the  London  Hospital  for 
Diseases  of  the  Throat  and  Chest.  26  Illustrations.  Cloth,  $1.50 

W OLFF.  Manual  of  Applied  Medical  Chemistry  for  Students  and  Practitioners  of 
Medicine.  By  Lawrence  Wolff,  m.d.,  Demonstrator  of  Chemistry  in  Jeffer¬ 
son  Medical  College,  Philadelphia.  Cloth,  $1.00 

WOOD.  Brain  Work  and  Overwork.  By  Prof.  H.  C.  Wood,  Clinical  Professor 
of  Nervous  Diseases,  University  of  Pennsylvania.  i2mo.  Cloth,  .50 

WOODY.  Essentials  of  Chemistry  and  Urinalysis.  By  Sam  E.  Woody,  a.m., 
m.d.,  Professor  of  Chemistry  and  Public  Hygiene,  and  Clinical  Lecturer  on 
Diseases  of  Children,  in  the  Kentucky  School  of  Medicine.  Third  Edition. 
Illustrated.  i2mo.  Cloth,  $1.25 

WYNTER  and  WETHERED.  Clinical  and  Practical  Pathology.  A  Manual 
of  Clinical  and  Practical  Pathology.  By  W.  Essex  Wynter,  m.d.,  Medical  Reg¬ 
istrar  and  late  Dem.  of  Anat.  and  Chem.  at  the  Middlesex  Hospital,  and 
Frank  J.  Wethered,  m.d.,  Asst.  Phys.  to  the  City  of  London  Hospital  for  Dis. 
of  the  Chest.  4  Colored  Plates  and  67  other  Illustrations.  8vo.  Cloth,  $4.00 

WYTHE.  Dose  and  Symptom  Book.  The  Physician’s  Pocket  Dose  and  Symptom 
Book.  Containing  the  Doses  and  Uses  of  all  the  Principal  Articles  of  the 
Materia  Medica,  and  Officinal  Preparations.  By  Joseph  H.  Wythe,  a.m.,  m.d. 
17th  Edition,  Revised  and  Rewritten. 

Cloth,  $1.00;  Leather,  with  Tucks  and  Pocket,  $1.25 

YEO’S  Manual  of  Physiology.  Fifth  Edition.  A  Text-book  for  Students  of 
Medicine.  By  Gerald  F.  Yeo.,  m.d.  f.r.c.s.,  Professor  of  Physiology  in  King’s 
College,  London.  Fifth  Edition ;  revised  and  enlarged  by  the  author.  With 
321  Wood  Engravings  and  a  Glossary.  Crown  Octavo.  Being  No.  4 ,  Nesv 
Series  of  Manuais.  Cloth,  $3.00;  Leather,  $3.50. 


New  Series  of  Manuals. 

FOR  MEDICAL  STUDENTS  AND  PHYSICIANS. 

Demi-Octavo.  Price  of  each,  book,  Cloth,  $3.00  5  Leather,  $3,50. 


The  object  held  in  view  in  the  preparation  of  this  Series  was  to  make  books  that  should  be  concise  and 
practical  not  burdened  by  useless  theories  ai'd  discussions,  but  containing  all  that  is  needed  or  necessary  for 
the  student  and  practitioner.  No  pains  have  been  spared  to  bring  them  up  to  the  times,  and  the  very  low 
price  at  which  they  have  been  published  is  an  additional  point  in  their  favor.  Full  circular,  descriptive  of 
the  Series,  will  be  sent  upon  application. 

WALSH  AM’S  PRACTICAL  SURGERY.  A  Manual  for  Students  and  Physicians.  Third  Edition 
By  Wm.  T.  WALSHAM,  M.D.,  Asst.  Surgeon  to,  and  Demonstrator  of  Surgery  in  St.  Bartholomews 
Hospital:  Surgeon  to  Metropolitan  Free  Hospital,  London,  etc.  318  Illustrations.  748  pages. 

^  Cloth,  $3.00;  Leather,  $3.50 


Fr°™  WhU^vfdendy  intended  to  be  a  text-book  for  students,  and  therefore  small  in  size  and  compactly  written,  is  neverthe¬ 
less  full  enough  for  the  use  of  those  practitioners  who  desire  a  short  account  of  the  various  surgical  principles  and  operations 
involved  in  the  Treatment  of  the  ordinary  run  of  surgical  cases.  The  author  seems  to  be  a  conservative  and  judicious  surgeon 

PARvTn^S-WIN CKEL’S  DISEASES  OF  WOMEN.  Second  Edition.  A  Treatise  on  the  Dis¬ 
eases  of  Women.  Including  the  Diseases  of  the  Bladder  and  Urethra.  _  By  Dr.  F.  WiNCKEL,  Professor 
of  Gynaecology  and  Director  of  the  Royal  University  Clinic  for  Women,  in  Munich.  Revised  and  Edited 
by  Theophilus  Parvin,  m.d.,  Professor  of  Obstetrics  and  Diseases  of  Women  and  Children  in  Jeffer¬ 
son  Medical  College.  Illustrated  by  150  fine  Engravings  on  Wood,  most  of  which  are  new  760  pp. 

Cloth,  $3  00;  Leather,  $3.50 

GALABIN’S  MIDWIFERY.  A  Manual  of  Widwifery.  By  Alfred  Lewis  Galabin,  m.a.,  m.d., 
Obstetric  Physician  and  Lecturer  on  Midwifery  and  the  Diseases  of  Women  at  Guy’s  Hospital,  London; 
Examiner  in  Midwifery  to  the  Conjoint  Examining  Board  of  England.  227  Illustrations.  753  pages. 

Cloth,  $3.00;  Leather,  $3.50 

°”‘  l^ihus/mfont^are  mostly’NEW  and  well  executed,  and  we  heartily  commend  this  book  as  far  superior  to  any  manual 
upon  this  subject.” 

YEO’S  MANUAL  OF  PHYSIOLOGY.  Fifth  Edition.  A  New  Text-book  for  Students.  By 
"  Gerald  F.  Yeo,  m.d.,  f.r.C.s.,  Professor  of  Physiology  in  King’s  College,  London.  321  Illustra¬ 
tions  and  a  Glossary.  758  pages.  Cloth,  $3.00 ;  Leather,  $3.50 

Fr/»n  Prof  Lewis  A  Stimson,  M.D  ,  37  East  33d  Street ,  New  York. 

“  The  brief  examination  I  have  given  it  was  so  favorable  that  I  placed  it  in  the  list  of  text-books  recommended  in  the  cir¬ 
cular  of  the  University  Medical  College.” 

GOODHART  AND  STARR,  DISEASES  OF  CHILDREN.  Second  Edition  By  J.  F.Goodhart, 
MD  Physician  to  the  Evelina  Hospital  for  Children ;  Assistant  Physician  to  Guys  Hospital,  London. 
Second  American  from  third  English  Edition.  Revised  and  Edited  by  Louis  Starr,  m.d.,  Clinical 
Professor  of  Diseases  of  Children  in  the  Hospital  of  the  University  of  Pennsylvania,  and  Physician  to  the 
Children’s  Hospital,  Phila.  With  many  new  Prescriptions  and  Directions  for  making  Artificial  Human 
Milk,  for  the  Artificial  Digestion  of  Milk,  etc.  760  pages.  Cloth,  $3.00;  Leather,  #3.50 

Fr""  ”ftSidKoAomf  ‘ '“L^so  fAight  be  said  ol  some  books  that  they  are  •  born  to  greatness.’  This  new  volume  has 
we  believe  a  mission,  particularly  in  thebands  of  the  young  members  of  the  profession  In  these  days  ol  prol.xttj  in  medtca. 
literature  it  is  refreshing  to  meet  with  an  author  who  knows  both  what  to  say  and  when  he  has  said  T, 

WARING’ S  PRACTICAL  THERAPEUTICS.  Fourth  Edition.  A  Manual  of  Practical  Thera¬ 
peutics,  considered  with  reference  to  Articles  of  the  Materia  Mechca  Containing  aLo  an  Index  of 
Diseases  with  a  list  of  Medicines  applicable  as  Remedies,  and  a  fu,l  InJex  of  the  Medicines  and 
Preparations  noticed  in  the  work.  By  Edward  John  Waring,  m.d.,  f.r.c  p.,  f.l  s.,  etc.  4th 
Edidon.  Rewritten  and  Revised.  Edited  by  Dudley  W  Buxton  m.d  ,  Asst  to  the  Prof,  of  Medicine 
at  University  College  Hospital;  Member  of  the  Royal  College  of  Phystctans  of  Dtadon.  «*££»• 


f’""‘  As'l  wo!kol  retirenctitixcjh'in  account  of  tile  several  complete  in'Jette-t  added  to  this  ethtion  It  was  deservedly 
popular  in  former  editions,  and  will  be  more  so  in  the  one  before  us,  on  account  of  the  careful  arrangement  of  the  subjects. 

REESE’S  MEDICAL  JURISPRUDENCE  AND  TOXICOLOGY.  Third  Edition.  By  John 
J.  Reese,  m.d.,  Professor  of  Medical  Jurisprudence  and  Toxicology  in  the  University  of  1  ennsylvama ; 
late  President  of  the  Medical  Jurisprudence  Society  of  Philadelphia;  Physician  to  St.  Joseph  s  Hospital , 
Member  of  the  College  of  Physicians  of  Phila.;  Corresponding  Member  of  the  New  York  Medico- Legal 
Society,  etc.  Third  Edition.  Revised  and  Enlarged.  666  pages.  Cloth,  $3.00 ;  Leather,  #3.50 

From  The  American  Journal  of  Medical  Sciences. — “  1  his  admirable  text-book. 

Fr°™VJl<z\"y this  volume  as  idef after  a  careful  perusal  of  its  pages,  with  the  profound  impression  that  it  should  be  in  the  hands 

of  every  doctor  and  lawyer.  It  fully  meets  the  wants  of  all  students.  .  .  .  He  has  succeeded  in  admirably  condensing  into 

a  handy  volume  all  the  essential  points. 

THE  MOST  PRACTICAL  SERIES  OF  TEXT-BOOKS. 


PHYSIOLOGY. 


Landois.  A  Text-Book  of  Human  Physiology. 
Edition.  692  Illustrations. 


Third 

1889. 


SPECIMEN  OF  ILLUSTRATIONS, 


INCLUDING  HISTOLOGY  AND  MICROSCOPICAL  ANATOMY, 
with  special  reference  to  the  requirements  of  Practi¬ 
cal  Medicine.  By  Dr.  L.  Landois,  Professor  of 
Physiology  and  Director  of  the  Physiological  Insti¬ 
tute  in  the  University  of  Greifswald.  Third  Ameri¬ 
can,  translated  from  the  Sixth  German  Edition,  with 
additions,  by  Wm.  Stirling,  m.d.,  d.Sc.,  Bracken- 
bury  Professor  of  Physiology  and  Histology  in  Owens 
College,  Manchester;  Examiner  in  Physiology  in 
University  of  Oxford.  With  692  Illustrations.  En¬ 
larged,  Revised  and  Improved.  Royal  Octavo. 
One  Volume.  Cloth,  $6.50;  Leather,  $7.50 

The  practical  value  of  this  book  to  the  physician 
can  scarcely  be  over-estimated.  It  is  not  a  text-book  as 
the  term  is  generally  understood,  but  a  treatise  on  Phy¬ 
siology  in  its  relations  to  practical  medicine,  and  in¬ 
cludes  much  clinical  information. 

“  It  is  the  most  complete  and  satisfactory  text-book  on  physiology 
extant.  The  translator  and  publisher  have  each  done  something  to 
increase  the  value  of  the  volume.  Dr.  Stirling  has  added  numerous 
useful  annotations  and  a  large  number  of  new  plates.  .  .  .  We 

wish  that  every  medical  student  and  physician  could  be  drilled  on 
these  volumes.” — The  N  Y.  Medical  Record. 


Yeo’s  Manual  of  Physiology.  Fifth  Edition.  1891. 


A  TEXT-BOOK  FOR  STUDENTS  OF  MEDICINE.  By 

Gerald  F.  Yeo,  m.d.,  f.r.c.s.,  Professor  of 
Physiology  in  King’s  College,  London,  Fifth 
Edition.  With  New  Illustrations.  321  Wood 
Engravings  and  a  Glossary.  Crown  Octavo. 
Being  No.  4 ,  New  Series  of  Manuals. 

Cloth,  $3.00;  Leather,  $3.50 

This  volume  was  specially  prepared  to  furnish 
a  new  text-book  of  Physiology,  elementary  so  far  as 
to  avoid  theories  which  have  not  borne  the  test  of 
time  and  such  details  of  methods  as  are  unnecessary 
for  students.  While  endeavoring  to  save  the  student 
from  doubtful  and  erroneous  doctrines,  great  care  has 
been  taken  not  to  omit  any  important  facts  that  are 
necessary  to  an  acquirement  of  a  clear  idea  of  the 
principles  of  Physiology.  Such  subjects  as  are  useful 
in  the  practice  of  medicine  and  surgery  are  treated 
more  fully  than  those  which  are  essential  only  to  an 
abstract  physiological  knowledge.  A  book  in  every 
way  suited  for  student’s  use. 

“  Dr.  Yeo’s  manual  has  reached  the  position  of  being,  we 
believe,  the  best  by  far  of  the  smaller  text-books  on  Physiology.” 
—  Therapeutic  Gazette. 


PRACTICE  OF  MEDICINE. 


Taylor.  Practice  of  Medicine.  1890. 

a  manual  of  the  practice  of  medicine.  By  Frederick  Taylor,  m.  d.,  Physician 
to,  and  Lecturer  on  Medicine  at,  Guy’s  Hospital,  London;  Physician  to  the  Evelina 
Hospital  for  Sick  Children  ;  Examiner  in  Materia  Medica  and  Pharmaceutical  Chem¬ 
istry,  at  the  University  of  London.  Cloth,  $4.00;  Leather,  $5.00 

“  By  consulting  the  most  recent  works,  especially  those  of  Fagge,  Strumpell,  Payne, 
Ziegler,  Gowers,  M.  Mackenzie,  Douglas  Powell,  Ralfe,  H.  Morris  and  Crocker,  to 
whom  I  must  express  my  indebtedness,  I  have  sought  to  bring  this  book  fully  up  to  the 
modern  state  of  knowledge.  I  have  not,  however,  devoted  much  space  to  the  discussion 
of  theories,  finding  that  the  facts  of  medicine  are  amply  sufficient  to  fill,  and  more  than 
fill,  a  volume  such  as  this,  and  being  convinced  that  these  facts  require  to  be  seized  and 
held  fast  by  the  beginners  in  medicine,  not  only  for  the  sake  of  diagnosis  and  treatment, 
but  also  for  the  right  estimation  of  the  various  theories  which  are  advanced.  With  a 
brief  statement,  therefore,  of  such  views  I  have  in  most  cases  been  content. 


“  It  is  an  entirely  original  work,  by  one  accustomed  to  teach  his  subject  both  didactically  and  clinically, 
who  knows  and  understands  how  to  present  to  the  reader  1  oth  the  essential  elements  and  the  endless  detai  s 
of  the  science  and  art  of  medicine.  How  well  Dr.  Frederick  Taylor  has  performed  his  task,  may  be  Earned 

almost  ad  aperturam.  .  .  .  The  author  has  taken  great  pains  to  embody  in  this  work  the  latest  advances 

in  our  knowledge  of  the  nature  and  treatment  of  disease.  We  find,  for  example,  accounts  of  actinomycosi 
and  the  use  of  suspension,  and  even  of  the  epidemic  of  Russian  influenza  which  swept  over  Europe  las 

Wint<<\ye  have  noted  with  particular  care,  and  we  will  say  with  particular  approval,  the  extremely  sensible 
remarks  which  Dr.  Taylor  has  given  us  under  the  head  of  treatment.  In  some  respects  the  sections  on  treat¬ 
ment  must  have  been  the  most  difficult  part  to  write  of  a  short  treatise  on  the  practice  of  medicine.  1 1  ni  >  y 
the  first  and  the  chief  end  to  be  attained,  is  the  inculcation  of  sound  therapeutical  principles,  but  m  the 
second  place,  the  students  and  young  practitioner  must  have  something  concrete  supplied  to  them,  1 
shape  ofdetails  to  which  they  can  refer,  when  they  are  either  following  the  practice  of  their  teachers i  or 
themselves  face  to  face  with  patients  of  their  own.  Dr.  Taylor  has  succeeded  admirably  in  fulfilling  both 
these  indications,  if  we  may  borrow  what  is  itself  a  therapeutical  phrase.”—  The  Practitioner ,  London,  Sep- 

'^‘"se^atEes,  Dr.  Taylor  further  says,  in  speaking  of  capillary  bronchitis,  must  be  given  with  the  greatest 
caution,  or  entirely  avoided,  for  the  reasons  given.  In  referring  to  the  treatment  of  chronic  bronchitis  the 
author  recommends,  among  other  good  agents,  turpentine,  copaiba,  and  the  more  modem  drag  tereben^ 
This  will,  on  examination,  be  found  to  abound  in  very  many  such  practical  observations,  making  the  manual 
of  great  service  to  the  physician.” — Medical  Bulletin,  Philadelphia,  January,  1 89 1.  .  .  ,, 

Dr  Taylor  has  given  us  a  very  valuable  work.  We  are  pleased  to  miss  the  long  and  mtermmable 
dissertations  on  etiology  and  pathological  anatomy,  these  subjects  being  clearly  and  brief y  stated.  On  the 
o  her  hand,  the  pages  of  the  took  are  mostly  taken  up  with  the  subjects  of  symptoms,  d.agnosts  prognosis  and 
treatment,  all  oftire  utmost  importance  in  actual  practice.  The  work  is  up  to  date  ^ 

medical  advance.  This  is  one  of  the  books  to  buy  for  this  season.  —Medical  World  Hula.,  DecemLer,  lb,  . 

“  We  have  already  spoken  in  warm  praise  of  the  took,  and  have  only  to  add  that  it  is  just  the  one  to  put 
in  the  hands  of  a  student  who  wishes  to  read  up  a  subject  while  he  is  listening  to  ketures^ on  practme|U  s 
full  enough  to  be  clear,  without  being  full  enough  to  confuse.”— Medical  and  Surgical  Refoiter ,  Pbiladel 

ph|a,  J^book^  just  such  a  one  as  may  lead  the  student  to  regard  the  mastery  of  medical  fcience  asaneasy 
task  the  subtle  and  obscure  points  having  been  placed  in  the  background.  It  seems  to  us  that  m  this  the  author 
Ks  acted  well.  We  know  of  no  work  that,  while  being  satisfactorily  full,  addresses  itself  more  readily  o  the 
understanding  than  does  this.  When  this  is  mastered,  the  student  will  feel  e«coUraged  for  greater  tasks, 
instead  of  being  disheartened  and  having  his  ardor  disappointed  at  the  very  threshold  ot  his  studie  . 

“  So  far  as  we  are  informed,  this  is  the  first  instance  in  which  Dr.  Taylor  has  come  before  the  Medical 
World  as  an  author.  His  reputation  as  a  teacher  and  practitioner  has,  for  some  time  been  ™  e"',a 
extensive  one.  Many  candidates  for  degrees,  and  many  now  in  the  ranks  of  the 

knowledge  of  medicine  and  his  efficiency  in  his  practice.  His  literary  effort  now  just  being  F^ented  deserves 
respect  and  fair  examination  on  account  of  the  author’s  record  and  position,  irrespective  of  its  intrinsic  wortffi 
But  the  book,  we  are  convinced,  has  merits  that  will  gain  for  it  recognition,  even  if  its  author  were  unknown 

or  nameless.  It  is  a  handbook  on  the  practice  of  medicine,  peb- 

eliminated,  and  facts  of  practical  utility  alone  recognized.  —  Pacific  Medical  Journal,  San  hi 

^  On  ttowhole,  we  think  it  would  be  difficult  to  find  another  work  on  the  same  rfiect^Uch  contained 
in  a  similar  space  so  much  information.  Dr.  Taylor’s  style  of  writing,  too,  is  clear  tfAfPf'T 
sure  that  his  book  will  be  widely  read  and  appreciated.”—  The  Dublin  Journal  of  Medical  Science. 


NEW  AND  REVISED  EDITIONS. 


?  QUIZ-COMPENDS.  ? 

A  SERIES  OF  PRACTICAL  MANUALS  FOR  THE  PHYSICIAN  AND  STUDENT. 

Compiled  in  accordance  with  the  latest  teachings  of  prominent  lecturers 
and  the  most  popular  Text-books. 

Bound  in  Cloth,  each  $1.00.  Interleaved,  for  the  Addition  of  Notes,  $1.25. 

They  form  a  most  complete,  practical  and  exhaustive  set  of  manuals,  containing  information  nowhere  else 
collected  in  such  a  practical  shape.  Thoroughly  up  to  the  times  in  every  respect,  containing  many  new  pre¬ 
scriptions  and  formulae,  and  over  300  illustrations,  many  of  which  have  been  drawn  and  engraved  specially  for 
this  series.  The  authors  have  had  large  experience  as  quiz-masters  and  attaches  of  colleges,  with  exceptional 
opportunities  for  noting  the  most  recent  advances  and  methods.  The  arrangement  of  the  subjects,  illustrations, 
types,  etc.,  are  all  of  the  most  approved  form.  They  are  constantly  being  revised,  so  as  to  include  the  latest 
and  best  teachings,  and  can  be  used  by  students  of  any  college  of  medicine,  dentistry  and  pharmacy. 

No.  1.  Human  Anatomy.  Fifth  Edition  (1891),  including  Visceral  Anatomy,  formerly  pub¬ 
lished  separately.  16  Lithograph  Plates,  Tables,  and  117  Illustrations.  By  Samuel  O.  L. 
Potter,  m.a.,  m.d.,  late  A.  A.  Surgeon,  U.  S.  Army.  Professor  of  Practice,  Cooper  Med.  College, 
San  Francisco. 

Nos.  2  and  3.  Practice  of  Medicine.  Fourth  Edition,  Enlarged  (1890).  By  Daniel  E.  Hughes, 
m.d.,  late  Demonstrator  of  Clinical  Medicine  in  Jefferson  Med.  College,  Phila. ;  Physician-in  Chief,  Phila¬ 
delphia  Plospital.  In  two  parts. 

Part  I. — Continued,  Eruptive  and  Periodical  Fevers,  Diseases  of  the  Stomach,  Intestines,  Peritoneum,  Biliary  Passages, 
Liver,  Kidneys,  etc.  (including  Tests  for  Urine),  General  Diseases,  etc. 

Part  II.  —  Diseases  of  the  Respiratory  System  (including  Physical  Diagnosis),  Circulatory  System  and  Nervous  System; 
Diseases  of  the  Blood,  etc. 

***  These  little  books  can  be  regarded  as  a  full  set  of  notes  upon  the  Practice  of  Medicine,  containing  the  Synonyms, 
Definitions,  Causes,  Symptoms,  Prognosis,  Diagnosis,  Treatment,  etc.,  of  each  disease,  and  including  a  number  of  prescrip¬ 
tions  hitherto  unpublished. 

No.  4.  Physiology,  including  Embryology.  Sixth  Edition  (1891).  By  Albert  P.  Brubaker,  m.d., 
Prof,  of  Physiology,  Penn’a  College  of  Dental  Surgery;  Demonstrator  of  Physiology  in  Jefferson  Med. 
College,  Phila.  Revised,  Enlarged  and  Illustrated.  In  Press. 

No.  5.  Obstetrics.  Illustrated.  Fourth  Edition  (1889).  For  Physicians  and  Students.  By  Henry 
G.  Landis,  m.d.,  Prof,  of  Obstetrics  and  Diseases  of  Women,  in  Starling  Medical  College,  Columbus. 
Revised  Edition.  New  Illustrations. 

No.  6.  Materia  Medica,  Therapeutics  and  Prescription  Writing.  Fifth  Revised  Edition  (1891). 
With  especial  Reference  to  the  Physiological  Action  of  Drugs,  and  a  complete  article  on  Prescription 
Writing.  Based  on  the  Last  Revision  (Sixth)  of  the  U-  S.  Pharmacopoeia,  and  including  many  unofficinal 
remedies.  By  Samuel  O.  L.  Potter,  m.a.,  m.d.,  late  A.  A.  Surg.  U.  S.  Army;  Prof,  of  Practice, 
Cooper  Med.  College,  San  Francisco.  5th  Edition.  Improved  and  Enlarged. 

No.  7.  Gynaecology.  (1891.)  A  Compend  of  Diseases  of  Women.  By  Henry  Morris,  m.d.,  Demon¬ 
strator  of  Obstetrics,  Jefferson  Medical  College,  Philadelphia.  Many  Illustrations. 

No.  8.  Diseases  of  the  Eye  and  Refraction.  Second  Edition  (1888).  Including  Treatment  and 
Surgery.  By  L.  Webster  Fox,  m.d.,  Chief  Clinical  Assistant  Opthalmological  Dept.,  Jefferson  Medical 
College,  etc.,  and  Geo.  M.  Gould,  m  d.  71  Illustrations,  39  Formulae. 

No.  g.  Surgery,  Minor  Surgery  and  Bandaging.  Illustrated.  Fourth  Edition  (1890).  Including 
Fractures,  Wounds,  Dislocations,  Sprains,  Amputations  and  other  operations ;  Inflammation,  Suppuration, 
Ulcers,  Syphilis,  Tumors,  Shock,  etc.  Diseases  of  the  Spine,  Ear,  Bladder,  Testicles,  Anus,  and  other 
Surgical  Diseases.  By  Orville  Horwitz,  a.m.,  m.d.,  Demonstrator  of  Surgery,  Jefferson  Medical 
College.  84  Formulae  and  136  Illustrations. 

No.  10.  Medical  Chemistry.  Third  Edition  (1890).  Inorganic  and  Organic,  including  Urine  Analysis. 
For  Medical  and  Dental  Students.  By  Henry  Leffmann,  m.d.,  Prof,  of  Chemistry  in  Penn’a  College 
of  Dental  Surgery,  Phila.  Third  Edition.  Revised  and  Enlarged. 

No.  11.  Pharmacy.  Third  Edition  (1890).  Based  upon  “  Remington’s  Text-Book  of  Pharmacy.”  By 
F.  E.  Stewart,  m.d.,  ph.g.,  Professor  of  Pharmacy,  Powers  College  of  Pharmacy;  late  Quiz-Master  at 
Philadelphia  College  of  Pharmacy.  Third  Edition.  Revised. 

No.  12.  Veterinary  Anatomy  and  Physiology.  Illustrated.  (1890.)  By  Wm.  R.  Ballou,  m.d. ,  Prof. 

of  Equine  Anatomy,  New  York  College  of  Veterinary  Surgeons,  etc.  29  Illustrations. 

No.  13.  Dental  Pathology  and  Dental  Medicine.  (1890.)  Containing  all  the  most  noteworthy  points 
of  interest  to  the  Dental  Student.  By  Geo.  W.  Warren,  d.d.s.,  Clinical  Chief,  Penn’a  College  of 
Dental  Surgery,  Philadelphia.  Ulus. 

No.  14.  Diseases  of  Children.  (1890.)  By  Marcus  P.  Hatfield,  Professor  of  Diseases  of  Children, 
Chicago  Medical  College.  With  Colored  Plate. 

These  books  are  constantly  revised  to  keep  up  with  the  latest  teachings  and  discoveries. 


From  The  Southern  Clinic. — “  We  know  of  no  series  of  books  issued  by  a.7iy  house  that  so 
fully  meets  our  approval  as  these  ?  Quiz-  Compe7ids  ?  They  are  well  arra7iged,  full  a7id  co7icise, 
a7id  are  really  the  best  line  of  text-books  that  could  be  fowl'd  for  either  student  or  practitio7ier." 


NEW  REFERENCE  BOOKS. 


Fowler’s  Dictionary  of  Practical  Medicine.  1890. 

BY  VARIOUS  AUTHORS. 


AN  ENCYCLOPEDIA  OF  MEDICINE.  Edited  by  JAMES  KINGSTON  FOWLER,  M.A.,  M  D., 
f.r.c.p.,  Senior  Asst.  Physician  to,  and  Lecturer  on  Path.  Anat.  at,  the  Middlesex 
Hospital;  Senior  Physician  to  the  Hospital  for  Consumption  and  Diseases  of  the 
Chest,  Brompton,  London.  8vo.  Cloth,  $5.00;  Half  Dark  Leather,  $6.00 

***  This  work  is  an  attempt  to  present  in  a  concise  form,  an  account  of  all  the 
important  subjects  comprised  under  the  head  of  Practical  Medicine,  including  the  Dis¬ 
eases  of  Women  and  similar  branches.  In  its  preparation,  practical  utility  has  been 
considered,  in  the  belief  that  a  book  of  this  character  is  used  as  one  of  quick  reference, 
rather  than  systematic  reading.  Each  article  concludes  with  the  treatment  of  the  disease, 
and  in  order'to  avoid  as  far  as  possible  a  criticism  frequently  expressed,  that  little  help  is 
to  be  gained  on  that  head  from  works  on  medicine,  the  exact  doses  and  combinations 
of  the  various  drugs  recommended  have  in  most  cases  been  given. 

«  If  we  turn  to  the  list  of  contributors  the  names  are  those  of  competent  men,  and  some  of  them  eminently 
so.  What  the  writers  know  they  tell  simply  and  plainly,  and  generally  manage  to  put  it  into  a  short  com¬ 
pass;  and,  what  is  m  ire,  the  treatment  that  is  recommended  is  clearly  and  succinctly  set  forth.  The  contribu- 
[ions’  are  generally  signed  by  their  authors,  and  the  greater  number  of  those  not  signed  are  by  Dr.  John 
Abercromie,  and  the  editor,  Dr.  James  Kingston  Fowler.  The  dictionary  consists  of  942  pages  of  double 
column,  and  is  furnished  with  a  general  index,  including  a  list  of  articles,  with  cross  references.  ...  It 
is,  however,  impossible  within  the  limits  of  space  at  our  disposal,  to  direct  attention  to  even  one-tenth  of  t  e 
pages  we  had  marked  for  reference.  Where  there  is  so  much  that  is  excellent  selection  becomes  exceedingly 
difficult.  Let  it  suffice  that  we  can  heartily  congratulate  the  editor  and  his  colleagues  on  having  admirably 
fulfil1  ed  th-ir  purpose,  viz:  To  produce  a  first-rate  dictionary  of  medicine— at  once  scientific  and  practical— 
which  will  well  deserve  the  success  we  have  no  doubt  it  will  meet  with.” — The  Lancet ,  London,  September 

2 /th’«  'editor  of  this  dictionary,  and  the  contributors  thereto,  are  to  be  congratulated  upon  having  been  able 
to  present,  in  these  days  of  many  volumed  treatises  on  medicine,  so  much  real  information  concerning  the 
subjects  belonging  to  practical  medicine  within  the  moderate  compass  of  a  single  octavo  volume  of  less  than  a 
thousand  pa^es.  .  .  .  Not  the  least  valuable  feature  of  this  book  is  the  thoroughness  with  which  the 

various  authors,  as  a  rule,  have  incorporated  in  their  contributions  the  most  recent  discoveries  in  the  various 
departments  of  medicine.  Upon  the  whole,  the  dictionary  may  be  said  to  be  thoroughly  up  to  date  and  may 
be* recommended  to  those  who  wish  concise  information  upon  the  newest  additions  to  medical  knowledge. 

The  American  Journal  of  Medical  Science,  February,  1891. 


Robinson.  The  Latin  Grammar  of  Pharmacy  and 
Medicine.  1890. 

By  H.  D.  Robinson,  ph.d.,  Professor  of  Latin  Language  and  Literature,  University 
of  Kansas,  Lawrence.  With  an  Introduction  by  L.  E.  Sayre,  ph.g.  ,  Professor  of 
Pharmacy,  and  Dean  of  the  Dept,  of  Pharmacy,  in  the  University  of  Kansas.  i2mo. 

275  Pages.  Cloth>  £2-°° 


« It  is  a  work  that  meets  with  my  hearty  approval.  There  is  great  need  of  just  such  a  book  in  our 
American  schools  of  pharmacy  and  medicine.” — E.  S.  B as tin,  Professor  of  Botany ,  Dept,  of  Pharmacy , 

Northwestern  University ,  Chicago.  .  ..  ...  T  ..  ,  , 

«  The  object  of  this  useful  book  is  a  very  laudable  one,  namely,  to  improve,  if  possible,  the  Latin  used  by 

both  physicians  and  druggists,  chiefly  in  the  prescribing  of  drugs.  While  it  is  true  that  many  of  the  profession 
find  it  unnecessary  to  remember  the  genitive  endings  of  w’ords  used  in  medicine,  because  of  the  customary 
abbreviations  in  prescribing-writing,  there  are  others  who  frequently  desire  to  write  their  directions  to  the 
druggist  in  Latin,  in  order  that  the  patient  may  not  learn  of  facts  about  which  it  is  often  necessary  for  him  o 
remain  in  ignorance.  We  hope  that  the  book  will  prove  a  success,  and  by  its  general  employment  in  both 
pharmaceutical  and  medical  schools,  improve  the  knowledge  of  Latin  in  both  pro  essions.  ic  ‘  lca 

News,  Philadelphia,  January  loth,  1891.  .  ,.  ,  .  A  . 

“The  plan  of  the  book  is  excellent,  the  field  new,  as  it  fills  a  long-felt  want.  All  medical  students 

should  have  it,  both  the  collegian,  as  it  will  give  a  practical  turn  to  his  knowledge  o  atm,  an  e  non 
graduate,  as  it  will  give  him  a  direct  and  useful  acquaintance  wdth  that  language.  .  e  country  .  oc  or  w  .iO 
lias  not  had  the  advantages  of  the  younger  men  will  find  it  a  great  help  in  overcoming  t  is  v,  ec  ,  am  ma\ 
speedily  acquire  a  familiarity  with  this  language  that  will  surprise  his  classical  conjreie .  ou  ern  a  . 
Practitioner,  December,  1890. 


SURGERY. 

A  COMPLETE  PRACTICAL  TREATISE, 

WITH  SPECIAL  REFERENCE  TO  TREATMENT. 


BY  C.  W.  MANSELL  MOU  LLIN,  M.A.,  M.D..  OXON., 

FELLOW  OF  THE  ROYAL  COLLEGE  OF  SURGEONS;  SURGEON  AND  LECTURER  ON  PHYSIOLOGY  TO  THE  LONDON  HOSPITAL,  ETC 

ASSISTED  BY  VARIOUS  WRITERS  ON  SPECIAL  SUBJECTS. 


FIVE  HUNDRED  ILLUSTRATIONS. 


200  OF  WHICH  ARE  ORIGINAL  WITH  THIS  WORK. 


ROYAL  OCTAVO.  1190  PAGES. 

Royal  8vo.  Handsome  Cloth,  $7.00;  Leather,  Raised  Bands,  $8.00. 

Extract  from  the  Preface. — Modern  Surgery  has  advanced  with  such  rapid  strides,  and  in  so  many 
cufferent  directions,  that  it  is  almost  impossible  within  the  space  of  a  single  volume  to  give  more  than  an 
epitome  of  its  main  principles.  I  have  therefore  touched  but  lightly  upon  controversial  matters,  and  have 
cndea\ored  to  make  this  book  a  practical  one,  in  the  hope  that  it  may  be  of  greater  service  to  students  and 
general  piactitioners.  With  this  object,  I  have  given  special  attention  to  the  question  of  Treatment;  and  I 
have  included  under  the  head  of  each  organ  a  brief  description  of  the  malformations  to  which  it  is  liable,  and 
tne  v  anous  operations  that  may  be  performed  under  it,  instead  of  relegating  them  to  chapters  by  themselves. 
The  General  Pathology  of  Surgical  Diseases  is  dealt  with  in  Part  I ;  that  of  Injuries  in  Part  II.  In  Part  III, 
tne  Diseases  and  Injuries  of  Special  Structures  and  Organs  are  considered  more  fully.  Throughout,  I  have 
cndeavoied  to  enforce  the  idea  that  the  chief  aim  and  object  of  Surgery  at  the  present  day  is,  to  assist  the 
tissues  in  every  possible  way  in  their  struggle  against  disease. 

.  ^  ^ve  hundred  illustrations,  nearly  two  hundred  were  (with  four  exceptions)  drawn  from  original 
specimens  by  my  brother,  Dr.  J.  A.  Mansell  Moulin  (to  whom  I  am  also  indebted  for  the  article  on  Diseases 
of  the  Female  Generative  Organs),  or  myself. 

I  have  to  express  my  thanks  to  Mr.  J.  Hutchinson,  junior,  for  his  chapters  on  Diseases  of  the  Skin  and 

Dye ;  to  Mr.  T.  Mark  Plovell,  for  that  on  Diseases  of  the  Ear  and  Larynx ;  and  to  Mr.  F.  S.  Eve,  for  that 
on  Tumors.” 


I. 

II. 


I. 

II. 

III. 

IV. 
V. 

VI. 

VII. 

VIII. 

IX. 

X. 

XI. 

XII. 


XIII. 

XIV. 


OUTLINE  OF  CONTENTS. 

PART  I.— GENERAL  PATHOLOGY  OF  SURGICAL  DISEASES. 

TYi'c/LpP H TT3 nt  •  r  ..  ~  .  |  III  &  IV.  Diseases  due  to  Infective  Organisms. 

Diseases  due  to  Non-infective  Organisms.  |  V.  Tumors. 

PART  XL— GENERAL  PATHOLOGY  OF  INJURIES. 


The  General  Effects  of  Injury. 


II.  The  Local  Effects  of  Injury, 


PART  III.— DISEASES  AND  INJURIES  OF  SPECIAL  STRUCTURES. 

XV.  Diseases  of  the  Thyroid. 

XVI.  Injuries  and  Diseases  of  the  Pharynx  and 
CEsophagus. 

Injuries  and  Diseases  of  the  Chest. 

Injuries  and  Diseases  of  the  Abdomen. 


Diseases  of  the  Skin. 

Injuries  and  Diseases  of  Blood-vessels. 

Injuries  and  Diseases  of  Lymphatics. 

Injuries  and  Diseases  of  Nerves. 

Injuries  and  Diseases  of  Muscles,  Tendons,  etc. 
Injuries  and  Diseases  of  Bones  and  Joints. 
Injuries  and  Diseases  of  the  Head. 

Injuries  and  Diseases  of  the  Back. 

Injuries  and  Diseases  of  the  Eye. 

Injuries  and  Diseases  of  the  Face  and  Nose 
Injuries  and  Diseases  of  the  Mouth  and  Jaws. 
Injuries  and  Diseases  of  the  Tongue,  Salivary 
Glands  and  Tonsils. 

Diseases  of  the  Ear  and  Larvnx. 

Injuries  and  Diseases  of  the  Neck  and  Throat. 


XVII. 

XVIII. 

XIX. 

XX. 

XXI. 

XXII. 

XXIII. 

XXIV. 

XXV. 

XXVI. 

XXVII. 

XXVIII. 


Injuries  and  Diseases  of  the  Rectum. 
Injuries  and  Diseases  of  the  Kidney. 
Injuries  and  Diseases  of  the  Bladdei. 
Diseases  of  the  Prostate. 

Injuries  and  Diseases  of  the  Urethra. 
Injuries  and  Diseases  of  the  Male  Organs. 
Diseases  of  the  Female  Generative  Organs. 
Diseases  of  the  Breast. 

Amputations. 

Anaesthetics. 


NOW  READY.  SUBSCRIPTION  EDITION.  COLORED  PLATES.  HALF  RUSSIA,  $9.00. 


Now  Ready  for  1892.  41ST  Year 


The  Physician's  Visiting  List. 

(LINDSAY  &  BLAKISTON’S.) 

Contents.— Special  Revision,  1892. 

Calendar,  1892-1893  ;  Table  of  Signs;  The  Metric  or  French  Decimal  System  of  Weights  and  Measures; 
Table  for  Converting  Apothecaries’  Weights  and  Measures  into  Grams;  Posological  Table  (Meadows);  Dose 
Table,  giving  Doses  in  both  English  and  Metric  Systems  to  correspond  with  new  U.  S.  P.,  rewritten  foi 
1892;  List  of  New  Remedies,  prepared  for  1892;  Incompatibility;  Poisons  and  Antidotes,  revised  for  1892; 
Disinfectants;  Examination  of  Urine  (Dr.  J.  Daland,  based  upon  Tyson );  Bright’s  Disease,  Differentia'. 
Diagnosis  of;  Diagnosis  and  Treatment  of  the  Simpler  Diseases  of  the  Eye  (Dr.  George  M.  Gould);  The 
Eruptive  Fevers,  Table  of;  Asphyxia  and  Apnoea;  A  New  Complete  Table  for  Calculating  the  Period  of 
Utero-Gestation ;  Comparison  of  Thermometers;  Blank  Leaves,  suitably  ruled,  for  V  isiting  Lists,  Monthl} 
Memoranda,  Addresses  of  Patients  and  others;  Addresses  of  Nurses,  their  references,  etc.;  Accounts  asked 
for;  Memoranda  of  Wants;  Obstetric  and  Vaccination  Engagements;  Record  of  Births  and  Deaths;  Cash 
Account,  etc. ;  Special  Pencil  with  Rubber  Tip. 

This  Visiting  List  is  published  in  November  of  each  year. 


SIZES  AND  PRICES. 


REGULAR  EDITION. 


PERPETUAL  EDITION,  without  Dates. 


For  25 

Patients  weekly.  Tucks,  pockets  and 

Pencil, 

$l.CO 

5° 

it 

a 

if 

1.25 

75 

tl 

tt 

it 

1.50 

100 

it 

tl 

tl 

2.00 

50 

“  ■Wfossfis:] 

.  “ 

it 

2.50 

ICO 

■  “ 

it 

3.00 

INTERLEAVED  EDITION. 

For  25  Patients  weekly.  Interleaved,  tucks  and  Pencil, 

1.25 

5“ 

If 

<  € 

il 

1.50 

5° 

“  2  Vols  /  Jan-  t0  June 

2  VOlS.jjuly  tQ  DeC 

“ 

it 

3.00 

No.  1.  Containing  space  for  over  1300  names,  with 
blank  page  opposite  each  Visiting  List  page. 

Bound  in  Red  Leather  cover,  with  pocket  and 
Pencil, . $125 

No.  2.  Containing  space  for  2600  names,  with  blank 
.  page  opposite  each  Visiting  List  page.  Bound 

like  No.  1,  with  Pocket  and  Pencd,  *  .  1.50 

MONTHLY  EDITION,  without  Dates. 

No.  1.  Bound,  Seal  leather,  without  Flap  or  Pencil, 

gilt  edges, . 75 

No.  2.  Bound,  Seal  leather,  with  Tucks,  Pencil,  etc., 

gilt  edges, . 1.00 


SPECIAL  SIZES  AND  BINDINGS  MADE  TO  ORDER. 


PRESS  NOTICES  OF  EDITION  FOR  1891. 


“  Nothing  can  seem  better  fitted  to  meet  the  purpose  for 
which  they  are  designed  than  these  Visiting  Lists  of 
Messrs.  Blakiston,  and  the  forty  years  of  patronage  they 
have  enjoyed  must  have  convinced  public  and  publisher 
alike  of  their  value.  We  not  only  have  the  convenient 
arrangement  for  keeping  visiting  accounts,  but  a  fund  of 
useful  information  of  all  kinds,  embracing  dose  tables, 
weights  and  measures,  posological  tables,  disinfectants, 
urinary  analysis,  poisons  and  antidotes,  etc.,  all  arranged 
for  ready  reference  in  a  w'ell  bound  leather  book  that  can 
at  all  times  be  carried  in  the  coat  pocket.  These  books 
are  complete,  comprehensive,  and  convenient.” — The 
Physician  and  Surgeon ,  Ann  Arbor ,  Mich. 

“  It  has  long  been  known  to  the  profession,  and  needs  no 
further  notice  than  to  say  that  it  maintains  the  standard 
of  excellence  acquired  by  its  predecessors.” — New  Orleans 
Medical  and  Surgical  Journal. 

“  This  oldest  and  best  known  of  the  Visiting  Lists 
comes  with  the  new  year  unchanged  in  form,  and  with 
such  alterations  in  contents  only  as  were  called  for  by 
recent  therapeutic  advance.  In  compactness,  neatness, 
and  completeness  it  is  a  marvel.” — American  Practitioner 
and  News ,  Louisville. 

“  This  is  the  thirty-ninth  year  of  the  publication  of  this 
neat,  compact,  and  universally-acknowledged-to-be  the 
best  of  its  kind  published.  It  has  stood  the  test  of  time 
and  finds  ready  sale  from  a  simple  announcement  that  it  is 
ready  ’  ’ —  The  Medical  Brief  \  St.  Louis. 

‘‘The  best  endorsement  I  can  give  of  my  appreciation 
of  the  Lindsay  &  Blakiston  Visiting  List  is,  that  I  have 
been  using  it  from  its  first  issue  and  find  it  is  the  best  in 
use.” — O.  F.  Potter,  M.D.,  St.  Louis. 


“  This  is  the  eleventh  year  that  we  are  using  this  Visit¬ 
ing  List  in  our  practice,  and  we  can  truly  say  that  we 
could  not  wish  for  anything  better.  It  has  saved  us  many 
times  its  cost,  and,  besides,  has  furnished  a  permanent  and 
pleasing  record  of  our  daily  work  during  the  years  that 
have  passed.” — Canada  Medical  Record. 

Dear  Sirs : — We  received  the  Visiting  List  for  1891.  It  is 
the  finest  of  all.  We  had  five  (5)  sent  us,  from  the  same 
number  of  firms,  and  must  acknowledge  it  is  the  smallest, 
neatest  and  most  compact,  as  any  physician  can  place  it  in 
his  side  pocket  with  ease,  while,  if  you  have  noticed  or 
seen  the  others,  they  will  require  the  tailor  to  enlarge  the 
coat  pocket.  Very  truly  yours, 

N.  W.  Medical  Journal, 
Minneapolis,  Minn 

“  The  fact  that  this  Visiting  List  has  been  published  an¬ 
nually  for  forty  years  is  sufficient  guarantee  of  its  excellence 
and  popularity.  In  addition  to  the  visiting  list  proper,  i 
contains  easily-accessible  suggestions  upon  many  of  tin 
emergencies  that  may  arise  in  a  physician’s  practice,  am 
when  he  is  too  far  from  home  to  learn  from  his  text-book, 
the  antidote  for  a  poison  that  may  have  been  swallowed 
or  the  proper  method  of  resuscitating  a  half-drowned  per 
son.  True,  he  should  know  these  things,  but  who  does  no 
occasionally  forget,  when  he  most  washes  to  remember. 
There  are  also  dose-tables,  tables  of  the  metric  system,  i 
list  of  new  remedies  for  1890,  rules  for  examining  urine,  t 
table  for  calculating  the  period  of  pregnancy,  and  other 
equally  useful  information.  The  arrangement  for  entering 
patients,  visits,  consultations,  etc.,  is  exceeding  simple 
and  the  whole  makes  a  thin,  compact,  and  easily-carriec 
volume.” — Medical  News,  Philada.,  January  jd,  1891. 

f 


**p.  Blakiston,  Son  &  Co.  wish  to  announce  that  the  edition  for  1892  contains  severa. 

7* 

improvements  that  will,  without  making  any  radical  changes,  greatly  enhance  its  usefulness 
compactness  and  durability. 


/ 


»HD*X  paT* 
sot,  t,  3* 


